Our findings suggest that although pregnancy and lactation are periods of physiological calcium loss, higher parity is not associated with an increased risk of postmenopausal osteoporosis; rather, it appears to confer a long-term protective effect. Osteoporosis is a significant public health burden. While parity induces transient bone loss, their long-term skeletal impact remains poorly understood. This study aimed to clarify the associations between parity, defined as the number of live births, and the risk of osteoporosis, osteoporotic fractures, and bone mineral density (BMD). We analyzed data from 119,969 women in the UK Biobank. Associations between parity and incident osteoporosis or fractures were evaluated using unweighted and inverse probability of treatment weighting Cox proportional hazards models. Generalized linear models assessed associations with femoral neck and lumbar spine BMD. Models were adjusted for sociodemographic, genetic, lifestyle, and clinical factors. Compared with nulliparous women, those with a parity of 2 or 3 exhibited a significantly reduced risk of osteoporosis in the weighted fully adjusted model. In addition, parity of 3 exhibited a significantly reduced risk of osteoporotic fracture compared with the nulliparous group. This protection was evident in women ≥ 60 years and those with normal body mass index. Parity was not significantly associated with areal BMD changes after full covariate adjustment. In women aged 40–69 years at baseline, a parity of 2 or 3 confers long-term protection against osteoporosis and osteoporotic fracture (a arity of 3), occurring independently of BMD changes. These findings support the integration of parity into clinical risk assessment tools, ultimately contributing to more effective osteoporosis prevention and a reduced fracture burden across women’s lifespan.
Brief rationale: To investigate associations between breastfeeding behaviours and maternal bone health at 10-year follow-up. Main result: Breastfeeding durations were not associated with DXA measurements. Significance of the paper: These findings add to the evidence that breastfeeding is not associated with adverse long-term maternal bone health. To investigate associations between breastfeeding behaviours and dual-energy X-ray absorptiometry (DXA) measurements of maternal bone health at 10-year follow-up. Associations with bone turnover markers (BTMs) were examined as exploratory secondary outcomes. This was an analysis of 196 women from the ROLO (Randomised cOntrol trial of a LOw glycaemic index diet in pregnancy to prevent macrosomia) longitudinal cohort study at 10-year follow-up. Data on demographics, lifestyle and breastfeeding were collected by questionnaire. DXA measurements were available for 171 participants and BTM measurements for 60. Exclusive breastfeeding duration, any breastfeeding duration and three mutually exclusive cumulative breastfeeding groups (never breastfed, breastfed for <12 months, and breastfed for ≥12 months) were each examined in relation to bone health outcomes. The mean (SD) age of participants was 42.8 (3.87) years and 97.9
In Mongolia, osteoporosis screening is difficult because advanced scans are scarce. In 356 adults aged 40 years or older, stronger handgrip strength was associated with a lower OSTA-defined osteoporosis risk category in both men and women, whereas lifestyle factors were not. Adding handgrip testing could improve low-cost screening strategies. Osteoporosis is a growing public health concern in Mongolia, where access to dual-energy X-ray absorptiometry (DXA) is limited. The Osteoporosis Self-Assessment Test (OSTA) provides a simple, low-cost alternative for identifying individuals at risk. This study aimed to examine factors associated with OSTA-defined osteoporosis risk categories among adults aged 40 years and older in Mongolia. A cross-sectional study was conducted among 356 adults (200 men, 156 women) recruited from two urban health units. Sociodemographic characteristics, lifestyle factors, medical history, and handgrip strength were assessed through structured interviews and standardized measurements. OSTA scores were categorized into low, moderate, and high risk based on established sex-specific thresholds. Group differences in categorical variables were evaluated using chi-square tests. Logistic regression models were performed separately for men and women to identify factors independently associated with the combined moderate/high OSTA risk category. Age, sex, educational level, comorbidities, and BMI were significantly associated with OSTA categories. Higher dominant handgrip strength was associated with lower odds of the combined moderate/high OSTA risk category in both men (OR 0.19, 95
Menopause is characterized by the rapid decline of estrogen exposure, resulting in accelerated bone loss superimposed on the gradual age-related decline in bone mass. This process is particularly relevant in India, where women experience menopause earlier than Western populations, thereby increasing lifetime fracture risk. Menopausal hormone therapy (MHT) has been evaluated extensively over the years for skeletal health, with consistent evidence demonstrating preservation of bone mineral density and reduction in vertebral and hip fractures, especially when initiated early after menopause. Although multiple concerns arose following the Women’s Health Initiative in terms of cardiovascular safety and breast cancer risk, leading to a decline in MHT use, subsequent analyses have supported a more favorable benefit–risk profile in appropriately selected younger postmenopausal women. Current evidence suggests that individualized MHT can also improve skeletal outcomes while benefiting menopausal symptoms and overall quality of life. This review revisits the evolving role of MHT in bone health in the Indian context.
The IMSS 2024 multicenter hip fracture (HF) registry showed an in-hospital mortality rate of 2.6
