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How does women's bone health recover after lactation? A systematic review and meta-analysis.

Publication ,  Journal Article
Grizzo, FMF; Alarcão, ACJ; Dell' Agnolo, CM; Pedroso, RB; Santos, TS; Vissoci, JRN; Pinheiro, MM; Carvalho, MDB; Pelloso, SM
Published in: Osteoporos Int
March 2020

This is a systematic review aiming to evaluate the recovery of bone mass after lactation-related loss. Bone loss is transitory with recovery depending on the return of menstruation and weaning, and several compensatory homeostatic mechanisms are involved to minimize any significant damage to the maternal skeleton. Lactation has been associated with significant temporary bone loss, especially during the exclusive breastfeeding period. In the bone recovery phase, there is wide methodological heterogeneity among clinical trials, including follow-up timing, methods and sites of bone measurements, and body composition changes. The purpose of this study is to perform a systematic review and meta-analysis aiming to evaluate the recovery rate of bone mass after lactation-related loss, including the PubMed, Web of Science, and Scopus databases, with no publication date restrictions. The following MeSH terms were used: "bone diseases," "bone resorption," "bone density," "osteoporosis," "calcium," "postpartum period," "weaning," "breast feeding," and "lactation." The inclusion criteria were as follows: prospective human studies in women of reproductive age and bone measurements with two assessments in the postpartum period at least: the first one within the first weeks of lactation and another one 12 months after delivery, 3 months following the return of menses or 3 months postweaning. This research was recorded on the Prospero database (CRD42018096586Bone). A total of 9455 studies were found and 32 papers met the inclusion criteria. The follow-up period ranged from one to 3.6 years postpartum. Lactation was associated with transient bone loss, with a strong tendency to recover in all the sites studied, depending on the return of menstruation and weaning. Small deficits in the microarchitecture of the peripheral skeleton may be present, especially in women with prolonged breastfeeding, but with no deficit regarding the hip geometry was found. Women with a successive gestation after prolonged lactation and women who had breastfed when adolescents had no significant bone loss. Bone loss related to lactation is transitory, and several compensatory homeostatic mechanisms are involved to minimize any significant damage to the maternal skeleton.

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Published In

Osteoporos Int

DOI

EISSN

1433-2965

Publication Date

March 2020

Volume

31

Issue

3

Start / End Page

413 / 427

Location

England

Related Subject Headings

  • Prospective Studies
  • Pregnancy
  • Postpartum Period
  • Osteoporosis
  • Lactation
  • Infant, Newborn
  • Humans
  • Female
  • Endocrinology & Metabolism
  • Breast Feeding
 

Citation

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ICMJE
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Grizzo, F. M. F., Alarcão, A. C. J., Dell’ Agnolo, C. M., Pedroso, R. B., Santos, T. S., Vissoci, J. R. N., … Pelloso, S. M. (2020). How does women's bone health recover after lactation? A systematic review and meta-analysis. Osteoporos Int, 31(3), 413–427. https://doi.org/10.1007/s00198-019-05236-8
Grizzo, F. M. F., A. C. J. Alarcão, C. M. Dell’ Agnolo, R. B. Pedroso, T. S. Santos, J. R. N. Vissoci, M. M. Pinheiro, M. D. B. Carvalho, and S. M. Pelloso. “How does women's bone health recover after lactation? A systematic review and meta-analysis.Osteoporos Int 31, no. 3 (March 2020): 413–27. https://doi.org/10.1007/s00198-019-05236-8.
Grizzo FMF, Alarcão ACJ, Dell’ Agnolo CM, Pedroso RB, Santos TS, Vissoci JRN, et al. How does women's bone health recover after lactation? A systematic review and meta-analysis. Osteoporos Int. 2020 Mar;31(3):413–27.
Grizzo, F. M. F., et al. “How does women's bone health recover after lactation? A systematic review and meta-analysis.Osteoporos Int, vol. 31, no. 3, Mar. 2020, pp. 413–27. Pubmed, doi:10.1007/s00198-019-05236-8.
Grizzo FMF, Alarcão ACJ, Dell’ Agnolo CM, Pedroso RB, Santos TS, Vissoci JRN, Pinheiro MM, Carvalho MDB, Pelloso SM. How does women's bone health recover after lactation? A systematic review and meta-analysis. Osteoporos Int. 2020 Mar;31(3):413–427.
Journal cover image

Published In

Osteoporos Int

DOI

EISSN

1433-2965

Publication Date

March 2020

Volume

31

Issue

3

Start / End Page

413 / 427

Location

England

Related Subject Headings

  • Prospective Studies
  • Pregnancy
  • Postpartum Period
  • Osteoporosis
  • Lactation
  • Infant, Newborn
  • Humans
  • Female
  • Endocrinology & Metabolism
  • Breast Feeding