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Review
. 2021 Apr 26;9(5):475.
doi: 10.3390/biomedicines9050475.

Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature

Elena Tsourdi  1 , Athanasios D Anastasilakis  2
Affiliations
Review

Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature

Elena Tsourdi et al. Biomedicines. .

Abstract

Pregnancy and lactation are characterized by sophisticated adaptations of calcium homeostasis, aiming to meet fetal, neonatal, and maternal calcium requirements. Pregnancy is primarily characterized by an enhancement of intestinal calcium absorption, whereas during lactation additional calcium is obtained through resorption from the maternal skeleton, a process which leads to bone loss but is reversible following weaning. These maternal adaptations during pregnancy and lactation may influence or confound the presentation, diagnosis, and management of parathyroid disorders such as primary hyperparathyroidism or hypoparathyroidism. Parathyroid diseases are uncommon in these settings but can be severe when they occur and may affect both maternal and fetal health. This review aims to delineate the changes in calcium physiology that occur with pregnancy and lactation, describe the disorders of calcium and parathyroid physiology that can occur, and outline treatment strategies for these diseases in the above settings.

Keywords: calcium; hyperparathyroidism; hypoparathyroidism; lactation; pregnancy.

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Conflict of interest statement

E. Tsourdi received research funding from MSD, honoraria for lectures from Amgen, UCB, Shire, Kyowa Kirin and educational grants from Shire and UCB. A.D. Anastasilakis reports lecture fees from Amgen, Bianex, Eli-Lilly, ITF, and UCB.

Figures

Figure 1
Figure 1
Physiological calcium changes during pregnancy and lactation. Doubles arrows denote reciprocal relationship which single arrows denote increase and decrease.
Figure 2
Figure 2
Management of parathyroid disorders during pregnancy and lactation.
See this image and copyright information in PMC

References

    1. Cooper M.S. Disorders of calcium metabolism and parathyroid disease. Best Pract. Res. Clin. Endocrinol. Metab. 2011;25:975–983. doi: 10.1016/j.beem.2011.07.001. - DOI - PubMed
    1. Kovacs C.S. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol. Rev. 2016;96:449–547. doi: 10.1152/physrev.00027.2015. - DOI - PubMed
    1. Leere J.S., Vestergaard P. Calcium metabolic disorders in pregnancy: Primary hyperparathyroidism, pregnancy-induced osteoporosis, and vitamin D deficiency in pregnancy. Endocrinol. Metab. Clin. N. Am. 2019;48:643–655. doi: 10.1016/j.ecl.2019.05.007. - DOI - PubMed
    1. Diaz-Soto G., Linglart A., Sénat M.V., Kamenicky P., Chanson P. Primary hyperparathyroidism in pregnancy. Endocrine. 2013;44:591–597. doi: 10.1007/s12020-013-9980-4. - DOI - PubMed
    1. Philbrick W.M., Wysolmerski J.J., Galbraith S., Holt E., Orloff J.J., Yang K.H., Vasavada R.C., Weir E.C., Broadus A.E., Stewart A.F. Defining the roles of parathyroid hormone-related protein in normal physiology. Physiol. Rev. 1996;76:127–173. doi: 10.1152/physrev.1996.76.1.127. - DOI - PubMed

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