妊娠哺乳相关骨质疏松症的影响因素分析

Analysis of Influencing Factors of Pregnancy and Lactation-associated Osteoporosis

目的:探讨妊娠哺乳相关骨质疏松患者的影响因素,为妊娠哺乳相关性骨质疏松症的预防提供依据。方法:纳入中山市博爱医院产后6周复诊的女性1101例,使用双能X线吸收检测法检测受试者L2~4椎体以及左股骨颈的骨密度,根据骨量分为正常组(372例)、减少组(596例)、疏松组(133例)分成三组(骨量正常组、骨量减少组、骨质疏松组)。比较各组之间年龄、体重、身高、体重指数、奶制品摄入、补钙、新生儿性别、分娩方式、是否哺乳等情况的差异。结果:产后女性骨量减少和骨质疏松发生风险较高;钙摄入不够、奶制品摄入少、低体重、低体重指数及骨质疏松家庭史、是否哺乳及骨密度是导致产后骨密度下降的危险因素,差异具有统计学意义(P<0.05)。结论:妊娠及产后女性应注意体重管理以预防骨量丢失。妊娠期常规补钙有助于防止妊娠及哺乳期骨量的丢失,提高妇女的峰值骨密度,产后常规测量骨密度有助于骨质疏松的早期诊断及治疗。

Objective:To explore the influencing factors of osteoporosis associated with pregnancy and lactation and provide a basis for the prevention of osteoporosis associated with pregnancy and lactation.Methods:A total of 1101 women who were re�checked in Boai Hospital of Zhongshan at postpartum 6 weeks were included.The bone mineral density of L2-L4 vertebrae and the left femoral neck was measured by dual-energy X-ray absorptiometry.According to the bone mass,the included women were divided into three groups:normal group(372 cases,normal bone mass),osteopenia group(596 cases,decreased bone mass)and osteoporosis group(133 cases,osteoporosis).The age,weight,height,body mass index,dairy intake,calcium supplementation,gender of newborn,delivery mode,and breastfeeding were compared among these groups.Results:Postpartum females were at a higher risk of osteopenia and osteoporosis;insufficient calcium intake,low dairy intake,low body weight,low body mass index,family history of osteoprosis,breastfeeding or not and the bone mineral density were risk factors for decreased bone mineral density after delivery,and the difference was statistically significant(P<0.05).Conclusion:Pregnant and postpartum women should focus on the weight management to prevent bone mass loss.Calcium supplementation during the pregnancy is beneficial for preventing bone mass loss during the pregnancy and lactation,and increases peak bone mineral density.The routine measurement of bone mineral density after delivery is beneficial for early diagnosis and treatment of osteoporosis.