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Lykking EK, Damkier P, Kammerlander H, Broe A, Folkestad L. Pregnancy complications and birth outcome in patients with osteogenesis imperfecta - A population-based register study. Bone 2024; 187:117202. [PMID: 39002839 DOI: 10.1016/j.bone.2024.117202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE Patients with Osteogenesis Imperfecta (OI) have varying degrees of bone fragility and increased fracture rates. There is a paucity of data related to complications to pregnancies in patients with OI and to their offspring. With this study we aim to evaluate the risk of complications to pregnancies, delivery, and offspring in pregnancies where the mother or father have OI. DESIGN Nationwide, register-based, cohort study. SETTING Danish health register-based data. POPULATION All pregnancies registered in the Danish health registers where one parent has OI and a reference population of all other pregnancies in the general population from 1997 to 2018. METHODS Descriptive epidemiology MAIN OUTCOME MEASURES: Pregnancy and delivery complications (e.g. prevalence of pre-eclampsia, eclampsia and perinatal haemorrhage), and complications in the offspring (e.g. prevalence of low birth weight, low Apgar Score, need of CPAP or NICU, prevalence of congenital malformations (using the EUROCAT classification), incidence of osteogenesis imperfecta, prevalence of birth related fractures and hospital contacts during the first year of life) from pregnancies with parental OI. RESULTS We identified 433 OI related pregnancies among 134 mothers with OI and 73 fathers with OI. The rates of pregnancy and delivery complications were similar between the OI cohorts and the reference population. More (31 % vs 19 %) children were delivered by caesarean section in the OI cohort than in the reference population. CONCLUSION Pregnancies, where one parent have OI, result in live births to term with very few complications.
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Affiliation(s)
| | - Per Damkier
- Department of Clinical Pharmacology, Odense University Hospital, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | | | - Anne Broe
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.
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2
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Rapoport M, Bober MB, Raggio C, Wekre LL, Rauch F, Westerheim I, Hart T, van Welzenis T, Mistry A, Clancy J, Booth L, Prince S, Semler O. The patient clinical journey and socioeconomic impact of osteogenesis imperfecta: a systematic scoping review. Orphanet J Rare Dis 2023; 18:34. [PMID: 36814274 PMCID: PMC9945474 DOI: 10.1186/s13023-023-02627-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder primarily characterised by skeletal deformity and fragility, and an array of secondary features. The purpose of this review was to capture and quantify the published evidence relating specifically to the clinical, humanistic, and economic impact of OI on individuals, their families, and wider society. METHODS A systematic scoping review of 11 databases (MEDLINE, MEDLINE in-progress, EMBASE, CENTRAL, PsycINFO, NHS EED, CEA Registry, PEDE, ScHARRHUd, Orphanet and Google Scholar), supplemented by hand searches of grey literature, was conducted to identify OI literature published 1st January 1995-18th December 2021. Searches were restricted to English language but without geographical limitations. The quality of included records was assessed using the AGREE II checklist and an adapted version of the JBI cross-sectional study checklist. RESULTS Of the identified 7,850 records, 271 records of 245 unique studies met the inclusion criteria; overall, 168 included records examined clinical aspects of OI, 67 provided humanistic data, 6 reported on the economic impact of OI, and 30 provided data on mixed outcomes. Bone conditions, anthropometric measurements, oral conditions, diagnostic techniques, use of pharmacotherapy, and physical functioning of adults and children with OI were well described. However, few records included current care practice, diagnosis and monitoring, interactions with the healthcare system, or transition of care across life stages. Limited data on wider health concerns beyond bone health, how these concerns may impact health-related quality of life, in particular that of adult men and other family members, were identified. Few records described fatigue in children or adults. Markedly few records provided data on the socioeconomic impact of OI on patients and their caregivers, and associated costs to healthcare systems, and wider society. Most included records had qualitative limitations. CONCLUSION Despite the rarity of OI, the volume of recently published literature highlights the breadth of interest in the OI field from the research community. However, significant data gaps describing the experience of OI for individuals, their families, and wider society warrant further research to capture and quantify the full impact of OI.
