, vol. 37 (A), pp. 265-283, 2002.
Objectives: To evaluate the levels of some parameters related to bone metabolism during pregnancy i.e. total calcium (CA), 1,25-dihydroxyvitamin D (Vit.D), parathormone hormone (PTH), phosphorous, osteocalcin, total acid phosphatase and its tartrate resistant isoform (TrACP), total alkaline phosphatase (TALP) and its isoenzmes activities, total protein, albumin, globulin in sera and haemoglobin in blood in a group of egyptian pregnant women who are living in cairo and under reasonable medical care.
Cases: The study was conducted on 33 healthy pregnant women (age range from 20 to 38 years) and 16 healthy non-pregnant women within the same age range to serve as controls. Twenty blood samples were collected from the pregnant women at the end of first trimester of pregnancy (Week-11), twenty four were collected at the end of third trimester (Week-38).
Results: Regarding the osteoblastic activity, the T.ALP was significantly increased due to placental T.ALP and to a lesser degree to bone ALP, while osteocalcin levels. Showed a non significant increment in the 1st and 2nd trimesters of pregnancy with significant increase in the 3rd trimester of pregnancy .concerning the osteoclastic activity, The TrACP isoform decreased significantly in the 2nd trimester of pregnancy, Then returned to the normal values of non-pregnant control levels. Women in the last trimester of pregnancy have higher estrogen level than any other time of life. Although, estrogens at physiologic concentration inhibit osteoclastic activity, hight estrogen concentration increases osteoclastic activity.
As regards the factors that responsible for calcium homeostasis, significant decrease in serum intact PTH was concurrent with significant increase in Vit.D. The total serum calcium level was significantly decreased through the pregnancy, while the ionized calcium did not change, and the serum phosphorus was highly significantly increased.
Conclusion: From these results it has been concluded that, the pregnancy imposes major changes in the mother's nutritional requirement and causes physiological alternation in maternal bone metabolism. Minimal changes affecting the bone turnover were demonstrated among egyptian women throughout pregnancy due to the nutritional statue of the women and thier supplementation with Ca and/or Vit.D. Also,the changes in the haemodynamic parameters of the mother may be due to heamodilution that occur during pregnancy. The obtained patterns showed that the egyptian women who are living in urban areas (e.g. cairo), and under reasonable medical care are in good health compared to other communities in which the nutritional status and the poor medical care are the main reasons for the dramatic changes in the bone metabolism.