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Horm Mol Biol Clin Investig. 2019 Sep 20. pii: /j/hmbci.ahead-of-print/hmbci-2019-0021/hmbci-2019-0021.xml. doi: 10.1515/hmbci-2019-0021. [Epub ahead of print]

Clinical evidence of the effect of bisphosphonates on pregnancy and the infant.

Author information

1
Obstetric Gynecology Department, Royal Oldham Hospital, The Pennine Acute Hospitals Trust, Oldham, UK.
2
Department of Endocrinology-Diabetes, Evangelismos Hospital, Athens, Greece.
3
MITERA PRIVATE HOSPITAL, 3rd INTERNAL MEDICINE CLINIC, ATHENS, Greece.
4
Internal Medicine Department, "Thriassio" General Hospital, Athens, Greece.
5
First Department of Obstetrics Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

Bisphosphonates (BPs) are potent inhibitors of osteoclast mediated bone resorption. These drugs are widely used in the management of osteoporosis and other diseases, characterized by high bone turnover. The effect of BPs on gestation and lactation, when they are used as therapeutic agents in premenopausal women, is yet unknown. We conducted a detailed literature review and identified the cases of BPs use in young women, as well as, the effects of this therapy on the gestation and the embryo. The published data, regarding the use of BPs in premenopausal women and their effects on the pregnancy outcome, are limited. However, we could identify the outcomes of 40 pregnant women, who had received BPs prior to or during pregnancy, that have been documented in the literature. All women had valid indications to receive BPs for serious bone metabolism conditions. We could not identify any prospective trials, which focus on pregnancy outcomes following after the in-utero exposure to BPs. In total, no serious adverse effects were reported. Problems related to the offspring, such as hypocalcemia and a tendency for low body weight (LBW), were self-resolving. In addition, no serious adverse outcomes were reported for women having completed pregnancy. Nevertheless, follow-up was limited for both outcomes suggesting the necessity of national and international registries.

KEYWORDS:

bisphosphonates; metabolic bone disorders; premenopausal women

PMID:
31539355
DOI:
10.1515/hmbci-2019-0021

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