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Hypoparathyroidism During Pregnancy, Lactation, and Fetal/Neonatal Development

  • Christopher S. KovacsEmail author
Chapter

Abstract

Specific adaptations are invoked during pregnancy and lactation to enable women to supply calcium and other minerals needed to support rapid growth and mineralization of the fetal and neonatal skeletons. These adaptations alter the expected normal values for serum minerals and calciotropic hormones and can occasionally lead to maternal hypercalcemia or fractures. Moreover, the presentation, diagnosis, and management of hypoparathyroidism and pseudohypoparathyroidism can also be altered by these adaptations. Fetal mineral metabolism is characterized by low levels of parathyroid hormone and calcitriol as compared to adult values. The fetus can be adversely affected by maternal hypocalcemia or hypercalcemia and genetic parathyroid disorders. The blood calcium normally falls after birth, and this triggers an upregulation in parathyroid function and calcitriol synthesis. Neonatal mineral homeostasis can be impacted by genetic parathyroid disorders and by prior exposure in utero to abnormal mineral concentrations in the mother.

Keywords

Pregnancy Lactation Fetus Neonate Hypoparathyroidism Parathyroid hormone Parathyroid hormone-related protein Pseudohypoparathyroidism Pseudohyperparathyroidism Placenta Calcitriol Skeletal development and mineralization 

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© Springer-Verlag Italia 2015

Authors and Affiliations

  1. 1.Faculty of Medicine – Endocrinology, Obstetrics and Gynecology, and BioMedical Sciences, Health Sciences CentreMemorial University of NewfoundlandSt. John’sCanada

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