Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis

Sowers, MaryFran

doi:10.1002/jbmr.5650110803

Cited by 214 publications

(119 citation statements)

References 81 publications

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“…The composition of milk also varies within and between feedings (536,654), between an individual's breasts (654), and between mothers and different ethnic groups (536). The calcium content of milk is higher at 3 mo than at 6 mo postpartum (459,536,856,957), but the volume of milk per feed is higher at 6 mo (856). Consequently, daily maternal loss of calcium could be greater at 6 mo and beyond, compared with the first 3 mo of lactation (856).…”

Section: Skeletal and Mineral Physiology During Lactation And Posmentioning

confidence: 99%

“…The calcium content of milk is higher at 3 mo than at 6 mo postpartum (459,536,856,957), but the volume of milk per feed is higher at 6 mo (856). Consequently, daily maternal loss of calcium could be greater at 6 mo and beyond, compared with the first 3 mo of lactation (856). However, the number of feeds is usually fewer after 6 mo, thereby leading to an overall decline in daily calcium losses.…”

Section: Skeletal and Mineral Physiology During Lactation And Posmentioning

confidence: 99%

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

Kovacs

2016

Physiological Reviews

338

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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Section: Skeletal and Mineral Physiology During Lactation And Posmentioning

confidence: 99%

Section: Skeletal and Mineral Physiology During Lactation And Posmentioning

confidence: 99%

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

Kovacs

2016

Physiological Reviews

338

524

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“…Several risk factors Patient have been identified: low body weight, poor intake of calcium in the diet, alcohol or tobacco abuse, past history of eating disorders or menstrual irregularities, and family history of osteoporosis. In normal women there is little change in BMD following pregnancy and breastfeeding (7,9,10). In Argentina there are only two reported series of patients with OPL: the first showed 3 cases (11), and the second one reviewed 8 cases (two with regional osteoporosis of the hip) (12).…”

Section: Discussionmentioning

confidence: 99%

Two cases of pregnancy- and lactation-associated osteoporosis successfully treated with denosumab

Sánchez

Zanchetta

Danilowicz

2017

Bone

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“…Enquanto na gestação há elevados ní-veis de estrógeno, na lactação há hipoestrogenismo e hiperprolactinemia (3), que podem estar envolvidos na gênese da osteopenia lactacional. Além disso, durante a gestação e a lactação, há transferência de cálcio da mãe para o feto e hipercalciúria (4), o que causa na mãe desequilíbrio entre reabsorção e aposição ósseas, balanço negativo de cálcio sérico (5) e osteoporose lactacional (3). Assim, gestações sucessivas sem recuperação da massa óssea podem ter impacto negativo futuro sobre o tecido ósseo, aumentando o risco de osteoporose durante o período reprodutivo ou na menopausa (4).…”

Section: Introductionunclassified

“…Além disso, durante a gestação e a lactação, há transferência de cálcio da mãe para o feto e hipercalciúria (4), o que causa na mãe desequilíbrio entre reabsorção e aposição ósseas, balanço negativo de cálcio sérico (5) e osteoporose lactacional (3). Assim, gestações sucessivas sem recuperação da massa óssea podem ter impacto negativo futuro sobre o tecido ósseo, aumentando o risco de osteoporose durante o período reprodutivo ou na menopausa (4). Além disso, deficiências de cálcio, vitaminas e alterações endócrinas podem alterar o metabolismo ósseo, agravando a osteopenia lactacional (6).…”

Section: Introductionunclassified

Histomorfometria óssea de ratas hipertireóideas lactantes e não-lactantes

Serákides

Ocarino

Magalhães

et al. 2008

Arq Bras Endocrinol Metab

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RESUMOO objetivo deste estudo foi verificar se o hipertireoidismo potencializa a osteopenia causada pela lactação. Foram utilizadas 24 ratas adultas distribuídas em quatro grupos: eutireóideo não lactante (controle), eutireóideo lactante, hipertireóideo não-lactante e hipertireóideo lactante. Todos os animais foram necropsiados, 20 dias após a gestação. As vértebras torácicas e lombares, o fêmur e a tíbia foram colhidos, descalcificados e submetidos à análise histomorfométrica. O grupo eutireóideo lactante apresentou osteopenia intensa em todos os sítios ósseos estudados. No grupo hipertireóideo não-lactante, não houve alteração da porcentagem de tecido ósseo trabecular nos sítios analisados. No grupo hipertireóideo lactante, havia osteopenia na tíbia e no fêmur, semelhante à do grupo eutireóideo lactante. Mas a porcentagem de tecido ósseo trabecular em todos os corpos vertebrais foi significativamente maior em comparação ao grupo eutireóideo lactante. Conclui-se que o hipertireoidismo não agrava a osteopenia lactacional em ratas, mas minimiza a osteopenia vertebral por estimular a atividade osteoblástica. ABSTRACT Bone Histomorphometry of Lactating and No Lactating Hyperthyroid Rats.The objective of this study was to verify if hyperthyroidism potentiates the osteopenia lactational. 24 adult female rats were distributed in four groups: euthyroid no lactating (control), euthyroid lactating, hyperthyroid no lactating and hyperthyroid lactating. 20 days after gestation, all the animals were necropsied. The thoracic and lumbar vertebrae, the femur and tibia were decalcified and processed for histomorphometric analysis. The euthyroid lactating group presented intense osteopenia in the studied bones. In the hyperthyroid no lactating group, there was not any change in trabecular bone percentage in none of the analyzed bone. In the hyperthyroid lactating group, there was osteopenia in the tibia and femur, similar to the one in the euthyroid lactating group. But the trabecular bone percentage in all the vertebral bodies was significantly larger in comparison with the euthyroid lactating group. It was concluded that the hyperthyroidism does not potentiate the osteopenia lactational in female rats, but it minimizes the vertebral osteopenia once it stimulates the osteoblastic activity.

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Pregnancy and lactation as risk factors for subsequent bone loss and osteoporosis

Cited by 214 publications

References 81 publications

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

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

Two cases of pregnancy- and lactation-associated osteoporosis successfully treated with denosumab

Histomorfometria óssea de ratas hipertireóideas lactantes e não-lactantes

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