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Affiliation(s)
| | | | | | - Lena Lande Wekre
- TRS National Resource Center for Rare Disorders, Sunnaas Rehabilitation Hospital, Bjørnemyr, Nesodden, Norway
| | | | | | - Tracy Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | | | | | - Lucy Booth
- Wickenstones Ltd, Abingdon, Oxfordshire, UK
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3
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Koumakis E, Cormier-Daire V, Dellal A, Debernardi M, Cortet B, Debiais F, Javier RM, Thomas T, Mehsen-Cetre N, Cohen-Solal M, Fontanges E, Laroche M, Porquet-Bordes V, Marcelli C, Benachi A, Briot K, Roux C, Cormier C. Osteogenesis Imperfecta: characterization of fractures during pregnancy and post-partum. Orphanet J Rare Dis 2022; 17:22. [PMID: 35090500 PMCID: PMC8796450 DOI: 10.1186/s13023-021-02148-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background Pregnancy and breastfeeding are associated with bone density loss. Fracture occurrence during pregnancy and post-partum, and its determinants, remain poorly known in Osteogenesis Imperfecta (OI). The aim of this study was to characterize fractures that occurred during pregnancy and post-partum in OI patients. Results We conducted a retrospective multicentric study including a total of 50 previously pregnant OI women from 10 Bone Centers in France. Among these patients, 12 (24%) patients experienced fractures during pregnancy or in the 6 months following delivery, and 38 (76%) did not experience any fracture. The most frequent localizations were: proximal femur (25%), spine (25%), distal femur (12.5%), and pelvis (12.5%). Fractures during pregnancy occurred during the third trimester and post-partum fractures occurred with a mean delay of 2 months following delivery. No fractures occurred during childbirth. We next compared the 12 patients with pregnancy or post-partum fractures with the 38 patients without fractures. Mean age at pregnancy was 32.7 ± 3.1 years-old in the fractured group, vs 29.3 ± 5.0 years-old in the non-fractured group (p = 0.002). Breastfeeding was reported in 85.7% of patients in the fractured group, vs 47.1% in the non-fractured group (p = 0.03). All patients with post-partum fractures were breastfeeding. Bone mineral density was significantly lower in patients with pregnancy-related fractures compared with other patients: spine Z-score − 2.9 ± 1.6DS vs − 1.5 ± 1.7DS (p = 0.03), and total hip Z-score − 2.0 ± 0.7DS vs − 0.5 ± 1.4DS (p = 0.04). At least one osteoporosis-inducing risk factor or disease other than OI was identified in 81.8% vs 58.6% of fractured vs non-fractured patients (not significant). Fracture during pregnancy or post-partum was not associated with the severity of OI. Bisphosphonates before pregnancy were reported in 16.7% and 21.1% of patients with pregnancy-related fractures and non-fractured patients, respectively (not significant). Conclusions OI management during pregnancy and post-partum should aim for optimal control of modifiable osteoporosis risk factors, particularly in patients with low BMD. Breastfeeding should be avoided.
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Affiliation(s)
- Eugénie Koumakis
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. .,Clinical Genetics, Reference Center for bone disorders, INSERM UMR 1163, Imagine Institute, Necker Enfants-Malades Hospital, AP-HP, Paris University, Paris, France.
