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Pregnancy and lactation have no long-term deleterious effect on measures of bone mineral in healthy women: a twin study^1,2,3

¹ From the University of Melbourne, Department of Medicine (Royal Melbourne Hospital) Parkville, Australia (LMP, JLA, CM, MGF, BK, and JDW), and the School of Health Sciences, Deakin University, Burwood, Australia (CAN).

Background: The long-term effects of pregnancy and lactation on measures of bone mineral in women remain unclear.

Objective: We studied whether pregnancy or lactation has deleterious long-term effects on bone mineral in healthy women.

Design: We measured bone mineral density (BMD; g/cm²) in women aged 18 y. Analyses were performed on 3 data sets: study 1, 83 female twin pairs (21 monozygous and 62 dizygous) aged ( ± SD) 42.2 ± 15.5 y who were discordant for ever having been pregnant beyond 20 wk; study 2, 498 twin pairs aged 42.3 ± 15.0 y; and study 3, 1354 individual twins, their siblings, and family members.

Results: In study 1, there were no significant within-pair differences in unadjusted BMD or BMD adjusted for age, height, and fat mass at the lumbar spine or total-hip or in total-body bone mineral content (BMC; kg) (paired t tests). In study 2, there was no significant within-pair difference in measures of bone mineral or body composition related to the within-pair difference in number of pregnancies. In study 3, subjects with 1 or 2 (n = 455) and 3 pregnancies (n = 473) had higher adjusted lumbar spine BMD (2.9% and 3.8%, respectively; P = 0.001) and total-body BMC (2.2% and 3.1%; P < 0.001) than did nulliparous women (n = 426). Parous women who breast-fed had higher adjusted total-body BMC (2.6%; P = 0.005), total-hip BMD (3.2%; P = 0.04), and lower fat mass (10.9%; P = 0.01) than did parous non-breast-feeders.

Conclusion: We found no long-term detrimental effect of pregnancy or breast-feeding on bone mineral measures.

Key Words: Pregnancy • lactation • bone mineral density • twins • bone mineral content • women

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