Endocrinology Department, 960 Hospital of People's Liberation Army, NO.25 Shifan Road, Jinan, Shandong, 250031, People's Republic of China.
Orthopaedic Department, 960 Hospital of People's Liberation Army, NO.25 Shifan Road, Jinan, Shandong, 250031, People's Republic of China.
BMC Musculoskelet Disord. 2021 Nov 3;22(1):926. doi: 10.1186/s12891-021-04776-7.
To review, analyze and characterize the pregnancy and lactation-related osteoporosis (PLO) with vertebral fractures based on the extraction data in the previous studies.
A comprehensive literature search of electronic databases including the PubMed, Embase and Web of Science was conducted from January 1st,1990 to December 1st, 2020. The enrolled data were pooled to analyze the baseline characteristics, clinical features, risk factors and treatment options.
A total of 65 articles with 338 cases were enrolled for data extraction. The enrolled cases aged from 19 to 47 years, with a mean value of 35.7 years old. The average body mass index (BMI) was 22.2 kg/m ranged from 16.0 to 39.0 kg/m. Of the 173 cases, 149 cases with vertebral fractures occurred in the first pregnancy, 19 cases in the second pregnancy, four cases in the third pregnancy and one case in the fourth pregnancy. Up to 91.5% of the back pain occurred within the last 3 months of pregnancy and the first 3 months after delivery. The most involved vertebral levels were L2, L1 and T12 accounting for 32.6% of all the fractures. The average fracture numbers were 4.4 levels per patient. The lumbar Z-scores were mostly recorded with a mean value of - 3.2 ranged from - 7.8 to 0.
PLO with vertebral fractures is a rare clinical entity, which is more likely to occur in older and thinner pregnant women. Back pain is the clinical complaint and mostly occurs in the late pregnancy and early lactation periods. Most vertebral fractures appear in the first pregnancy but it can occur in any time of pregnancy. Thoracolumbar region is the mostly involved region. As compared with postmenopausal osteoporotic fractures, PLO usually has multiple levels fractures. Bisphosphonates are the most widely used treatment so far, however, many factors need to be taken into account to decide which drug to choose in PLO and further studies are necessary for clear recommendation in the future.
回顾、分析和描述基于既往研究中提取数据的与妊娠和哺乳期相关的骨质疏松性椎体骨折（PLO）。
从 1990 年 1 月 1 日至 2020 年 12 月 1 日，对包括 PubMed、Embase 和 Web of Science 在内的电子数据库进行全面文献检索。对纳入的数据进行汇总分析，以分析基线特征、临床特征、危险因素和治疗选择。
共纳入 65 篇文章 338 例进行数据提取。纳入病例年龄 19 至 47 岁，平均年龄 35.7 岁。平均体重指数（BMI）为 22.2kg/m²，范围为 16.0 至 39.0kg/m²。173 例中，149 例在第一次妊娠时发生椎体骨折，19 例在第二次妊娠时发生，4 例在第三次妊娠时发生，1 例在第四次妊娠时发生。91.5%的背痛发生在妊娠最后 3 个月和分娩后 3 个月内。最常受累的椎体水平为 L2、L1 和 T12，占所有骨折的 32.6%。平均骨折数为每个患者 4.4 个椎体。腰椎 Z 评分多有记录，平均为-3.2，范围为-7.8 至 0。
PLO 合并椎体骨折是一种罕见的临床实体，更可能发生在年龄较大和较瘦的孕妇中。背痛是主要的临床症状，多发生在妊娠晚期和哺乳期早期。大多数椎体骨折发生在第一次妊娠，但也可发生在妊娠的任何时间。胸腰段是最常受累的部位。与绝经后骨质疏松性骨折相比，PLO 通常有多个椎体骨折。目前，双膦酸盐是最广泛使用的治疗方法，但在 PLO 中选择哪种药物需要考虑许多因素，未来有必要进行进一步研究以明确推荐。
