Mechanical Regulation of the Maternal Skeleton during Reproduction and Lactation

  • X. Sherry LiuEmail author
  • Liyun Wang
  • Chantal M. J. de Bakker
  • Xiaohan Lai
Biomechanics (G Niebur and J Wallace, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Biomechanics


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.


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.


Bone structure Bone mechanics Pregnancy Lactation Bone adaptation Perilacunar/canalicular remodeling (PLR) Bone fluid flow Osteocyte 


Funding information

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).

Compliance with Ethical Standards

Conflict of Interest

X. Sherry Liu, Liyun Wang, Chantal M. J. de Bakker, and Xiaohan Lai declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • X. Sherry Liu
    • 1
    Email author
  • Liyun Wang
    • 2
  • Chantal M. J. de Bakker
    • 3
  • Xiaohan Lai
    • 4
  1. 1.McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Center for Biomechanical Research, Department of Mechanical EngineeringUniversity of DelawareNewarkUSA
  3. 3.McCaig Institute for Bone and Joint HealthUniversity of CalgaryCalgaryCanada
  4. 4.School of Life SciencesUniversity of Science and Technology of ChinaHefeiChina

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