{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:10:48Z","timestamp":1784304648242,"version":"3.55.0"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction Pregnancy- and lactation-associated osteoporosis (PLO) with predominantly vertebral fractures is a rare but severe disease which can occur in the last trimester of\n\t\t\t\t\tpregnancy or postpartum. The aim of the present study was to assess the impact of teriparatide on subsequent fractures and bone mineral density (BMD) in patients with PLO.<\/jats:p>\n                  <jats:p>Materials and Methods A total of 47 patients with PLO and postpartum spinal fractures (mean: 4 fractures) undergoing treatment with teriparatide were investigated. The data\n\t\t\t\t\tcollection period was set between 2006 and 2018. All patients received a subcutaneous injection of 20\u2009\u00b5g teriparatide once a day for 24 months as well as individually adapted vitamin D\n\t\t\t\t\tsupplementation. After 24 months of treatment, all women received no further treatment and either had regular menstrual cycles or took oral contraceptives. Fractures were confirmed by X-ray\n\t\t\t\t\tor MRI. Changes in BMD from baseline were examined using serial DXA measurements.<\/jats:p>\n                  <jats:p>Results After 24 months of teriparatide treatment, we could demonstrate an increase in BMD at the lumbar spine, femoral neck and total hip of +\u200a30.1%, +\u200a11.7% and +\u200a12.2%\n\t\t\t\t\trespectively (p\u2009&lt;\u20090.001 for all). At 12 months after cessation of treatment, BMD remained stable compared to the 24-month measurements at the lumbar spine, femoral neck and total hip\n\t\t\t\t\twhich showed non-significant changes of +\u200a1.4%, +\u200a2.6% and +\u200a4.1% respectively. Out of the 47 patients with PLO with a mean of 4 existing fractures, 4 patients (7.8%) sustained a subsequent\n\t\t\t\t\tfracture, two after 3\u200a\u2013\u200a5 months of treatment and two at &gt;\u20096 months of treatment.<\/jats:p>\n                  <jats:p>Conclusion 24 months of treatment with teriparatide in women with PLO and multiple vertebral fractures significantly increased BMD, predominantly BMD of the spine. As patients were\n\t\t\t\t\tpremenopausal, there was no significant decrease in BMD in the following 12 months after cessation of treatment.<\/jats:p>","DOI":"10.1055\/a-1816-6700","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T19:27:32Z","timestamp":1654284452000},"page":"619-626","source":"Crossref","is-referenced-by-count":16,"title":["Effect of Teriparatide on Subsequent Fracture and Bone Mineral Density in 47 Women with Pregnancy- and Lactation-associated Osteoporosis and Vertebral Fractures"],"prefix":"10.1055","volume":"82","author":[{"given":"Peyman","family":"Hadji","sequence":"additional","affiliation":[{"name":"Frankfurt Centre for Bone Health, Frankfurt, Germany"},{"name":"Philipps-University of Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niki","family":"Mouzakiti","sequence":"additional","affiliation":[{"name":"Dpt. of Obstetrics and Gynaecology, Centre for Ultrasound and Prenatal Medicine, Buergerhospital and Clementine Children\u02bcs Hospital Frankfurt a.\u200aM., Dr. Senckenberg Foundation and\n\t\t\t\t\tJohann-Wolfgang-Goethe University of Frankfurt, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Kyvernitakis","sequence":"additional","affiliation":[{"name":"Dpt. Of Obstetrics and Prenatal Medicine, Asklepios Clinic Barmbek, University of Semmelweis, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","article-title":"An estimate of the worldwide prevalence and disability associated with osteoporotic fractures","volume":"17","author":"O Johnell","year":"2006","journal-title":"Osteoporos Int"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S0140-6736(55)90214-2","article-title":"Post-pregnancy osteoporosis; a syndrome?","volume":"268","author":"B E Nordin","year":"1955","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"R143","DOI":"10.1530\/EC-20-0055","article-title":"Pregnancy and lactation, a challenge for the skeleton","volume":"9","author":"E M Winter","year":"2020","journal-title":"Endocr Connect"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1016\/S0140-6736(02)08761-5","article-title":"Diagnosis of osteoporosis and assessment of fracture risk","volume":"359","author":"J A Kanis","year":"2002","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00198-004-1677-3","article-title":"Special report on the official positions of the International Society for Clinical Densitometry","volume":"15","author":"E M Lewiecki","year":"2004","journal-title":"Osteoporos Int"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.31138\/mjr.28.3.161","article-title":"Clinical