A Meta-analysis Of Breastfeeding And Osteoporotic Fracture Risk In The Females

Purpose: Several epidemiologic studies have investigated that breastfeeding is associated with short-term bone loss in the women,but the long-term effect on osteoporotic fracture risk remains unclear.Thus,we conducted this meta-analysis to explore the potential association between breastfeeding and osteoporotic fracture risk in the females and possible does-response relationship between them.Methods: We searched Pub Med,Embase and Web of Science(ISI)for relevant articles associated between breastfeeding and osteoporotic fracture.Pooled relative risks(RRs)with 95% confidence intervals(CIs)were calculated with a random-effects model.Dose-response analysis was performed by restricted cubic spline.A sensitivity analysis was performed with one study removed at a time to assess whether the results could have been affected markedly by a single study.Funnel plot and Egger's test were used to examine publication bias.Results: Twelve articles including 14954 participants were identified.The pooled RRs of osteoporotic fracture for the highest vs lowest duration of breastfeeding were 0.84(95% CI: 67-1.05).The pooled RR was 0.70(95% CI: 0.49-0.99)and 0.66(95%CI: 0.47-0.93)in case-control studies,studies among postmenopausal women,respectively.In other subgroups,the results showed no significant association between breastfeeding and osteoporotic fracture.In dose-response analysis,we found a linear relationship of breastfeeding with osteoporotic fracture(P nonlinearity = 0.305).The dose-response analysis suggested that osteoporotic fractures risk decreased by 0.9% for one month increment of breastfeeding.Eight articles were included to explore the association between breastfeeding and hip fracture.For the highest vs lowest duration of breastfeeding,the pooled RR of hip fractures was 0.72(95% CI 0.52-0.99,I2 = 64.8%,P heterogeneity = 0.006).We conducted subgroup analysis stratified by menopausal status.The pooled RR(95% CI)was 0.52(0.27,1)among postmenopausal women.In dose-response analysis,we found a linear relationship of breastfeeding with osteoporotic hip fracture(P nonlinearity = 0.564).The dose-response analysis suggested that osteoporotic fractures risk decreased by 1.2% for one month increment of breastfeeding.Conclusions: Our meta-analysis revealed that breastfeeding was associated with the risk of osteoporotic fracture.Breastfeeding may well reduce the risk of osteoporotic hip fracture.