Assessment of bone health in pregnancy

We performed a review of the literature on the use of radiofrequency echographic multi spectrometry (REMS) technology in pregnancy, in order to assess bone mineral density (BMD) and objectively measure its reduction during pregnancy. In a prospective case-control observational study, 78 women at 39.1 ± 1.5 weeks of gestation were submitted to a sonographic examination of the proximal femur using REMS technology to quantify BMD. The study group, when compared with a control group of non-pregnant women, was found to have significantly lower BMD values (0.769±0.094 g/cm2 vs. 0.831±0.101 g/cm2, p = 0.0001) with a mean reduction of 8.1%. Lower BMD values were found in older women (p<0.0001), women with a lower BMI (p=0.0004), and Caucasian women (p<0.0001). In another study, 65 pregnant women underwent femoral BMD measurement in the first and the third trimester using REMS. A significant reduction in BMD (0.723±0.069 vs. 0.709±0.069 g/cm2; p<0.001) was noted, with a mean change of −1.9±0.6% between the first and the third trimester. On multivariable linear regression analysis, none of the population characteristics was independently associated with BMD changes. In conclusion, decreased BMD in pregnancy has been demonstrated using REMS technology. Further studies are needed to identify risk factors for decreased BMD in pregnancy. KEY WORDS: Bone mineral density, REMS, ultrasound technology, pregnancy.