How does women’s bone health recover after lactation? a systematic review and meta-analysis

Grizzo, F. M. F.; Alarcão, A. C. J.; Agnolo, C. M. Dell’; Pedroso, R. B.; Santos, T. S.; Vissoci, J. R. N.; Pinheiro, M. M.; Carvalho, M. D. B.; Pelloso, S. M.

Affiliations

¹Post Graduate Program in Health Sciences, Maringá State University, Maringá, Brazil

²Hospital University of Maringá, Maringá, Brazil

³Post Graduate Program in Biosciences and Physiopathology, Maringa State University, Maringá, Brazil

⁴Global Neurosurgery and Neuroscience Division, Duke Global Health Institute, Duke University, Durham, USA

⁵Rheumatology Division, Bone and Mineral Section and Spondyloarthritis Section, Federal University of São Paulo (Unifesp/EPM), São Paulo, Brazil

⁶Department of Health Sciences, State University of Maringá, Maringá, Brazil

Abstract and keywords

Mini abstract: This is a systematic review aiming to evaluate the recovery of bone mass after lactation-related loss. Bone loss is transitory with recovery depending on the return of menstruation and weaning, and several compensatory homeostatic mechanisms are involved to minimize any significant damage to the maternal skeleton.

Abstract: Lactation has been associated with significant temporary bone loss, especially during the exclusive breastfeeding period. In the bone recovery phase, there is wide methodological heterogeneity among clinical trials, including follow-up timing, methods and sites of bone measurements, and body composition changes. The purpose of this study is to perform a systematic review and meta-analysis aiming to evaluate the recovery rate of bone mass after lactation-related loss, including the PubMed, Web of Science, and Scopus databases, with no publication date restrictions. The following MeSH terms were used: “bone diseases,” “bone resorption,” “bone density,” “osteoporosis,” “calcium,” “postpartum period,” “weaning,” “breast feeding,” and “lactation.” The inclusion criteria were as follows: prospective human studies in women of reproductive age and bone measurements with two assessments in the postpartum period at least: the first one within the first weeks of lactation and another one 12 months after delivery, 3 months following the return of menses or 3 months postweaning. This research was recorded on the Prospero database (CRD42018096586Bone). A total of 9455 studies were found and 32 papers met the inclusion criteria. The follow-up period ranged from one to 3.6 years postpartum. Lactation was associated with transient bone loss, with a strong tendency to recover in all the sites studied, depending on the return of menstruation and weaning. Small deficits in the microarchitecture of the peripheral skeleton may be present, especially in women with prolonged breastfeeding, but with no deficit regarding the hip geometry was found. Women with a successive gestation after prolonged lactation and women who had breastfed when adolescents had no significant bone loss. Bone loss related to lactation is transitory, and several compensatory homeostatic mechanisms are involved to minimize any significant damage to the maternal skeleton.

Keywords: Bone density; Bone resorption; Breastfeeding; Lactation; Osteoporosis; Postpartum period

Links

DOI: 10.1007/s00198-019-05236-8

PubMed: 31897544

WoS: 000505342800001

History

Received: 2019-07-24

Accepted: 2019-11-14

Online: 2020-01-02

Cited By (1)

Year	Entry
2021	de Bakker CMJ, Burt LA, Gabel L, Hanley DA, Boyd SK. Parity, breastfeeding, and osteoporosis: authors’ response. Calcif Tiss Int. February 2021;108(2):279-280.