A Study on Bone Density in Women during Pregnancy and Postpartum Noriyuki OHARA, Hajime MORIKAWA, Yasuo UEDA, Masaki DEGUCHI and Matsuto MOCHIZUKI Dep

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1 A Study on Bone Density in Women during Pregnancy and Postpartum Noriyuki OHARA, Hajime MORIKAWA, Yasuo UEDA, Masaki DEGUCHI and Matsuto MOCHIZUKI Department of Obstetrics and Gynecology, Kobe University School of Medicine, Kobe 650, Japan (Director: Prof. Matsuto Mochizuki) Soo Yong CHOUGH Department of Obstetrics and Gynecology, Korea University, School of Medicine, Seoul, Korea Although grams of calcium is transported into the fetus during pregnancy, it is suggested that the maternal bone might be kept at the same density as in non-pregnant women by measuring serum or urinary calcium concentrations and calcium regulating hormones simultaneously (Ohara et al. Folia Endocrinol., 1986). In this study, the influence of pregnancy on the maternal bone was investigated by measuring the degree of bone density in the second metacarpal bone of pregnant or puerperal women in an X-ray picture using a microdensitometer and a computer (Microdensitometry method; MD method, Inoue et al., 1983). Among six indices provided by this method, d (bone marrow width) tended to increase, but MCI (Barnett's metacarpal index) tended to decrease toward late pregnancy. GSmin, GSmax and EGS/D were significantly lower in the third trimester of pregnancy than in the second trimester of pregnancy. The densitometric patterns were A in most of the pregnant and puerperal women, but one case with the pattern of AB and two cases with the pattern of B were found in the third trimester of pregnancy. The sum of the scores of the six indices, which were based on the severity of each index, was within 0-3 in pregnant or puerperal women though it tended to increase as pregnancy progressed.

2 From these results, it was confirmed that maternal bone density was maintained within the normal limits throughout pregnancy and postpartum.

3 Fig. 1. A plain X-ray film of the hands of a pregnant women taken with the alminum step-wedge. Fig. 2. Densitometer chart. Fig. 3. Bone model and densitometric patterns.

4 Fig. 4. Serum concentrations of total calcium during pregnancy and postpartum.

5 Fig. 5. Serum concentrations of albumin during pregnancy and postpartum. Fig. 6. Serum concentrations of inorganic phosphorus during pregnancy and postpartum.

6 Fig. 7. Urinary calcium/creatinine ratio during pregnancy and postpartum.

7 Fig. 8. Changes in MCI during pregnancy and postpartum. Fig. 9. Changes in d during pregnancy and postpartum.

8 Fig. 10. Changes in GSmin during pregnancy and postpartum.

9 Fig. 11. Changes in GSmax during pregnancy and postpartum.

10 Fig. 12. Changes in E GS/D during pregnancy and postpartum.

11 Fig. 13. Densitometric patterns during pregnancy and postpartum. Fig. 14. The number of cases at each scoring of six indices in pregnant and puerperal women. Fig. 15. Total scores of six indices which show the severity of the bone atrophy in pregnant and puerperal women.

14 1) Atkinson, P.J. and West, R.R.: Loss of skeletal calcium in lactating women. J. Obstet. Gynecol., 77: , ) Barnett, E. and Nordin, B.E.C.: The radiological diagnosis of osteoporosis: A new approach. Clin. Radiol., 11: , ) Bonsnes, R.W. and Taussky, H.H.: On the colorimetric determination of creatinine by the Jaffe reaction. J. Biol. Chem., 158: , ) Christiansen, C., Rghdbro, P. and Heinild, B.: Unchanged total body calcium in normal human pregnancy. Acta Obstet. Gynecol. Scand., 55: , ) Connerty, H.V. and Briggs, A.R.: Determination of serum calcium by means of orthocresolphthalein com plexone. Am. J. Clin. Path., 45: , ) Doumas, B.T., Watson, W.A. and Briggs, H.G.: Albumin standards and the measurement of serum albumin with bromcresol green. Clin. Chim. Acta, 31: 87-96, ) Fiske, C.H. and Subbarow, T.: The colorimetric determination of phosphorus.j. Biol. Chem., 66: , ) Frisancho, A.R., Gran, S.M. and Ascoli, W.: Unaltered cortical area of pregnant and lactating women. Studies of the secondmetacarpal bone in north and central American populations. Invest. Radiol., 6: , ) Inoue, T., Kusida, K., Miyamoto, S., Sumi, Y., Orimo, H., and Yamashita, G.: Quantitative assessment of bone density on X-ray picture. J. Jpn. Orthop. Ass., 57: , B.E.: Parity and osteoporosis. Surg. Gynecol. Obstet., 129:27-28, ) Nordin, B.E.C., and Roper, A.: Post-pregnancy osteoporosis. A syndrome? Lancet, 1: , 1955.

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