Serap DEMİR, Selma KARAAHMETOĞLU, Müjde AKTÜRK, Mustafa CESUR

The effect of multiple pregnancies and lactation on bone mineral density in postmenopausal women

Amaç: Gebelik ve laktasyon hayatın, kalsiyum ve kemik metabolizmasında değişikliklere neden olan iki dönemidir. Bu çalışma postmenopozal kadınlarda gebelik sayısı ve laktasyonun kemik mineral dansitesi (KMD) üzerine etkisini araştırmak için planlanmıştır. Metod: Normal vücut ağırlığında, sigara içmeyen, immobilizasyon veya osteoporoza neden olacak ilaç öyküsü olmayan 99 postmenapozal kadın çalışmaya alındı. Olgular gebelik sayılarına (1-4 gebelik öyküsü olanlar grup l, 5-9 gebelik grup 2, > 10 gebelik grup 3) ve toplam laktasyon sürelerine ( 60 ay grup 3) göre gruplandırıldı. Her olgu için toplam menstruasyon süresi hesaplandı. Lomber vertebra 1-4 (Ll-4), femur boynu, ward's üçgeni ve trokanterik bölgede kemik dansitesi dual enerji X-ray absorbsiyometri ile ölçüldü. Bulgular: Artmış gebelik sayısının vertebralarda KMD'de azalmaya neden olabileceği, fakat toplam laktasyon süresinin hiçbir bölgede KMD üzerine bir etkisi olmadığı ve toplam menstruasyon süresinin postmenapozal dönemde KMD'yi etkileyen bir faktör olmadığı tesbit edilmiştir. Sonuç: Aralarında yeterli süre bulunmayan ardarda olan gebelikler, maternal dokularda yetersiz mineral replasmanına neden olarak osteoporoz gelişimine zemin hazırlıyor olabilir.

Postmenapozal kadınlarda gebelik sayısı ve laktasyonun kemik mineral dansitesi üzerine etkileri

Purpose: Pregnancy and lactation are the two stages of life that cause changes in the calcium and bone metabolism. This study was designed to evaluate the effect of multiple pregnancies and lactation on the bone mineral density (BMD) of postmenopausal women. Methods: Ninety-nine normal weight, non-smoking postmenopausal women without a history of immobilization and drugs affecting BMD were included in the study. The subjects were grouped according to the number of pregnancies (group 1 included 1-4 pregnancies, group 2 included 5-9 and group 3 included >10) and total duration of lactation ( 60 months as group 3). Total duration of menses was calculated for each subject. Bone density of the lumbar vertebrae 1-4 (Ll-4), femoral neck, Ward's triangle and trochanter regions were measured with dual energy X-ray absorptiometry. Results: An increased number of pregnancies caused lower BMD in the spine, but the duration oflactation has no effect on the BMD of any site and the total duration of menstruation also had no effect on BMD in the postmenopausal period. Conclusion: Subsequent pregnancies without a sufficient interval in between may cause insufficient mineral replacement in maternal tissues and predispose the woman to osteoporosis.

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