Bone-mass peak in multiparity and reduced risk of bone-fractures in menopause

• Published in: International journal of gynecology and obstetrics Vol. 76; no. 3; pp. 285 - 291
• Main Authors: Cure-Cure, C, Cure-Ramı́rez, P, Terán, E, López-Jaramillo, P
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.03.2002; Elsevier Science
• Subjects: Aged; Biological and medical sciences; Bone Density - physiology; Bone Diseases, Metabolic - epidemiology; Colombia - epidemiology; Diseases of the osteoarticular system; Female; Fractures, Bone - epidemiology; Gestational bone-mass peak; Humans; Medical sciences; Menopause; Middle Aged; Osteopenia; Osteoporosis; Osteoporosis, Postmenopausal - epidemiology; Osteoporosis. Osteomalacia. Paget disease; Parity - physiology; Pregnancy; Risk Factors; South America; Colombia; America; Pregnancy; Osteoporosis; Menopause; Osteopenia; Gestational bone-mass peak; Human; Diseases of the osteoarticular system; Risk factor; Postmenopause; Female; Bone disease; Bone mineral density; Fracture; Multiparity
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/S0020-7292(01)00583-5

Objectives: Pregnancy has been proposed as a risk factor for the development of osteoporosis; however, the results are controversial. Women in Colombia are multiparous, and therefore they represent an ideal population for the investigation of the effect of parity on osteoporosis. Methods: The study included 1855 post-menopausal Hispanic women from Barranquilla, Colombia who were referred to our osteoporosis clinic for a routine evaluation of their bone mineral status. Bone mineral density (BMD, g/cm 2) was measured using dual energy X-ray absorptiometry. Total body, femoral and lumbar areas were scanned. Results: BMD of total body, hip and legs ( P<0.0001), Ward's area ( P<0.002) and intertrochanteric area ( P<0.003) was high in women with at least one delivery in comparison with nulliparous women. Total mineral and calcium body contents were also high in women after second delivery. A history of fractures was found in 22.9% ( n=425) of the study women. The relative risk for bone-fractures was high (O.R. 0.41; P<0.000002) in nulliparous women in comparison to multiparous women. In addition, osteopenia (O.R. 2.01; P=0.008) and osteoporosis (O.R. 3.99; P=0.0004) were most often present in nulliparous women in comparison to multiparous women. Conclusions: Pregnancies in this population appear to be a protective factor against development of osteoporosis. The increase in total mineral and calcium contents was related to the number of pregnancies, suggesting the existence of a bone mass peak during pregnancy.