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The medical records of sixteen patients with PAO who presented to a specialist clinic at the Western General Hospital in Edinburgh over a 20-year period were reviewed to evaluate the mode of presentation, potential risk factors and response to treatment. The most common presentation was back pain occurring in 13\/16 (81.2%) individuals due to multiple vertebral fractures. The diagnosis was usually made postpartum and in 12\/16 individuals (75.0%), PAO presented during the woman\u2019s first pregnancy. Medicines which could have contributed to the development of PAO included thromboprophylaxis therapies in 8 subjects (50.0%), inhaled or injected corticosteroids in 5 (31.3%), anticonvulsants in 2 (12.5%) and a LHRH agonist in 1 (6.3%). Five individuals reported a family history of osteoporosis, and two pregnancies were complicated by hyperemesis gravidarum. Treatments administered included calcium and vitamin D supplements, bisphosphonates and teriparatide. Bone mineral density increased following the diagnosis in all cases, regardless of treatment given. One patient had further fracture during follow-up, but four patients had subsequent pregnancies without fractures. We estimated that in this locality, the incidence of PAO was 6.8\/100,000 pregnancies with a point prevalence of 4.1 per 100,000 women. This case series indicates the importance of family history of osteoporosis and thromboprophylaxis drugs as risk factors for PAO while also demonstrating that the reductions in bone density tend to reverse with time, irrespective of the treatment given.<\/jats:p>","DOI":"10.1007\/s00223-023-01139-3","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T04:02:16Z","timestamp":1696996936000},"page":"591-596","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Clinical Features, Incidence and Treatment Outcome in Pregnancy-Associated Osteoporosis: A Single-Centre Experience over Two Decades"],"prefix":"10.1007","volume":"113","author":[{"given":"Elizabeth","family":"Orhadje","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Hauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2804-7586","authenticated-orcid":false,"given":"Stuart H.","family":"Ralston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"1139_CR1","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/BF01623007","volume":"6","author":"W Khovidhunkit","year":"1996","unstructured":"Khovidhunkit W, Epstein S (1996) Osteoporosis in pregnancy. 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SHR reports funding to his institution from Abbvie, Alexion, Amgen, Eli Lilly, Janssen-Cilag, Kyowa Kirin, the National Institute for Health Care Research, Novartis, Pfizer, the Paget\u2019s Association, Sanofi- Genzyme, Thornton & Ross and UCB, outside the submitted work. EO and KB have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}