| | - Valérie Cormier-Daire
- Clinical Genetics, Reference Center for bone disorders, INSERM UMR 1163, Imagine Institute, Necker Enfants-Malades Hospital, AP-HP, Paris University, Paris, France
| | - Azeddine Dellal
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Marc Debernardi
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Bernard Cortet
- Department of Rheumatology and ULR 4490 (MABLAB), Competence Center for Rare Genetic Bone Disorders, University-Hospital of Lille, 59000, Lille, France
| | - Françoise Debiais
- Department of Rheumatology, CHU Poitiers; CNRS ERL7003, University of Poitiers, Poitiers, France
| | - Rose-Marie Javier
- Rheumatology Department, Competence Center for Rare Genetic Bone Disorders, University-Hospital of Strasbourg, 67098, Strasbourg, France
| | - Thierry Thomas
- Department of Rheumatology, CHU Saint-Etienne, INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - Nadia Mehsen-Cetre
- Service de Rhumatologie, Centre de Compétence MOC et Dysplasie Fibreuse, CHU Bordeaux-Tripode, Bordeaux, France
| | - Martine Cohen-Solal
- Biocar Inserm U1132 and Université de Paris, Hôpital Lariboisière, 75010, Paris, France
| | - Elisabeth Fontanges
- Department of Rheumatology, Hôpital Edouard Herriot, CHU de Lyon, Lyon, France
| | - Michel Laroche
- Centre de Rhumatologie, CHU Purpan, 1 place du Dr Baylac, 31059, Toulouse Cedex, France
| | - Valérie Porquet-Bordes
- Endocrine, Bone Diseases, and Genetics Unit, Reference Centre for Rare Diseases of the Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | | | - Alexandra Benachi
- Departement of Obstetrics, Gynecology and Reproductive Medicine, Hôpital Antoine-Béclère - Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
| | - Karine Briot
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR 1153, INSERM, PRESS Sorbonne Paris-Cité, Paris, France
| | - Christian Roux
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR 1153, INSERM, PRESS Sorbonne Paris-Cité, Paris, France
| | - Catherine Cormier
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
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4
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Lykking EK, Kammerlander H, van Dijk FS, Prieto-Alhambra D, Abrahamsen B, Folkestad L. Fractures following pregnancy in Osteogenesis imperfecta - A self-controlled case series using Danish Health Registers. Bone 2022; 154:116177. [PMID: 34508880 DOI: 10.1016/j.bone.2021.116177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/23/2021] [Accepted: 09/04/2021] [Indexed: 11/26/2022]
Abstract
Osteogenesis imperfecta (OI) is a rare inherited connective tissue disorder with considerable clinical and genetic heterogeneity. The clinical hallmark of OI is liability to fractures due to reduced bone strength. Pregnancy and lactation are periods of increased calcium demand resulting in a decrease in maternal bone mineral density (BMD). This self-controlled case series evaluates fracture risk 12- and 19-months prior to conception compared to a period of 12- and 19 months following childbirth in women with OI. This study is based on data from the Danish National Patient Register collected between 1995 and 2018. Modified Poisson models were fitted to estimate Incidence Rate Ratio in the post/pre-pregnancy period/s, adjusted by parity and age. The 12-month observation group included 111 women with 205 pregnancies, and the 19-month observation 108 women with 197 pregnancies. We calculated fracture rates (IR) of 48.78 [95%CI 18.55-79.01] per 1000 person years 12 months prior to conception, and of 27.87 [95%CI 10.60-45.14] in the 12 months post-delivery. Comparing pre- and post-pregnancy period we found an incidence rate ratio (IRR) of 1.00 [95%CI 0.42-2.40]. When adjusting for parity and age at delivery no significant change in the IRR was noted. In the 19 months observation-period, the IR per 1000 person years prior to conception was 74.84 [95%CI 44.25-105.43] and the IR postpartum was 36.86 [95%CI 17.55-56.17], leading to an IRR of 0.61 [95%CI 0.31-1.18]. We could not identify any increased risk of fractures when comparing fracture rates during pregnancy and 12 or 19 months postpartum to fracture rates 12 or 19 months prior to conception.
