Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Apr 3

PMID 33805460

Citations 11

Authors

Dalal S Ali

Karel Dandurand

Aliya A Khan

Affiliations

Soon will be listed here.

Abstract

Background: Hypoparathyroidism is an uncommon endocrine disorder. During pregnancy, multiple changes occur in the calcium-regulating hormones, which may affect the requirements of calcium and active vitamin D during pregnancy in patients with hypoparathyroidism. Close monitoring of serum calcium during pregnancy and lactation is ideal in order to optimize maternal and fetal outcomes. In this review, we describe calcium homeostasis during pregnancy in euparathyroid individuals and also review the diagnosis and management of hypoparathyroidism during pregnancy and lactation.

Methods: We searched the MEDLINE, CINAHL, EMBASE, and Google scholar databases from 1 January 1990 to 31 December 2020. Case reports, case series, book chapters, and clinical guidelines were included in this review.

Conclusions: During pregnancy, rises in 1,25-dihydroxyvitamin D (1,25-(OH)2-D3) and PTH-related peptide result in suppression of PTH and enhanced calcium absorption from the bowel. In individuals with hypoparathyroidism, the requirements for calcium and active vitamin D may decrease. Close monitoring of serum calcium is advised in women with hypoparathyroidism with adjustment of the doses of calcium and active vitamin D to ensure that serum calcium is maintained in the low-normal to mid-normal reference range. Hyper- and hypocalcemia should be avoided in order to reduce the maternal and fetal complications of hypoparathyroidism during pregnancy and lactation. Standard of care therapy consisting of elemental calcium, active vitamin D, and vitamin D is safe during pregnancy.

Citing Articles

Hypoparathyroidism: diagnosis, management and emerging therapies.

Khan S, Khan A Nat Rev Endocrinol. 2025; .

PMID: 39905273 DOI: 10.1038/s41574-024-01075-8.

Maternal Undernutrition Affects Fetal Thymus DNA Methylation, Gene Expression, and, Thereby, Metabolism and Immunopoiesis in Wagyu (Japanese Black) Cattle.

Phomvisith O, Muroya S, Otomaru K, Oshima K, Oshima I, Nishino D Int J Mol Sci. 2024; 25(17).

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Diagnosing Primary Hyperparathyroidism in Pregnancy: A Case of Altered Parathyroid Hormone Degradation in Pregnancy.

Luong D, Hawke K, De Waal E, Duke M, Wolski P JCEM Case Rep. 2024; 2(9):luae159.

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A Scoping Review of the Apparent Phenomenon of the Improvement in Hypoparathyroidism in Pregnant and Postpartum Females.

John Levy Barnett M Cureus. 2023; 15(9):e46123.

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Mwafy S, Abed El-Nabi S, Laqqan M, Yassin M PLoS One. 2023; 18(3):e0283392.

PMID: 36996084 PMC: 10062660. DOI: 10.1371/journal.pone.0283392.

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