Effects of pregnancy and lactation-associated osteoporosis on children: analysis using linked mother and child data

INTRODUCTION: The health status of children born to mothers with pregnancy and lactation-associated osteoporosis (PLO) and impaired bone homeostasis remains unknown. This study aimed to investigate the effects of maternal PLO on child health, the PLO-predisposing factors related to such effects, and the incidence of the condition. MATERIALS AND METHODS: From a claims dataset comprising 172,730 mothers linked with their 210,124 children, mothers who developed fragility fractures between 5 months before and 12 months after delivery, along with their children, were defined as the PLO group. Healthy controls were randomly selected by matching maternal age and child sex. Body mass index (BMI), drug use, and maternal and pediatric diseases were compared between the two groups. RESULTS: Fifty-nine mothers and 65 children were included in the PLO group, and 11,556 mothers and 11,664 children served as the control group. The most common PLO fracture was a vertebral fracture, and delayed diagnosis was common. Maternal PLO had few adverse effects on child health. There were trends toward a higher frequency of birth asphyxia in singletons (P = 0.072) and low birth weight in twins (P = 0.070) in the case children, but with no significant differences. The incidence of PLO was estimated at 374 per million deliveries. Multiple delivery, maternal age ≥ 40 years, low BMI, heparin use, and ovulation disorder were identified as predisposing factors for PLO. CONCLUSION: There is little evidence that maternal PLO adversely affects child health. The predisposing factors for PLO suggest that caution is warranted regarding current advancements in reproductive technology.