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Pregnancy and lactation, a challenge for the skeleton.
E M Winter1, A Ireland2, N C Butterfield3
1Leiden University Medical Center, Department of Internal Medicine, Division of Endocrinology, Center for Bone Quality, Leiden, the Netherlands.
Endocrine Connections
|May 22, 2020
Summary
Pregnancy and lactation cause significant skeletal changes, primarily hormonal, which generally recover over time. Long-term effects may include site-specific bone density benefits, but rare osteoporosis can occur.
Area of Science:
- Skeletal physiology
- Reproductive endocrinology
Background:
- Pregnancy and lactation impose significant physiological demands on the maternal skeleton.
- Hormonal fluctuations during these periods influence calcium homeostasis and bone metabolism.
Purpose of the Study:
- To review skeletal adaptations during pregnancy and lactation.
- To discuss potential causes and long-term consequences of pregnancy- and lactation-induced osteoporosis (PLO).
- To explore fracture healing during these physiological states.
Main Methods:
- Literature review of skeletal adaptations.
- Discussion of hormonal influences on bone.
- Speculation on the pathophysiology of PLO.
Main Results:
- Bone structure changes during pregnancy and lactation typically show recovery over time.
- Lactation-induced bone changes may correlate with breastfeeding duration and intensity.
- Long-term studies indicate minor, site-specific improvements in bone density and geometry.
- Pregnancy- and lactation-induced osteoporosis (PLO) is rare, with unknown mechanisms.
Conclusions:
- Maternal skeletal adaptations to pregnancy and lactation are generally reversible.
- Further research is needed to elucidate the mechanisms of PLO.
- Estrogen's role in fracture healing during pregnancy and lactation warrants investigation.
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