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Influence of breastfeeding and other reproductive factors on bone mass later in life

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Abstract

The influence of reproductive factors on bone mass at six skeletal sites was assessed in an age-stratified random sample of white women residing in Rochester, Minnesota. After age-adjustment, whether or not women had ever breastfed, total duration of breastfeeding and duration of breastfeeding per child were not associated with reduced bone mineral, but breastfeeding for more than 8 months was associated with greater bone mineral at some sites. There were no consistent effects on bone mineral, after adjusting for age, of gravidity or parity, age at menarche, age at first delivery, use of oral contraceptives or estrogen replacement therapy, various sex hormones, nor any of the other reproductive factors assessed. There was a strong protective effect of obesity, which was also correlated with a number of the reproductive variables. While animal studies suggest that pregnancy and lactation may be associated with calcium loss from the skeleton, these data indicate that such factors have little long-term impact on bone mass in humans and little potential for identifying women at high risk of osteoporosis later in life.

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References

  1. Brommage R, DeLuca HF. Regulation of bone mineral loss during lactation. Am J Physiol 1985;11:E182–7.

    Google Scholar 

  2. Miller SC, Shupe JG, Redd EH, et al. Changes in bone mineral and bone formation rates during pregnancy and lactation in rats. Bone 1986;7:283–7.

    Google Scholar 

  3. Peng T-C, Kusy RP, Garner SC, et al. Influence of lactation and pregnancy + lactation on mechanical properties and mineral content of the rat femur. J Bone Miner Res 1987;2:249–57.

    Google Scholar 

  4. Hagaman JR, Ambrose WW, Hirsch PF. A scanning electron microscopic and photon absorptiometric study of the development, prolongation, and pattern of recovery from lactation-induced osteopenia in rats. J Bone Miner Res 1990;5:123–32.

    Google Scholar 

  5. Atkinson PJ, West RR. Loss of skeletal calcium in lactating women. J Obstet Gynaecol Br Commonw 1970;77:555–60.

    Google Scholar 

  6. Chan GM, Ronald N, Slater P, et al. Decreased bone mineral status in lactating adolescent mothers. J Pediatr 1982;101:767–70.

    Google Scholar 

  7. Goldsmith NF, Johnston JO. Bone mineral: effects of oral contraceptives, pregnancy, and lactation. J Bone Joint Surg [Am] 1975;57A:657–68.

    Google Scholar 

  8. Wasnich R, Yano K, Vogel J. Postmenopausal bone loss at multiple skeletal sites: relationship to estrogen use. J Chronic Dis 1983;36:781–90.

    Google Scholar 

  9. Johnell O, Nilsson BE. Life-style and bone mineral mass in perimenopausal women. Calcif Tissue Int 1984;36:354–6.

    Google Scholar 

  10. Sowers MF, Wallace RB, Lemke JH. Correlates of forearm bone mass among women during maximal bone mineralization. Prev Med 1985;14:585–96.

    Google Scholar 

  11. Wardlaw GM, Pike AM. The effect of lactation on peak adult shaft and ultra-distal forearm bone mass in women. Am J Clin Nutr 1986;44:283–6.

    Google Scholar 

  12. Lissner L, Bengtsson C, Hansson T. Bone mineral content in relation to lactation history in pre- and postmenopausal women. Calcif Tissue Int 1991;48:319–25.

    Google Scholar 

  13. Dent CE, Friedman M. Pregnancy and idiopathic osteoporosis. Q J Med 1965;34:341–57.

    Google Scholar 

  14. Gruber HE, Gutteridge DH, Baylink DJ. Osteoporosis associated with pregnancy and lactation: bone biopsy and skeletal features in three patients. Metab Bone Dis Rel Res 1984;5:159–65.

    Google Scholar 

  15. Smith R, Stevenson JC, Winearls CG, et al. Osteoporosis of pregnancy. Lancet 1985;1:1178–80.

    Google Scholar 

  16. Melton LJ III, Riggs BL. Clinical spectrum. In: Riggs BL, Melton LJ III, editors. Osteoporosis: etiology, diagnosis and management. New York: Raven Press, 1988; 155–79.

    Google Scholar 

  17. Gutteridge DH, Doyle FH, Joplin GF, et al. Two types of osteoporosis in younger women: natural history and relationship to pregnancy and lactation [abstract]. Calcif Tissue Int 1986;39(Suppl):A133.

    Google Scholar 

  18. Jackson WPU. Osteoporosis of unknown cause in younger people: idiopathic osteoporosis. J Bone Joint Surg [Br] 1958;40B:420–41.

    Google Scholar 

  19. Bordier PhJ, Miravet L, Hioco D. Young adult osteoporosis. Clin Endocrinol Metab 1973;2:277–92.

    Google Scholar 

  20. Perry HM III, Fallon MD, Bergfeld M, et al. Osteoporosis in young men: a syndrome of hypercalciuria and accelerated bone turnover. Arch Intern Med 1982;142:1295–8.

