CALCIUM AND PHOSPHORUS METABOLISM IN OSTEOMALACIA. XI. THE PATHOGENETIC RÔLE OF PREGNANCY AND RELATIVE IMPORTANCE OF CALCIUM AND VITAMIN D SUPPLY

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Abstract
Data on Ca, P and N metabolism during the latter part of pregnancy were obtained on 10 subjects showing various states of skeletal store and vit. D nutrition. Given an adequate supply of vit. D and Ca, patients with osteomalacia showed no inherent inability to retain minerals during pregnancy, compared with those with no skeletal depletion. The added requirement during gestation, unlike that in lactation, did not seem to go beyond fetal needs. Such needs had to be filled at the expense of the maternal tissue, if the supply of vit. D and minerals was inadequate. Under such circumstances, pregnancy plays an important pathogenetic role in osteomalacia inasmuch as it hastens the skeletal de-mineralization. While high Ca intake tends to ameliorate the effects of vit. D deficiency, the latter conserves Ca. Of the two, vit. D is probably more important, provided a reasonable level of Ca intake is available. The Ca requirement during pregnancy is conditioned by the prior skeletal store, the previous dietary intake, and the state of vit. D nutrition.