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Affiliation(s)
- Emilie Karense Lykking
- Department of Endocrinology, Odense University Hospital, Odense, Denmark; Institute of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Heidi Kammerlander
- Department of Gynecology and Obstetrics, Lillebælt Hospital Kolding, Denmark
| | - Fleur S van Dijk
- North West Thames Regional Genetics Service, London North West Health Care University NHS Trust, Harrow, UK; Department of Metabolism, Digestion and Reproduction, Section of Genetics and Genomics, Imperial College London, London, UK
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Bo Abrahamsen
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK; Department of Medicine, Holbæk Hospital, Holbæk, Denmark; Open Data Explorative Network, University of Southern Denmark, Odense, Denmark
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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5
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Rao R, Cuthbertson D, Nagamani SCS, Sutton VR, Lee BH, Krischer J, Krakow D. Pregnancy in women with osteogenesis imperfecta: pregnancy characteristics, maternal, and neonatal outcomes. Am J Obstet Gynecol MFM 2021; 3:100362. [PMID: 33781976 DOI: 10.1016/j.ajogmf.2021.100362] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Women with rare diseases, such as osteogenesis imperfecta, may consider pregnancy, although data regarding outcomes, specific risks, and management strategies are lacking. OBJECTIVE The Brittle Bone Disorders Consortium of the National Institute of Health Rare Diseases Clinical Research Network established an Osteogenesis Imperfecta Pregnancy Registry to collect and evaluate pregnancy, maternal, and neonatal outcomes in women with osteogenesis imperfecta. STUDY DESIGN This was a cross-sectional, survey-based study. Appropriate participants of the Brittle Bone Disorders Consortium Contact Registry were invited to participate in the study. Self-reported information regarding pregnancy characteristics and maternal and neonatal outcomes of women with osteogenesis imperfecta was compared with that of the general population, referenced by literature-based standards. Furthermore, compared with the general population, cohorts of women and fetuses with osteogenesis imperfecta were evaluated to determine whether the presence of osteogenesis imperfecta conveyed an increase in antepartum, intrapartum, and postpartum complications and an increase in adverse neonatal outcomes. RESULTS Here, a total 132 participants completed the survey. Compared with the general population, women with osteogenesis imperfecta had higher rates of diabetes in pregnancy (13.3% vs 7%; 95% confidence interval, 7.0-19.6; P=.049), cesarean delivery (68.5% vs 32.7%; 95% confidence interval, 59.9-77.1; P<.001), need for blood transfusion (8.3% vs 1.5%; 95% confidence interval, 3.9-12.8; P=.019), and antepartum and postpartum fractures (relative risk, 221; 95% confidence interval, 59.3-823; P<.001). Maternal hospitalization and cesarean delivery rates were higher in individuals with moderate or severe osteogenesis imperfecta than women who reported mild osteogenesis imperfecta. Neonates born to women with osteogenesis imperfecta had higher risk of being low (26.2% vs 6.8%; P<.001) or very low birthweight (13.8% vs 1.4%; P<.001) infants than the general population. Neonates born to women with osteogenesis imperfecta had a higher rate of neonatal intensive care unit admissions (19% vs 5.68%; P<.001) and higher neonatal mortality at 28 days of life (4.8% vs 0.4%; P=.026), regardless of neonatal osteogenesis imperfecta status. CONCLUSION Pregnancies for women with osteogenesis imperfecta are at an increased risk of complications, including hemorrhage, fractures, diabetes mellitus, and increased neonatal morbidity.
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Affiliation(s)
- Rashmi Rao
- Departments of Obstetrics and Gynecology (Drs Rao and Krakow)
| | - David Cuthbertson
- College of Medicine, University of South Florida, Tampa, FL (Mr. Cuthbertson and Dr Krischer)
| | - Sandesh C S Nagamani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX (Drs Nagamani, Sutton, and Lee); Texas Children's Hospital, Houston, TX (Drs Nagamani, Sutton, and Lee)
| | - Vernon Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX (Drs Nagamani, Sutton, and Lee); Texas Children's Hospital, Houston, TX (Drs Nagamani, Sutton, and Lee)
| | - Brendan H Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX (Drs Nagamani, Sutton, and Lee); Texas Children's Hospital, Houston, TX (Drs Nagamani, Sutton, and Lee)
| | - Jeffrey Krischer
- College of Medicine, University of South Florida, Tampa, FL (Mr. Cuthbertson and Dr Krischer)
| | - Deborah Krakow
- Departments of Obstetrics and Gynecology (Drs Rao and Krakow); Human Genetics (Dr Krakow); Orthopaedic Surgery (Dr Krakow); Pediatrics (Dr Krakow), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
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6
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Yan M, Knowland NP, Lien D. The Anesthetic Management of a Parturient With Osteogenesis Imperfecta Type I Undergoing Cesarean Delivery. Cureus 2021; 13:e13849. [PMID: 33859900 PMCID: PMC8038905 DOI: 10.7759/cureus.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a rare disorder of bone fragility caused by mutations in the COL1A1/2 genes, which encode type I procollagen. It commonly manifests with bone fractures, joint dislocations, and easy bruising. OI patients presenting for surgery may pose multiple challenges to the anesthesiologist such as management of a potentially difficult airway and heightened positional fracture risks. We present a case detailing the spinal anesthetic management of a 28-year-old woman with type I OI requiring cesarean delivery for a 32-week intrauterine pregnancy with fetal cardiac anomalies.