    Google Scholar 

  21. Kreiger N, Kelsey JL, Holford TR, et al. An epidemiologic study of hip fracture in postmenopausal women. Am J Epidemiol 1982;116:141–8.

    Google Scholar 

  22. Alderman BW, Weiss NS, Daling JR, et al. Reproductive history and postmenopausal risk of hip and forearm fracture. Am J Epidemiol 1986;124:262–7.

    Google Scholar 

  23. Cummings SR, Kelsey JL, Nevitt MC, et al. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985;7:178–208.

    Google Scholar 

  24. Kurland LT, Molgaard CA. The patient record in epidemiology. Sci Am 1981;245:54–63.

    Google Scholar 

  25. Melton LJ III, Wahner HW, Richelson LS, et al. Osteoporosis and the risk of hip fracture [Letter]. Am J Epidemiol 1987;126:1217–9.

    Google Scholar 

  26. Riggs BL, Wahner HW, Seeman E, et al. Changes in bone mineral density of the proximal femur and spine with aging: differences between the postmenopausal and senile osteoporosis syndromes. J Clin Invest 1982;70:716–23.

    Google Scholar 

  27. Riggs BL, Wahner HW, Melton LJ, et al. Rates of bone loss in the appendicular and axial skeletons of women. J Clin Invest 1986;77:1487–91.

    Google Scholar 

  28. Beard CM, Melton LJ, Cedel SL, et al. Ascertainment of risk factors for osteoporosis: comparison of interview data with medical record review. J Bone Miner Res 1990;5:691–9.

    Google Scholar 

  29. Judd HL, Judd GE, Lucas WE, et al. Endocrine function of the postmenopausal ovary: concentration of androgens and estrogens in ovarian and peripheral vein blood. J Clin Endocrinol Metab 1974;39:1020–4.

    Google Scholar 

  30. Anderson DC, Hopper BR, Lesley BL, et al. A simple method for the assay of eight steroids in small volumes of plasma. Steroids 1976;28:179–96.

    Google Scholar 

  31. Rosner W. A simplified method for the quantitative determination of testosterone-estradiol-binding globulin activity in human plasma. J Clin Endocrinol Metab 1972;34:983–8.

    Google Scholar 

  32. Kleinbaum DG, Kupper LL, Morgenstern H. Epidemiologic research: principles and quantitative methods. Belmont, CA: Lifetime Learning Publications, 1982.

    Google Scholar 

  33. Greer FR, Garn SM. Loss of bone mineral content in lactating adolescents. J Pediatr 1982;101:718–9.

    Google Scholar 

  34. Cunningham AS, Mazess RB. Bone mineral loss in lactating adolescents [letter]. J Pediatr 1983;103:338–9.

    Google Scholar 

  35. Lamke B, Brundin J, Moberg P. Changes of bone mineral content during pregancy and lactation. Acta Obstet Gynecol Scand 1977;56:217–9.

    Google Scholar 

  36. Frisancho AR, Garn SM, Ascoli W. Unaltered cortical area of pregnant and lactating women: studies of the second metacarpal bone in North and Central American populations. Invest Radiol 1971;6:119–21.

    Google Scholar 

  37. Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978;31:466–9.

    Google Scholar 

  38. Chan GM, Roberts CC, Folland D, et al. Growth and bone mineralization of normal breast-fed infants and the effects of lactation on maternal bone mineral status. Am J Clin Nutr 1982;36:438–43.

    Google Scholar 

  39. Hayslip CC, Klein TA, Wray HL, et al. The effects of lactation on bone mineral content in healthy postpartum women. Obstet Gynecol 1989;73:588–92.

    Google Scholar 

  40. Kent GN, Price RI, Gutteridge DH, et al. Human lactation: forearm trabecular bone loss, increased bone turnover, and renal conservation of calcium and inorganic phosphate with recovery of bone mass following weaning. J Bone Miner Res 1990;5:361–9.

    Google Scholar 

  41. Aloia JF, Vaswani A, Yeh JK, et al. Determinants of bone mass in postmenopausal women. Arch Intern Med 1983;143:1700–4.

    Google Scholar 

  42. Lindsay R, Herrington BS, Tohme J. Reproductive history and bone mass in women [abstract], J Bone Miner Res 1986;1(Suppl 1):248.

    Google Scholar 

  43. Koetting CA, Wardlaw GM. Wrist, spine, and hip bone density in women with variable histories of lactation. Am J Clin Nutr 1988;48:1479–81.

    Google Scholar 

  44. Hreshchyshyn MM, Hopkins A, Zylstra S, et al. Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities. Am J Obstet Gynecol 1988;159:318–22.

    Google Scholar 

  45. Hansen MA, Overgaard K, Riis BJ, et al. Potential risk factors for development of postmenopausal osteoporosis, examined over a 12-year period. Osteoporosis Int 1991;1:95–102.

