Bone metabolism in pregnancy and lactation
Anna CAPOZZI, Giovanni SCAMBIA, Stefano LELLO
Abstract
INTRODUCTION: Different hormonal mechanisms regulate bone metabolism during pregnancy and lactation. In both those periods of life, a fine modulation of calcium metabolism is necessary to meet the needs of foetus and new-born. EVIDENCE ACQUISITION: We reviewed scientific literature on the topic "osteoporosis," "pregnancy" and "lactation," evaluating the most relevant data from original articles, reviews and meta-analyses. EVIDENCE SYNTHESIS: Pregnancy- and lactation-associated bone loss and related fractures rarely occur and, generally, clinicians must manage it case to case, since there is not a unique guideline. Fortunately, bone mineral density (BMD) usually tends to recover within 12 months after weaning, thus, it could be reasonable waiting of assessing the effective magnitude of bone mass regain before starting any pharmacological treatment. CONCLUSIONS: Osteoporosis and/or fragility fractures remain uncommon events associated with gestation and/or breastfeeding. The management of bone loss and/or fractures during those periods is generally conservative and a tailored approach is advisable in the absence of any specific recommendation in this field.