Case: Pregnancy lactation osteoporosis","volume":"28","author":"O Loukadaki","year":"2017","journal-title":"Mediterr J Rheumatol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1152\/physrev.00027.2015","article-title":"Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery","volume":"96","author":"C S Kovacs","year":"2016","journal-title":"Physiol Rev"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"4047","DOI":"10.1210\/endo.142.9.8356","article-title":"Catabolic effects of continuous human PTH (1\u201338) in vivo is associated with sustained stimulation of RANKL and inhibition of osteoprotegerin and gene-associated bone formation","volume":"142","author":"Y L Ma","year":"2001","journal-title":"Endocrinology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1007\/s00198-015-3149-3","article-title":"Presentation and management of osteoporosis presenting in association with pregnancy or lactation","volume":"26","author":"C S Kovacs","year":"2015","journal-title":"Osteoporos Int"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"6787","DOI":"10.1038\/s41598-019-43049-1","article-title":"Changes in bone metabolic profile associated with pregnancy or lactation","volume":"9","author":"T Miyamoto","year":"2019","journal-title":"Sci Rep"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e238659","DOI":"10.1136\/bcr-2020-238659","article-title":"Transient osteoporosis of the hip in pregnancy: the orthopaedic management of bilateral neck of femur fractures in the third trimester","volume":"14","author":"E V Wright","year":"2021","journal-title":"BMJ Case Rep"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"100706","DOI":"10.1016\/j.bonr.2020.100706","article-title":"A case of pregnancy and lactation associated osteoporosis in the third pregnancy; robust response to teriparatide despite delayed administration","volume":"13","author":"E T Cerit","year":"2020","journal-title":"Bone Rep"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/S0899-9007(00)00430-5","article-title":"Osteoporosis with vertebral fractures associated with pregnancy and lactation","volume":"16","author":"S Di Gregorio","year":"2000","journal-title":"Nutrition"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11657-017-0310-y","article-title":"Pregnancy-associated transient osteoporosis of the hip: results of a case-control study","volume":"12","author":"P Hadji","year":"2017","journal-title":"Arch Osteoporos"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s12891-017-1509-1","article-title":"Effect of teriparatide (rh-PTH 1\u201334) versus bisphosphonate on the healing of osteoporotic vertebral compression fracture: A retrospective comparative study","volume":"18","author":"A Iwata","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1097\/MED.0000000000000102","article-title":"Osteoporosis presenting in pregnancy, puerperium, and lactation","volume":"21","author":"C S Kovacs","year":"2014","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1359\/jbmr.090731","article-title":"Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures","volume":"25","author":"P Aspenberg","year":"2010","journal-title":"J Bone Miner Res"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1007\/s00586-009-1041-6","article-title":"Factors affecting neurological deficits and intractable back pain in patients with insufficient bone union following osteoporotic vertebral fracture","volume":"18","author":"M Hoshino","year":"2009","journal-title":"Eur Spine J"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jocd.2013.03.003","article-title":"Effects of Exemestane and Tamoxifen treatment on bone texture analysis assessed by TBS in comparison with bone mineral density assessed by DXA in women with breast cancer","volume":"17","author":"M Kalder","year":"2014","journal-title":"J Clin Densitom"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"411","DOI":"10.3109\/13697137.2014.984675","article-title":"Comparison of dual-energy X-ray absorptiometry with six quantitative ultrasonometry devices in women with hip fractures","volume":"18","author":"P Hadji","year":"2015","journal-title":"Climacteric"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00198-017-4239-1","article-title":"Subsequent fracture risk of women with pregnancy and lactation-associated osteoporosis after a median of 6 years of follow-up","volume":"29","author":"I Kyvernitakis","year":"2018","journal-title":"Osteoporos Int"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1186\/s12891-021-04776-7","article-title":"Pregnancy- and lactation-associated osteoporosis with vertebral fractures: a systematic review","volume":"22","author":"Y