Changes in bone mineral status and bone size during pregnancy and the influences of body weight and calcium intake.

BACKGROUND: Calcium may be mobilized from the maternal skeleton during pregnancy, which may be influenced by several factors.

OBJECTIVE: The objective was to investigate changes in bone mineral status and size during pregnancy and to consider the influences of body weight and calcium intake.

DESIGN: Thirty-four British women were studied before pregnancy and 2 wk postpartum (Preg). Eighty-four nonpregnant, nonlactating (NPNL) women were studied over a corresponding time. Bone mineral content (BMC), bone area (BA), areal bone mineral density (aBMD), and BA-adjusted BMC of the whole-body, lumbar spine, radius, and hip were measured by dual-energy X-ray absorptiometry.

RESULTS: The Preg group experienced significant decreases in BMC, aBMD, and BA-adjusted BMC at the whole-body, spine, and total hip of between 1% and 4%. Whole-body BMC increased in the NPNL group, and aBMD and BA-adjusted BMC decreased at the spine and hip by 0.5% to 1%. Whole-body BMC decreased in the Preg group by -2.16 +/- 0.46%, equivalent to -2.71 +/- 0.43% relative to the NPNL group (P < or = 0.001). Weight change was a positive predictor of skeletal change at the spine, hip, and radius in both groups. Differences between the Preg and NPNL groups in change in BA-adjusted BMC, after correction for weight change and other influences, were as follows (P < or = 0.01): whole-body, -1.70 +/- 0.25%; spine, -3.03 +/- 0.72%; and total hip, -1.87 +/- 0.60%. Calcium intake was not a significant predictor of skeletal change in either group.

CONCLUSIONS: Pregnancy is associated with decreases in whole-body and regional bone mineral status sufficient to make a sizeable contribution to maternal and fetal calcium economy. Calcium intake is not a significant predictor of the skeletal response to pregnancy in well-nourished women.