J Korean Med Sci.  2016 Nov;31(11):1790-1796. 10.3346/jkms.2016.31.11.1790.

Prevalence of Low Bone Mineral Density and Associated Risk Factors in Korean Puerperal Women

Affiliations
  • 1Department of Obstetrics and Gynecology, The Catholic University of Korea, Seoul, Korea. ooooobbbbb@catholic.ac.kr

Abstract

Although pregnancy is a medical condition that contributes to bone loss, little information is available regarding bone mineral density (BMD) in puerperal women. This cross sectional study aimed to evaluate the prevalence of low BMD in puerperal women and to identify associated risk factors. We surveyed all puerperal women who had BMD measurements taken 4-6 weeks after delivery in a tertiary university hospital, and did not have any bone loss-related comorbidities. Among the 1,561 Korean puerperal women, 566 (36.3%) had low BMD at the lumbar spine, total hip, femoral neck, and/or trochanter. Multivariate analysis revealed that underweight women had a significantly higher risk of low BMD compared with obese women at pre-pregnancy (adjusted odds ratio [aOR], 3.21; 95% confidence interval [CI], 1.83-5.63). Also, women with inadequate gestational weight gain (GWG) were 1.4 times more likely to have low BMD than women with excessive GWG (aOR, 1.42; 95% CI, 1.04-1.94). One-way ANOVA showed that BMDs at the lumbar spine and total hip were significantly different between the 4 BMI groups (both P < 0.001) and also between the 3 GWG groups (both P < 0.001). In conclusion, this study identifies a high prevalence of low BMD in puerperal women and thus suggests the need for further evaluation about the change of BMD in pregnancy and postpartum period.

Keyword

Bone Density; Postpartum Period; Osteoporosis; Body Mass Index; Weight Gain; Korean

MeSH Terms

Adult
Asian Continental Ancestry Group
Body Mass Index
Bone Density
Cross-Sectional Studies
Female
Humans
Lumbar Vertebrae/physiology
Multivariate Analysis
Odds Ratio
Postpartum Period
Prevalence
Puerperal Disorders/*epidemiology
Republic of Korea/epidemiology
Risk Factors
Tertiary Care Centers
Women

Figure

  • Fig. 1 Mean bone mineral densities (BMDs) at the lumbar spine and total hip in the 4 body mass index (BMI) groups. Data are presented as means; vertical bars show the 95% confidence intervals. At both sites, the BMD tended to increase as the BMI increased (both P < 0.001, ANOVA test). Post hoc analysis revealed significant differences in BMD at the lumbar spine and total hip between the different BMI groups (all P < 0.05), with the exception of BMD at the lumbar spine in the overweight versus obese groups (P = 0.216).

  • Fig. 2 Mean bone mineral densities (BMDs) at the lumbar spine and hip in the 3 gestational weight gain (GWG) groups. Data are presented as means; vertical bars show the 95% confidence intervals. At both sites, the BMD tended to increase as the GWG increased (both P < 0.001, ANOVA test). Post hoc analysis revealed significant differences in BMD at both sites between the different GWG groups (all P < 0.05).


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