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Affiliation(s)
- Manshu Yan
- Anesthesiology and Perioperative Medicine, Loma Linda University Medical Center, Loma Linda, USA
| | - Nicholas P Knowland
- Anesthesiology and Perioperative Medicine, Loma Linda University Medical Center, Loma Linda, USA
| | - Donna Lien
- Anesthesiology and Perioperative Medicine, Loma Linda University Medical Center, Loma Linda, USA
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7
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Chougui K, Addab S, Palomo T, Morin SN, Veilleux LN, Bernstein M, Thorstad K, Hamdy R, Tsimicalis A. Clinical manifestations of osteogenesis imperfecta in adulthood: An integrative review of quantitative studies and case reports. Am J Med Genet A 2020; 182:842-865. [PMID: 32091187 DOI: 10.1002/ajmg.a.61497] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 12/03/2019] [Accepted: 01/03/2020] [Indexed: 12/16/2022]
Abstract
Osteogenesis imperfecta (OI) is a rare genetic disorder of the bones caused by a mutation in Type I collagen genes. As adults with OI are aging, medical concerns secondary to OI may arise. This integrative review sought to review, appraise, and synthesize the clinical manifestations faced by adults with OI. Four electronic bibliographic databases were searched. Published quantitative, qualitative, and mixed-methods studies, as well as case reports from 2000 to March 2019, addressing a clinical manifestation in adulthood, were reviewed. Eligible studies and case reports were subsequently appraised using the Mixed Methods Appraisal Tool and Case Report Checklist, respectively. Twenty quantitative studies and 88 case reports were included for review regardless of the varying methodological quality score. These studies collectively included 2,510 adults with different OI types. Several clinical manifestations were studied, and included: hearing loss, cardiac diseases, pregnancy complications, cerebrovascular manifestations, musculoskeletal manifestations, respiratory manifestations, vision impairment, and other clinical manifestations. Increased awareness may optimize prevention, treatment, and follow-up. Opportunities to enhance the methodological quality of research including better design and methodology, multisite collaborations, and larger and diverse sampling will optimize the generalizability and transferability of findings.
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Affiliation(s)
- Khadidja Chougui
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Psychology, Universite de Montreal, Montreal, Quebec, Canada
| | - Sofia Addab
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Telma Palomo
- Bone Densitometry, Fleury Medicina e Saúde, São Paulo, Brazil
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,General Internal Medicine and Bone Metabolism Center, Montreal General Hospital, Montreal, Quebec, Canada
| | - Louis-Nicolas Veilleux
- Experimental Surgery, McGill University, Montreal, Quebec, Canada.,Motion Analysis Center, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Mitchell Bernstein
- Orthopedic Surgery, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Department of Pediatric Surgery, McGill University, Montreal, Quebec, Canada
| | - Kelly Thorstad
- Nursing and Patient Services, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Reggie Hamdy
- Orthopedic Surgery, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Department of Pediatric Surgery, McGill University, Montreal, Quebec, Canada
| | - Argerie Tsimicalis
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada.,Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
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8
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Olvera D, Stolzenfeld R, Fisher E, Nolan B, Caird MS, Kozloff KM. Pamidronate Administration During Pregnancy and Lactation Induces Temporal Preservation of Maternal Bone Mass in a Mouse Model of Osteogenesis Imperfecta. J Bone Miner Res 2019; 34:2061-2074. [PMID: 31310351 PMCID: PMC6854294 DOI: 10.1002/jbmr.3831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 01/25/2023]
