Bone Abstracts

Background: Pregnancy and lactation-associated osteoporosis (PLO) is characterised by the occurrence of fragility fractures during late pregnancy or lactation. The limited understanding of the physical and psychosocial impact of PLO on the lives of affected women has posed a challenge to the effective management of this debilitating condition. This study aimed to investigate the physical and psychosocial impacts of PLO on women and their partners in the UK and to describe its clinical and radiological characteristics.

Methods: A mixed-methods, single centre, case-control study of women with PLO (n20) and healthy women (n20) matched for age and time postpartum. Participants completed four health-related quality of life questionnaires. Women from PLO group participated in semi-structured interviews. In addition, four partners were interviewed individually.

Results: The PLO group had significantly reduced physical functioning (SF-36 physical: 75 vs 100, P 0.001; Qualeffo-41 physical: 16 vs 2, P 0.001) and poorer mental health (SF-36 emotional wellbeing: 64 vs 88, P 0.007; Qualeffo-41 mental: 42 vs 39, P 0.06; PHQ-4: 3.5 vs 0, P 0.001). Social life was also negatively affected (SF-36 social 75 vs 100, P 0.06; Quallefo-41 social 38 vs 0, P 0.001). Interviews revealed themes including loss of physical autonomy, chronic pain, delayed return to work, loss of motherhood experience, anxiety and depression, altered body image, poor healthcare support, emotional resilience, relationship strain, social isolation, online peer support, and the impact of COVID-19. Partners reported emotional stress and difficulty balancing work and family responsibilities while adjusting to a new normal.

Conclusion: To our knowledge, this is the first study to comprehensively assess the physical and psychosocial burden of PLO using a mixed-methods, case-control design and the first to explore the frequently overlooked experiences of partners. Our results demonstrate that PLO has severe consequences on both affected women and their partners, highlighting the need for increased awareness, earlier diagnosis, improved management, and holistic support.