Associations Between Breastfeeding History and Early Postmenopausal Bone Loss
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This study aimed to evaluate associations of parity and breastfeeding history with postmenopausal bone loss. Early postmenopausal women from the Canadian Multicentre Osteoporosis Study were divided into three groups based on their reproductive histories: nulliparous (NP, n = 10), parous with < 6 months breastfeeding (P-NBF, n = 14), and parous with > 6 months breastfeeding (P-BF, n = 21). Women underwent dual X-ray absorptiometry and high-resolution peripheral quantitative computed tomography imaging at baseline and after 6 years to evaluate bone mineral density (BMD), bone microstructure, and finite element-estimated failure load. Average age at baseline was 57 years. Baseline density, microstructure, and failure load were not different among groups. In all women, total and cortical BMD decreased significantly at the tibia and radius. P-BF women only experienced a significant decline in tibial trabecular BMD, with a greater magnitude of change for P-BF than NP women (p = 0.002). Overall, results suggest that early postmenopausal bone health did not differ based on parity or breastfeeding history. Over the 6-year follow-up period, postmenopausal bone loss was evident in all women, with subtle differences in the rate of postmenopausal change among women with varying breastfeeding histories. Parous women who had breastfed for at least 6 months showed an elevated rate of trabecular BMD loss at the tibia. Meanwhile, correlation analyses suggest that longer durations of breastfeeding may be associated with reduced cortical bone loss at the radius. The lack of differences among groups in FE-derived failure load suggests that parity and breastfeeding history is unlikely to significantly affect postmenopausal risk of fracture.
KeywordsBone microarchitecture High-resolution peripheral quantitative computed tomography Menopause Breastfeeding Parity
Thank you to all of the participants who volunteered their time to take part in this study. The authors also would like to thank Anne Cooke, Taryn Harris, Duncan Raymond, Jane Allan, and Bernice Love for participant recruitment, questionnaire administration, and scan acquisition. This study was funded by the Canadian Institutes of Health Research (CIHR) MOP-106611. CMJdB and LG were supported by an Alberta Innovates Postgraduate Fellowship and T. Chen Fong Postdoctoral Fellowship (Department of Radiology, Cumming School of Medicine, University of Calgary).
Study design: CMJdB, LAB, DAH, SKB. Data acquisition & analysis: CMJdB, LAB, LG, SKB. Drafting of manuscript: CMJdB, LAB, LG. All authors contributed to revising the manuscript and approved the final version of the submitted manuscript. CMJdB and SKB take responsibility for the integrity of the data analysis, and all authors agree to be accountable for the work.
Compliance with Ethical Standards
Conflicts of interest
Chantal MJ de Bakker, Lauren A Burt, Leigh Gabel, and Steven K Boyd have nothing to disclose. David A Hanley reports grants and personal fees from Amgen and Eli Lilly outside of the submitted work.
Human and Animal Rights
All procedures in this study were approved by the University of Calgary Conjoint Health Research Ethics Board and are in accordance with international ethical standards.
Informed consent was obtained from all participants prior to study initiation.
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