Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities

Hreshchyshyn, Myroslaw M.; Hopkins, Amy; Zylstra, Samuel; Anbar, M.

doi:10.1016/s0002-9378(88)80075-9

Cited by 121 publications

(35 citation statements)

References 7 publications

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“…Drinkwater et al 19 reported in a prospective study a reduction in bone mineral density in the femur neck during pregnancy, which continued to decrease during the 6 months of lactation. Hreshchyshyn et al 20 reported a similar finding and predicted a reduction of 1.1% in bone mineral density of the femur neck during each pregnancy. With opposite results, Christiansen et al, 21 Goldsmith et al 22 and Alderman et al 23 did not record bone loss during pregnancy.…”

Section: Discussionmentioning

confidence: 60%

Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

et al. 2001

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CONTEXT: It is believed that about 25% of menopausal women in the USA will exhibit some kind of fracture as a consequence of osteoporosis. Fractures of the proximal femur are associated with a greater number of deaths and disabilities and higher medical expenses than all the other osteoporotic fractures together. OBJECTIVE: To study the clinical and epidemiological features of patients with proximal femur fracture in hospitals in São Paulo. DESIGN: Transversal and retrospective study. LOCAL: Hospital São Paulo and Hospital Servidor Público Estadual "Francisco Morato Oliveira". PARTICIPANTS: Patients aged sixty-five years or more hospitalized because of proximal femur fracture, from March to November 1996 (N = 73). This group was compared to patients of the same age without fracture of the proximal femur. INTERVENTION: Evaluation of weight, height, body mass index; lifestyle habits (physical activity at home, ingestion of dairy calcium, drinking of coffee, smoking habit), gynecological history (ages at menarche and menopause, number of pregnancies and lactations), previous morbidity, use of medications, history of previous fractures, family history of osteoporosis. MEASUREMENT: The comparison of the different data regarding lifestyle habits between the two groups was made using the chi-squared test. Other data were analyzed using the Mann -- Whitney test. P £ 0.05 was considered significant. RESULTS: We noted a predominance of proximal femur fracture among females in relation to males (a female/male ratio of 3.3:1) with a progressive increase in the frequency of proximal femur fracture with age in both sexes. The group with proximal femur fracture, in comparison with the control group, showed a lower body mass index, less physical activity, and a greater number of pregnancies and lactations. Other data were not different. CONCLUSION: In accordance with the literature, we found a predomination of proximal femur fracture in women in relation to men, and a favorable effect of higher body mass index and physical activity for decreasing the frequency of proximal femur fracture. We also discuss the role of pregnancies and lactation on the frequency of proximal femur fracture.

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Section: Discussionmentioning

confidence: 60%

Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

et al. 2001

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“…There are also divergent effects seen among the different studies. For example, one study reported that parity reduces femoral neck BMD but had no effect on lumbar spine (416). Another found that parity reduces total hip and femoral neck BMD in postmenopausal women, but not in premenopausal women who are closer in time to the event and therefore less likely to show confounding (1020).…”

Section: Human Datamentioning

confidence: 99%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

370

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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“…Ten (three cohort, [16][17][18] seven cross sectional [19][20][21][22][23][24][25] ) showed a positive effect, 29 (four RCTs, [26][27][28][29] nine cohort, 30-38 15 cross sectional, [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] one case series 54 ) showed no effect, and seven (four cohort, [55][56][57][58] three cross sectional [59][60][61] ) showed a negative effect. All of the RCTs showed no effect on BMD, as measured by either dual energy x ray absorptiometry (DXA) 26 27 29 or quantitative computed tomography.…”

Section: Healthy Premenopausal Womenmentioning

confidence: 99%

Effect of oral contraceptives and hormone replacement therapy on bone mineral density in premenopausal and perimenopausal women: a systematic review

2005

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Seventy five articles on the effect of oral contraceptives and other hormone replacement on bone density in premenopausal and perimenopausal women were reviewed. The evidence was appraised using the Oxford Centre for Evidence-Based Medicine levels of evidence. There is good evidence for a positive effect of oral contraceptives on bone density in perimenopausal women, and fair evidence for a positive effect in ''hypothalamic'' oligo/amenorrhoeic premenopausal women. There is limited evidence for a positive effect in healthy and anorexic premenopausal women. In hypothalamic oligo/ amenorrhoeic women, baseline bone density has been shown to be significantly lower than that in healthy controls, therefore the decision to treat is clinically more important. The ideal formulation(s) and duration of treatment remain to be determined by further longitudinal and prospective randomised controlled trials in larger subject populations.

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Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities

Cited by 121 publications

References 7 publications

Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Effect of oral contraceptives and hormone replacement therapy on bone mineral density in premenopausal and perimenopausal women: a systematic review

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