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Mechanical Regulation of the Maternal Skeleton during Reproduction and Lactation

  • Biomechanics (G Niebur and J Wallace, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of review

This review summarizes recently published data on the effects of pregnancy and lactation on bone structure, mechanical properties, and mechano-responsiveness in an effort to elucidate how the balance between the structural and metabolic functions of the skeleton is achieved during these physiological processes.

Recent findings

While pregnancy and lactation induce significant changes in bone density and structure to provide calcium for fetal/infant growth, the maternal physiology also comprises several innate compensatory mechanisms that allow for the maintenance of skeletal mechanical integrity. Both clinical and animal studies suggest that pregnancy and lactation lead to adaptations in cortical bone structure to allow for rapid calcium release from the trabecular compartment while maintaining whole bone stiffness and strength. Moreover, extents of lactation-induced bone loss and weaning-induced recovery are highly dependent on a given bone’s load-bearing function, resulting in better protection of the mechanical integrity at critical load-bearing sites. The recent discovery of lactation-induced osteocytic perilacunar/canalicular remodeling (PLR) indicates a new means for osteocytes to modulate mineral homeostasis and tissue-level mechanical properties of the maternal skeleton. Furthermore, lactation-induced PLR may also play an important role in maintaining the maternal skeleton’s load-bearing capacity by altering osteocyte’s microenvironment and modulating the transmission of anabolic mechanical signals to osteocytes.

Summary

Both clinical and animal studies show that parity and lactation have no adverse, or a positive effect on bone strength later in life. The skeletal effects during pregnancy and lactation reflect an optimized balance between the mechanical and metabolic functions of the skeleton.

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Funding

This work was supported by NIH K01-AR066743 (to XSL), NIH R01-AR071718 (to XSL), NIH R01-AR054385 (to LW), and NSF #1653216 (to XSL).

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Authors and Affiliations

  1. McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, 332A Stemmler Hall, 36th Street and Hamilton Walk, Philadelphia, PA, USA

    X. Sherry Liu

  2. Center for Biomechanical Research, Department of Mechanical Engineering, University of Delaware, Newark, DE, USA

    Liyun Wang

  3. McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada

    Chantal M. J. de Bakker

  4. School of Life Sciences, University of Science and Technology of China, Hefei, China

    Xiaohan Lai

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Correspondence to X. Sherry Liu.

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Liu, X.S., Wang, L., de Bakker, C.M.J. et al. Mechanical Regulation of the Maternal Skeleton during Reproduction and Lactation. Curr Osteoporos Rep 17, 375–386 (2019). https://doi.org/10.1007/s11914-019-00555-5

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