Abstract
During pregnancy and lactation, the maternal skeleton undergoes significant bone loss through increased resorption to provide the necessary calcium supply to the developing fetus and suckling neonate. This period of skeletal vulnerability has not been clearly associated with increased maternal fracture risk, but these physiological conditions can exacerbate an underlying metabolic bone condition like osteogenesis imperfecta. Although bisphosphonates (BPs) are commonly used in postmenopausal women, there are cases where premenopausal women taking BPs become pregnant. Given BPs' long half-life, there is a need to establish how BPs affect the maternal skeleton during periods of demanding metabolic bone changes that are critical for the skeletal development of their offspring. In the present study, pamidronate- (PAM-) amplified pregnancy-induced bone mass gains and lactation-induced bone loss were prevented. This preservation of bone mass was less robust when PAM was administered at late stages of lactation compared with early pregnancy and first day of lactation. Pregnancy-induced osteocyte osteolysis was also observed and was unaffected with PAM treatment. No negative skeletal effects were observed in offspring from PAM-treated dams despite lactation-induced bone loss prevention. These findings provide important insight into (1) a treatment window for when PAM is most effective in preserving maternal bone mass, and (2) the maternal changes in bone metabolism that maintain calcium homeostasis crucial for fetal and neonatal bone development. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Diana Olvera
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Rachel Stolzenfeld
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Emily Fisher
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Bonnie Nolan
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Michelle S Caird
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Kenneth M Kozloff
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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9
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Savarirayan R, Rossiter JP, Hoover-Fong JE, Irving M, Bompadre V, Goldberg MJ, Bober MB, Cho TJ, Kamps SE, Mackenzie WG, Raggio C, Spencer SS, White KK. Best practice guidelines regarding prenatal evaluation and delivery of patients with skeletal dysplasia. Am J Obstet Gynecol 2018; 219:545-562. [PMID: 30048634 DOI: 10.1016/j.ajog.2018.07.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/15/2018] [Accepted: 07/17/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Skeletal dysplasia comprises a heterogeneous and collectively common group of inherited disorders of development, growth, and maintenance of the human skeleton. There is potential for increased perinatal morbidity and mortality in pregnant women who themselves have skeletal dysplasia, and for affected fetuses where skeletal dysplasia is suspected in utero. OBJECTIVE We sought to establish guidelines for perinatal health care professionals who should be aware of these risks, to optimize maternal and child health pregnancy outcomes through best prenatal and delivery management practices. STUDY DESIGN A panel of 13 multidisciplinary international experts participated in a Delphi process, which comprised consideration of thorough literature review and a list of 54 possible care recommendations subject to 2 rounds of anonymous voting and a face-to-face meeting. Those recommendations with >80% agreement were considered as consensual. RESULTS During the first round, consensus was reached to support 30 out of the 54 statements. After the panel discussion, the group reached consensus on 40 statements. These statements include guidelines for the evaluation and treatment of pregnant women with skeletal dysplasia and for the unborn child with or suspected to have skeletal dysplasia. CONCLUSION Consensus-based best practice guidelines are provided as a minimum of standard care to minimize associated health risks, and improve clinical outcomes for patients with skeletal dysplasia.
