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Maternal and Infant Outcome after Pamidronate Treatment of Polyostotic Fibrous Dysplasia and Osteogenesis Imperfecta before Conception: A Report of Four Cases

Department of Endocrinology and Diabetes, Royal Children’s Hospital, Parkville 3052, Victoria, Australia

Address all correspondence and requests for reprints to: Dr. Margaret Zacharin, Department of Endocrinology and Diabetes, Royal Children’s Hospital, Flemington Road, Parkville 3052, Victoria, Australia. E-mail: margaret.zacharin{at}rch.org.au.

Background: Pamidronate is used extensively for treatment of osteoporotic and high bone turnover conditions. Because it has a long retention time in the human skeleton, concerns have been raised as to safety profile in women of child-bearing age.

Methods: Four infant outcomes of pregnancies of three women, two with polyostotic fibrous dysplasia and one with osteogenesis imperfecta, all of whom were treated with iv pamidronate before conception, are reported, with biochemical, radiological, and bone density data.

Results: Each pregnancy was uncomplicated, and the four offspring are healthy, with no evidence of biochemical or skeletal abnormality.

Conclusions: We found no evidence for adverse effects of prepregnancy pamidronate on maternal or fetal health. Until the results of systematic studies are available, caution is recommended regarding pamidronate use in women of child-bearing years.