Pregnancy Associated Osteoporosis: Knowledge Attitude and Practice of Exercise among Pregnant Women in a Selected Nigerian Community

Pregnancy induced decrease in bone mineral density (BMD) often occurs at the femoral necks, lumbar spine and other sites during the second or third trimester of pregnancy leading to pain in the hips, pelvis, low back etc and sometimes fractures even with mild trauma/falls. Exercising during pregnancy has been known to offer several benefits including improving bone health. However, there is paucity of studies investigating the knowledge, attitude and practice of pregnant women towards exercising to minimize the risk for osteoporosis. The aim of this study was to investigate the knowledge, attitude and practice (KAP) of exercise for the prevention of pregnancy associated osteoporosis among urban and rural dwelling pregnant women in a selected Nigerian community. A total of 258 (168 urban dwelling and 90 rural dwelling) pregnant women were recruited and subjected to interview using a pre-validated questionnaire on KAP of exercise in the prevention of Pregnancy associated osteoporosis. The urban and rural dwelling women had moderate and poor knowledge of exercising for osteoporosis prevention respectively. Both groups of women had moderately positive attitude towards exercising for osteoporosis prevention. Also both groups of women had poor practice towards exercising for osteoporosis prevention. A significant association was only found between having another source of income in the family and the women’s attitude towards exercise.

Pregnancy-Associated Osteoporosis Presented with Femoral Neck Fracture: A Case Report and Literature Review

Background: Pregnancy-associated osteoporosis (PAO) is a rare condition characterized by reduced bone mineral density during the third trimester or lactation. Multiple risk factors, such as genetic, sedentariness, and 25-hydroxy vitamin D deficiency, are associated with PAO. In the majority of cases, PAO is presented with a compression fracture in vertebras, but in our case, it presented with a fracture of the femoral neck. Case Presentation: A 29-year-old, gravida one woman, developed right hip joint pain during the gestational age 34 weeks who referred to our clinic. Despite conservative management, the pain intensified. The patient delivered a healthy neonate in the 38th week of gestation and afterward underwent magnetic resonance imaging of the pelvic, revealing a bruised bone in the femoral neck. Since she had developed a femoral neck fracture during the postpartum period, she underwent open reduction and fixation of the femoral neck. Dual-energy X-ray absorptiometry (DEXA) revealed osteoporosis of the vertebras and femoral neck. She received calcium supplements and alendronate, and the pain was relieved. On 2-year and 4-year follow-up, she was found to be osteopenic with significant improvement in DEXA indices. Conclusion: PAO is a rare condition among young women. This condition should be kept in mind when hip joint or back pain is encountered during pregnancy. [GMJ.2020;9:e1750] DOI:10.31661/gmj.v9i0.1750