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10
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Nghiem T, Chougui K, Michalovic A, Lalloo C, Stinson J, Lafrance ME, Palomo T, Dahan-Oliel N, Tsimicalis A. Pain experiences of adults with osteogenesis imperfecta: An integrative review. CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR 2018; 2:9-20. [PMID: 35005360 PMCID: PMC8730592 DOI: 10.1080/24740527.2017.1422115] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Tracy Nghiem
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children-Canada , Montreal, Quebec, Canada
| | - Khadidja Chougui
- Shriners Hospitals for Children-Canada , Montreal, Quebec, Canada
| | - Alisha Michalovic
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children-Canada , Montreal, Quebec, Canada
| | - Chitra Lalloo
- The Hospital for Sick Children , Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Stinson
- The Hospital for Sick Children , Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Telma Palomo
- Bone and Mineral Unit, Division of Endocrinology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Noémi Dahan-Oliel
- Shriners Hospitals for Children-Canada , Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children-Canada , Montreal, Quebec, Canada
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Management of osteogenesis imperfecta type I in pregnancy; a review of literature applied to clinical practice. Arch Gynecol Obstet 2016; 293:1153-9. [DOI: 10.1007/s00404-016-4012-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
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Yimgang DP, Shapiro JR. Pregnancy outcomes in women with osteogenesis imperfecta. J Matern Fetal Neonatal Med 2015; 29:2358-62. [PMID: 26372357 DOI: 10.3109/14767058.2015.1085965] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the relationship between osteogenesis imperfecta (OI) type, mode of delivery and outcomes as self-reported by women in the International Osteogenesis Imperfecta (OI) Registry. METHODS A cross-sectional study using data from 274 women with OI who reported their experience with pregnancy practices, including mode of delivery, number of children, genetic counseling, assisted conception techniques, mean ages at menarche and at menopause, and pregnancy complications. Chi-square analyses were performed to compare pregnancy outcomes, number of children and OI type. Prevalence ratios and 95% confidence intervals were obtained to quantify exposure-outcome relationships. RESULTS The most common mode of delivery was the sole use of cesarean section (C-section) reported by 55% of the participants. Approximately two-thirds had at least two children. Twenty-nine percent (n = 80) reported pregnancy complications. There was a significant relationship between the mode of delivery and OI type (p < 0.001), genetic counseling (p = 0.010), and number of children (p < 0.0001). There was neither evidence of an association between pregnancy complications and number of children (p = 0.16), OI type (p = 0.27), nor mode of delivery (p = 0.11). CONCLUSIONS These findings suggested that clinical OI type, pre-natal genetic counseling, and number of children were strong predictors for choosing the mode of delivery. Severity of OI, multiparity, and vaginal delivery were not associated with increased pregnancy complications in this cohort of women with OI.
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Affiliation(s)
- Doris Prisca Yimgang
- a Bone and Osteogenesis Imperfecta Department, Kennedy Krieger Institute, Johns Hopkins School of Medicine , Baltimore , MD , USA
| | - Jay Robert Shapiro
- a Bone and Osteogenesis Imperfecta Department, Kennedy Krieger Institute, Johns Hopkins School of Medicine , Baltimore , MD , USA
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13
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The collagenopathies: review of clinical phenotypes and molecular correlations. Curr Rheumatol Rep 2014; 16:394. [PMID: 24338780 DOI: 10.1007/s11926-013-0394-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Genetic defects of collagen formation (the collagenopathies) affect almost every organ system and tissue in the body. They can be grouped by clinical phenotype, which usually correlates with the tissue distribution of the affected collagen subtype. Many of these conditions present in childhood; however, milder phenotypes presenting in adulthood are increasingly recognized. Many are difficult to differentiate clinically. Precise diagnosis by means of genetic testing assists in providing prognosis information, family counseling, and individualized treatment. This review provides an overview of the current range of clinical presentations associated with collagen defects, and the molecular mechanisms important to understanding how the results of genetic testing affect medical care.
