CalciumNEW2026

Real-world treatment outcomes in pregnancy and lactation-associated osteoporosis: a nationwide multicenter cohort study.

Sözen Mehmet, Cantürk Zeynep, Öz Gül Özen, Gönen Mustafa Sait et al. — Frontiers in endocrinology

Summary

This study examined how different treatments affected bone density in young women who developed osteoporosis during or after pregnancy and breastfeeding. It found that various treatments, including calcium and vitamin D, helped improve bone density over time. While a specific medication showed faster initial improvement in some bone areas, this early difference didn't hold up in the long run after accounting for other factors.

AI-generated summary — read the original

Key points

Osteoporosis linked to pregnancy and breastfeeding often causes spinal fractures in young women.
Various treatments, including calcium and vitamin D, can help improve bone density in these women.
While one specific medication showed faster initial bone density gains, long-term improvements were similar across different treatments.
More research is needed to determine the optimal treatment approach for this condition.

What the study looked at

This study aimed to understand the real-world experiences and treatment outcomes for young women who develop osteoporosis specifically related to pregnancy and breastfeeding, a condition known as PLO. Researchers wanted to see how different treatments affected their bone density over time. This was a retrospective cohort study that looked back at the medical records of 59 women with PLO from 18 different medical centers in Türkiye. The participants' average age at diagnosis was around 29. Researchers collected data on their symptoms, fractures, the treatments they received (which included bisphosphonates, denosumab, teriparatide, or just calcium/vitamin D), and how their bone mineral density changed. The study found that most women with PLO experienced vertebral fractures. All treatment groups, including those receiving only calcium and vitamin D, showed significant improvement in bone density over the follow-up period. While one medication (teriparatide) initially led to a quicker increase in lumbar spine bone density compared to calcium/vitamin D alone, this difference was not sustained in later follow-ups and became insignificant after accounting for other patient characteristics.

Dietary takeaway

This study suggests that even for a specific condition like pregnancy and lactation-associated osteoporosis, maintaining adequate calcium and vitamin D intake is a foundational part of bone health recovery. While some medications might offer faster initial improvements, consistent nutritional support appears crucial for overall bone density gains. Remember that this is just one study, and individual treatment plans should always be discussed with a healthcare provider.

Abstract

BACKGROUND: Pregnancy and lactation-associated osteoporosis (PLO) is an uncommon cause of fragility fractures in young women, and the optimal treatment strategy remains unclear. This study aimed to investigate the clinical features, treatment approaches, and bone mineral density (BMD) outcomes of women with PLO across multiple centers in Türkiye. METHODS: This multicenter retrospective cohort study included 59 women with PLO from 18 endocrine centers in Türkiye. Data on demographics, clinical and laboratory results, fractures, treatments, and bone density were collected. Changes in the lumbar spine, femoral neck, and total hip BMD were tracked. Additionally, lumbar spine BMD outcomes were compared between women who received teriparatide and those managed with calcium/vitamin D alone. RESULTS: The mean age at diagnosis was 29.1 ± 4.8 years. Overall, 86.4% of patients had vertebral fractures, and 67.8% had multiple fractures. Of the 59 patients, 10 received bisphosphonates, 3 received denosumab, 22 received TPTD, and 24 received calcium/vitamin D supplementation alone as first-line treatment. Lumbar spine BMD improved significantly in all treatment groups and total hip BMD in the teriparatide and calcium/vitamin D groups, whereas femoral neck BMD improved significantly only in the teriparatide group. Women receiving TPTD demonstrated greater early improvement in lumbar spine BMD than those managed with calcium/vitamin D alone (19.1% vs 9.5%; Hodges-Lehmann median difference, 11.5 percentage points [95% CI, 1.5 to 22.8]; P = 0.019). However, the between-group difference in lumbar spine BMD improvement was no longer significant at the second follow-up. After adjustment for baseline lumbar spine BMD, age, BMI and multiple vertebral fractures, treatment group was no longer independently associated with early lumbar spine BMD change (B = 3.0 percentage points, 95% CI -12.8 to 18.9; P = 0.698). CONCLUSIONS: Women with PLO showed substantial recovery in bone density during follow-up across treatment groups. Although women receiving TPTD demonstrated greater early lumbar spine BMD improvement in unadjusted analyses, this association was not independent after multivariable adjustment, and between-group differences were no longer observed during later follow-up. Prospective comparative studies are needed to define the optimal treatment strategy.

View on PubMed →DOI: 10.3389/fendo.2026.1934166