New research offers hope for earlier diagnosis of Pregnancy Associated Osteoporosis

For our community at Pregnancy Associated Osteoporosis UK, this research marks an important step towards one of our key goals: improving recognition and diagnosis of this rare and often misunderstood condition.

A breakthrough in identifying PAO

The study, published in Osteoporosis International, shows that three symptoms – height loss, back pain and severe pain that interferes with daily life – are highly predictive of PAO.

Researchers found that when all three are present, the likelihood of PAO is very high.

• Half of those with PAO reported height loss, compared with less than one per cent of those without.

• Back pain was reported by almost 90 per cent of women with PAO, compared with 44 per cent of those without.

• Severe pain affected 84 per cent of those with PAO, compared with just 2 per cent of those without.

These simple measures could help doctors distinguish between common back pain in pregnancy and the much rarer but serious bone changes that occur with PAO.

The study was funded by the Royal Osteoporosis Society and the Kennedy Trust for Rheumatology Research and included several PAO UK trustees among the research team: Professor Stuart Ralston, Kathryn Berg and Karen Whitehead.

Dr Sarah Hardcastle, chair of PAO UK’s medical and scientific committee, said:

“We know that the diagnosis of PAO is often delayed and that some women are seen by multiple healthcare professionals before being referred for diagnostic tests such as x-rays.

This important research highlights three simple symptoms to assess clinical features which, when present together, can identify women likely to have PAO with a high degree of certainty. We hope this research will enable more women with PAO to be diagnosed early and referred promptly for the specialist care they need.”

A milestone for the PAO UK community

At PAO UK, our mission is to raise awareness, provide support, and enhance outcomes for mothers and families affected by PAO. We are an all-volunteer charity founded by women living with the condition, alongside dedicated clinicians and researchers.

This new research reflects the strength of that collaboration. It shows what can happen when lived experience and scientific expertise come together: a shared commitment to make sure no mother faces this condition without understanding or support.

Karen Whitehead, MBE, PAO UK co-chair and Patient Researcher, said:

“As someone who experienced PAO myself, I know how frightening it can be when pain and fractures are dismissed as ‘normal after pregnancy.’

This study gives doctors something simple to look for and is a small but powerful change that could lead to faster diagnosis and care for women in real need.”

A trustee’s perspective

“When I was affected by PAO, I didn’t know what was happening to my body. Like many women, I was told the pain was normal. This research is such a hopeful step because it shows there are simple ways to tell when something more serious might be going on. It’s exactly the kind of progress we’ve been working towards as a charity.” Tessa Gooding, PAO UK trustee and woman with PAO

Looking ahead

The paper, Height loss, back pain and severe pain are highly predictive of Pregnancy Associated Osteoporosis, was published online in Osteoporosis International on 12 September 2025. You can read it via the link below.

In response to these findings, we launched our #MeasureThatMum campaign to raise awareness among midwives, health visitors, GPs and obstetric and maternity teams of the importance of measuring height during pregnancy and after birth. By encouraging simple checks and better recognition of warning signs, we hope fewer women with PAO will have their pain dismissed or endure long waits for diagnosis.

As a charity, we will continue to share new research, raise awareness among health professionals, and offer community and guidance for those affected.

Together, we are building a future where every mother with PAO receives timely diagnosis, expert care, and the support she deserves.

Support our work

We are a small, all-volunteer charity making a big difference for women with PAO. Your donation helps us continue vital awareness work, including our #MeasureThatMum campaign, and ensures more mothers receive the understanding, care and support they need.

Donate through JustGiving to support PAO UK Pregnancy Associated Osteoporosis UK.

For more information or to get involved, visit www.pao.org.uk.