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Benbara A, Sellier N, Benchimol M, Carbillon L. Incomplete abortion at 13 weeks' gestation due to extreme pelvic deformity in a woman with severe osteogenesis imperfecta. J OBSTET GYNAECOL 2010; 30:196-8. [DOI: 10.3109/01443610903440919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Osteogenesis imperfecta: Recent findings shed new light on this once well-understood condition. Genet Med 2009; 11:375-85. [DOI: 10.1097/gim.0b013e3181a1ff7b] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Hwang DK, Oh JI, Yoon HJ, Kim SM, Jee YS, Lee IH, Shin YC. Spinal anesthesia during cesarean section in a patient with severe osteogenesis imperfecta - A case report -. Korean J Anesthesiol 2009; 57:662-665. [DOI: 10.4097/kjae.2009.57.5.662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dong Ki Hwang
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
| | - Jong In Oh
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
| | - Hea Jo Yoon
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Seoul, Korea
| | - Soo Mie Kim
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Seoul, Korea
| | - Young Seok Jee
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Seoul, Korea
| | - In Ho Lee
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Seoul, Korea
| | - Young Chul Shin
- Department of Anesthesiology and Pain Medicine, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea
- Department of Anesthesiology and Pain Medicine, Kwandong University College of Medicine, Seoul, Korea
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Litos M, Michala S, Brown R. Osteogenesis imperfecta and pregnancy. Eur J Obstet Gynecol Reprod Biol 2008; 136:126-7. [PMID: 17045730 DOI: 10.1016/j.ejogrb.2006.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 08/13/2006] [Accepted: 09/05/2006] [Indexed: 10/24/2022]
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McKiernan FE. Musculoskeletal manifestations of mild osteogenesis imperfecta in the adult. Osteoporos Int 2005; 16:1698-702. [PMID: 15902417 DOI: 10.1007/s00198-005-1905-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2004] [Accepted: 03/23/2005] [Indexed: 11/29/2022]
Abstract
The musculoskeletal manifestations of mild forms of osteogenesis imperfecta are not well defined in the adult. The aim of this study was to characterize the musculoskeletal manifestations and resulting impairments reported by adults with mild osteogenesis imperfecta. For this task a survey of musculoskeletal symptoms and impairments was hosted on the Osteogenesis Imperfecta Foundation web site for 6 weeks. Survey responses are reported herein. There were 111 unduplicated, adult respondents (78 female). Mean age was 40.8 years. More than one-quarter of 3,410 lifetime fractures occurred in adulthood. Nearly half of respondents reported an established diagnosis of "arthritis" (usually osteoarthritis), and the majority of these reported some degree of impairment attributable to arthritis. Articular pain, stiffness and instability were dominant in the large, weight-bearing joints of the lower extremities. Back pain and scoliosis were common. Of the respondents, 15% required assistance with light physical tasks and personal care. Two-thirds reported joint hyper-mobility, and one-third reported a previous tendon rupture. Complex regional pain syndrome was rare. Respondents reported frequent use of medications known to have potential adverse skeletal effects. In spite of these concerns the majority rated their overall physical health as good or excellent. Adults with mild osteogenesis imperfecta continue to sustain fractures into adulthood, and the majority reports some functional impairment due to musculoskeletal issues. Significant impairment is not rare.
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Affiliation(s)
- Fergus E McKiernan
- Center for Bone Diseases, Marshfield Clinic, 1000, North Oak Avenue, Marshfield, Wisconsin 54449, USA.
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Munns CFJ, Rauch F, Ward L, Glorieux FH. Maternal and fetal outcome after long-term pamidronate treatment before conception: a report of two cases. J Bone Miner Res 2004; 19:1742-5. [PMID: 15355570 DOI: 10.1359/jbmr.040711] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2004] [Revised: 05/27/2004] [Accepted: 06/24/2004] [Indexed: 11/18/2022]
Abstract
The pregnancies of two women with osteogenesis imperfecta who received intravenous pamidronate before conception are reported. The mothers suffered no ill effects. One baby had transient asymptomatic hypocalcemia and one had bilateral talipes equinovarus. This report documents the pregnancy outcomes of two women with osteogenesis imperfecta (OI), types I and IV, who received intravenous pamidronate as part of an observational trial before conception. Pamidronate was not administered after conception. Other than hyperemesis in one woman, the pregnancies and deliveries were uneventful. Both babies inherited OI from their mothers. The baby with OI type IV also had bilateral talipes equinovarus. Biochemical evaluation of the mothers and babies at 24 h and/or 2 weeks postpartum was normal, apart from one baby with asymptomatic hypocalcemia at 24 h of age that had resolved when next measured on day 11 of life. No biochemistry was available on the second child until 13 days of age. Neither baby had skeletal modeling abnormalities consistent with in utero pamidronate exposure. The lumbar spine (L1-L4) areal BMD and anterior to posterior height ratios of lumbar vertebral bodies of both women remained constant during pregnancy. Both the mothers and babies remain well and free of fracture 14 and 16 months postpartum.
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Affiliation(s)
- Craig F J Munns
- Genetics Unit, Shriners Hospital for Children, McGill University, Montréal, Québec, Canada
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