    Google Scholar 

  46. Smith RW Jr. Dietary and hormonal factors in bone loss. Fed Proc 1967;26:1737–46.

    Google Scholar 

  47. Heliövaara M, Aromaa A. Parity and obesity. J Epidemiol Community Health 1981;35:197–9.

    Google Scholar 

  48. Saville PD, Nilsson BER. Height and weight in symptomatic postmenopausal osteoporosis. Clin Orthop Rel Res 1966;45:49–54.

    Google Scholar 

  49. Dawson-Hughes B, Shipp C, Sadowski L, et al. Bone density of the radius, spine, and hip in relation to percent of ideal body weight in postmenopausal women. Calcif Tissue Int 1987;40:310–4.

    Google Scholar 

  50. Walker ARP, Richardson B, Walker F. The influence of numerous pregnancies and lactations on bone dimensions in South African Bantu and Caucasian mothers. Clin Sci 1972;42:189–96.

    Google Scholar 

  51. Nilsson BE. Parity and osteoporosis. Surg Gynecol Obstet 1969;129:27–8.

    Google Scholar 

  52. van Hemert AM, Vandenbroucke JP, Birkenhäger JC, et al. Prediction of osteoporotic fractures in the general population by a fracture risk score: a 9-year follow-up among middle-aged women. Am J Epidemiol 1990;132:123–35.

    Google Scholar 

  53. Wyshak G. Hip fracture in elderly women and reproductive history. J Gerontol 1981;36:424–7.

    Google Scholar 

  54. Georgiou E, Ntalles K, Papageorgiou A, et al. Bone mineral loss related to menstrual history. Acta Orthop Scand 1989;60:192–4.

    Google Scholar 

  55. Drinkwater BL, Bruemner B, Chestnut CH III. Menstrual history as a determinant of current bone density in young athletes. JAMA 1990;263:545–8.

    Google Scholar 

  56. Joyce JM, Warren DL, Humphries LL, et al. Osteoporosis in women with eating disorders: comparison of physical parameters, exercise, and menstrual status with SPA and DPA evaluation. J Nucl Med 1990;31:325–31.

    Google Scholar 

  57. Prior JC, Vigna YM, Schechter MT, et al. Spinal bone loss and ovulatory disturbances. N Engl J Med 1990;323:1221–7.

    Google Scholar 

  58. Lindsay R, Tohme J, Kanders B. The effect of oral contraceptive use on vertebral bone mass in pre- and post-menopausal women. Contraception 1986;34:333–40.

    Google Scholar 

  59. Collins CL, Thomas KA, Harding AF, et al. The effect of oral contraceptives on lumbar bone density in premenopausal women. J LA State Med Soc 1988;140:31–9.

    Google Scholar 

  60. Lloyd T, Buchanan JR, Ursino GR, et al. Long-term oral contraceptive use does not affect trabecular bone density. Am J Obstet Gynecol 1989;160:402–4.

    Google Scholar 

  61. Mazess RB, Barden HS. Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills. Am J Clin Nutr 1991;53:132–42.

    Google Scholar 

  62. Stevenson JC, Lees B, Devenport M, et al. Determinants of bone density in normal women: risk factors for future osteoporosis? BMJ 1989;298:924–8.

    Google Scholar 

  63. Cooper C, Hannaford P, Croft P, Kay C. Oral contraceptive pill use and fractures in women: a prospective study. Bone (In press).

  64. Gallagher JC, Goldgar D, Moy A. Total bone calcium in normal women: effect of age and menopause status. J Bone Miner Res 1987;2:491–6.

    Google Scholar 

  65. Lindsay R. Sex steroids in the pathogensis and prevention of osteoporosis. In: Riggs BL, Melton LJ III, editors. Osteoporosis: etiology, diagnosis, and management. New York: Raven Press, 1988:333–58.

    Google Scholar 

  66. Sowers MFR, Wallace RB, Lemke JH. Correlates of mid-radius bone density among postmenopausal women: a community study. Am J Clin Nutr 1985;41:1045–53.

    Google Scholar 

  67. Cauley JA, Gutai JP, Kuller LH, et al. Endogenous estrogen levels and calcium intakes in postmenopausal women: relationships with cortical bone measures. JAMA 1988;260:3150–5.

    Google Scholar 

  68. Riis BJ, Rødbro P, Christiansen C. The role of serum concentrations of sex steroids and bone turnover in the development and occurrence of postmenopausal osteoporosis. Calcif Tissue Int 1986;38:318–22.

    Google Scholar 

  69. Slemenda C, Hui SL, Longcope C, Johnston CC. Sex steroids and bone mass. A study of changes about the time of menopause. J Clin Invest 1987;80:1261–9.

    Google Scholar 

  70. Buchanan JR, Hospodar P, Myers C, et al. Effect of excess endogenous androgens on bone density in young women. J Clin Endocrinol Metab 1988;67:937–43.

    Google Scholar 

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Melton, L.J., Bryant, S.C., Wahner, H.W. et al. Influence of breastfeeding and other reproductive factors on bone mass later in life. Osteoporosis Int 3, 76–83 (1993). https://doi.org/10.1007/BF01623377

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  • DOI: https://doi.org/10.1007/BF01623377

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