Qian","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1007\/s00198-006-0112-3","article-title":"Bisphosphonates in pregnancy and lactation-associated osteoporosis","volume":"17","author":"S M O\u02bcSullivan","year":"2006","journal-title":"Osteoporos Int"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s00198-016-3897-8","article-title":"Pregnancy-associated osteoporosis: a case-control study","volume":"28","author":"P Hadji","year":"2017","journal-title":"Osteoporos Int"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"115911","DOI":"10.1016\/j.bone.2021.115911","article-title":"Relevant genetic variants are common in women with pregnancy and lactation-associated osteoporosis (PLO) and predispose to more severe clinical manifestations","volume":"147","author":"S Butscheidt","year":"2021","journal-title":"Bone"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1007\/s00198-018-4499-4","article-title":"Mutational analysis uncovers monogenic bone disorders in women with pregnancy-associated osteoporosis: three novel mutations in LRP5, COL1A1, and COL1A2","volume":"29","author":"S Butscheidt","year":"2018","journal-title":"Osteoporos Int"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"3135","DOI":"10.1007\/s00198-017-4165-2","article-title":"Pregnancy-related fractures: a retrospective study of a French cohort of 52 patients and review of the literature","volume":"28","author":"M Laroche","year":"2017","journal-title":"Osteoporos Int"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"495","DOI":"10.14310\/horm.2002.1383","article-title":"Case report: Teriparatide treatment in a case of severe pregnancy-and lactation- associated osteoporosis","volume":"11","author":"K Lampropoulou-Adamidou","year":"2012","journal-title":"Hormones (Athens)"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1002\/jbmr.3750","article-title":"Women With Pregnancy and Lactation-Associated Osteoporosis (PLO) Have Low Bone Remodeling Rates at the Tissue Level","volume":"34","author":"A Cohen","year":"2019","journal-title":"J Bone Miner Res"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3109\/09513591003649831","article-title":"Treatment with teriparatide in a patient with pregnancy-associated osteoporosis","volume":"26","author":"L Hellmeyer","year":"2010","journal-title":"Gynecol Endocrinol"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1007\/s00223-021-00871-y","article-title":"Teriparatide Treatment in Patients with Pregnancy- and Lactation-Associated Osteoporosis","volume":"109","author":"K Lampropoulou-Adamidou","year":"2021","journal-title":"Calcif Tissue Int"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1007\/s00774-011-0334-0","article-title":"Effect of teriparatide on pregnancy and lactation-associated osteoporosis with multiple vertebral fractures","volume":"30","author":"E Y Choe","year":"2012","journal-title":"J Bone Miner Metab"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1055\/s-0034-1382069","article-title":"Successful treatment of 1\u201334 parathyroid hormone (PTH) after failure of bisphosphonate therapy in a complex case of pregnancy associated osteoporosis and multiple fractures","volume":"218","author":"A S Winarno","year":"2014","journal-title":"Z Geburtshilfe Neonatol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"522","DOI":"10.3109\/09513590.2015.1014787","article-title":"Effective treatment of severe pregnancy and lactation-related osteoporosis with teriparatide: case report and review of the literature","volume":"31","author":"S B Polat","year":"2015","journal-title":"Gynecol Endocrinol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/cen.13557","article-title":"Changes in bone mineral density and bone turnover markers during treatment with teriparatide in pregnancy- and lactation-associated osteoporosis","volume":"88","author":"N Hong","year":"2018","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1007\/s00223-021-00869-6","article-title":"Bone Density After Teriparatide Discontinuation With or Without Antiresorptive Therapy in Pregnancy- and Lactation-Associated Osteoporosis","volume":"109","author":"S Lee","year":"2021","journal-title":"Calcif Tissue Int"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1816-6700.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:09:56Z","timestamp":1764072596000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1816-6700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":36,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,5,19]]},"published-print":{"date-parts":[[2022,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1816-6700","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}