Female reproductive history and the skeleton-a review.

Objective: Evaluate changes in bone mineral density (BMD) during pregnancy and lactation and evaluate BMD and fracture risk in nulliand multiparous women. Design: Review article Setting: Manuscript published in PubMed from 1966. Main outcome measure: Rate of BMD changes during pregnancy and lactation and BMD and fracture incidence in nulliand multiparous women. Results: Both a pregnancy and six month lactation was associated with an BMD loss of up to 5%. In spite of this, women with many children and a long total period of lactation similar or higher BMD and similar or lower fracture incidence compared to their peers who have not given birth Conclusions: The BMD loss found to be associated with a pregnancy and lactation must be regarded as a finding without clinical relevance, as multiparous women have similar or lower fracture risk than nulliparous women.