Parity and lactation are not associated with incident fragility fractures or radiographic vertebral fractures over 16 years of follow-up: Canadian Multicentre Osteoporosis …

S Cooke-Hubley, Z Gao, G Mugford, SM Kaiser… - Archives of …, 2019 - Springer
S Cooke-Hubley, Z Gao, G Mugford, SM Kaiser, D Goltzman, WD Leslie, KS Davison…
Archives of Osteoporosis, 2019Springer
Parity and lactation showed no associations with incident clinical fragility fractures or
radiographic vertebral compression fractures in the 16-year CaM os prospective study.
Parity was associated with slightly greater decline in femoral neck but not hip or spine areal
bone mineral density (aBMD), while lactation showed no associations with aBMD change.
Purpose Pregnancy and especially lactation cause loss of bone mass and microarchitectural
changes, which temporarily increase fracture risk. After weaning, aBMD increases but …
Summary
Parity and lactation showed no associations with incident clinical fragility fractures or radiographic vertebral compression fractures in the 16-year CaMos prospective study. Parity was associated with slightly greater decline in femoral neck but not hip or spine areal bone mineral density (aBMD), while lactation showed no associations with aBMD change.
Purpose
Pregnancy and especially lactation cause loss of bone mass and microarchitectural changes, which temporarily increase fracture risk. After weaning, aBMD increases but skeletal microarchitecture may be incompletely restored. Most retrospective clinical studies found neutral or even protective associations of parity and lactation with fragility fractures, but prospective data are sparse. CaMos is a randomly selected observational cohort that includes ~ 6500 women followed prospectively for over 16 years.
Methods
We determined whether parity or lactation were related to incident clinical fragility fractures over 16 years, radiographic (morphometric and morphologic) vertebral fractures over 10 years, and aBMD change (spine, total hip, and femoral neck) over 10 years. Parity and lactation duration were analyzed as continuous variables in predicting these outcomes using univariate and multivariate regression analyses.
Results
Three thousand four hundred thirty-seven women completed 16 years of follow-up for incident clinical fractures, 3839 completed 10 years of morphometric vertebral fracture assessment, 3788 completed 10 years of morphologic vertebral fracture assessment, and 4464 completed 10 years of follow-up for change in aBMD. In the multivariate analyses, parity and lactation duration showed no associations with clinical fragility fractures, radiographic vertebral fractures, or change in aBMD, except that parity associated with a probable chance finding of a slightly greater decline in femoral neck aBMD.
Conclusions
Parity and lactation have no adverse associations with clinical fragility or radiographic vertebral fractures, or the rate of BMD decline over 10 years, in this prospective, multicenter study of a randomly selected, population-based cohort of women.
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