Associação do antecedente de gravidez com a densidade mineral ossea na adolescencia

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Introduction: Studies have indicated that pregnancy can interfere with bone mineral density. Adolescence is a critical time of life for bone mass acquisition and it is still unknown whether pregnancy in this age range will increase the risk for future osteoporosis. Objective: To evaluate the association between pregnancy history and bone mineral density in adolescence. Subjects and methods: A cross-sectional study was conducted of 119 adolescents aged 12 to 20 years, 30 of whom had a history of at least one full-term pregnancy. Adolescents were selected during a routine visit to the Adolescent Gynecology Outpatient Facility at CAISM-Unicamp. All adolescents completed a questionnaire about their clinical history and underwent a physical exam to evaluate weight, height and Tanner stage. A lumbar spine and total body bone densitometry (DXA-LUNAR DPX) was performed to measure bone mineral density and body composition. For statistical analysis, the Chi-square test, the Fisher?s exact test, the Mann-Whitney test, the Anova test, Tukey?s test and multiple linear regression were used. Results: Of the 119 adolescents, 30 had a full-term pregnancy history and approximately 83% of these girls had breastfed. The mean postpartum period was 29.77 (SD±13.14) months and mean breastfeeding period was 5.92 (SD±5.28) months. A comparison of the mean measurements of the area, bone mineral content, areal and volumetric bone mineral density of the lumbar spine and area, total body bone mineral content and areal bone mineral density showed no significant difference between adolescents with and without a pregnancy history, stratified by chronologic and gynecologic ages. There was no statistical difference in both groups, regarding the percentage of adolescents with Z-scores below ?2 SD. The prevalence ratio showed no association between pregnancy history and low bone mass (PR=0.52). On multiple regression analysis, body mass index and lean body mass were the main factors associated with lumbar spine and total body bone measurements. Pregnancy history was inversely associated only with areal bone mineral density and volumetric bone mineral density of L1-L4 (R2=0.04), accounting for 4% variation in the lumbar spine. Conclusion: These data suggest that pregnancy in adolescence may exert some influence on bone mass, although its modest degree of effect does not allow us to confirm that it represents a risk factor for osteoporosis in the future

ASSUNTO(S)

densidade ossea adolescencia gravidez

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