AIMS: Fractures during childhood and adolescence are common as peak bone mass has not yet been accrued. Previous studies have reported that offspring are at higher risk of a fragility fracture if one or both parents have experienced a fracture, however, it is not known if this association holds true for fractures experienced in early life, and if so, whether there are differential risk profiles across the sexes. Therefore, this study aimed to determine the associations between maternal and paternal fracture history and offspring fracture risk in early life. METHODS: At baseline, Geelong Osteoporosis Study participants self-reported fracture history for themselves and their parents. This analysis included personal fracture data relating to birth until 20 years of age and parental fracture for 1336 female and 1174 male participants who provided complete data, including age and site of fracture. Multivariable logistic regression models were used to assess the odds of participant fracture in childhood or adolescence in association with paternal and/or maternal fracture. RESULTS: In total, 141 (12.2 %) female and 323 (25.7 %) male participants reported at least one fracture by age 20 years. For females, there were 247 maternal and 211 paternal parents with fractures and in males, 233 maternal and 189 paternal fractures. A maternal fracture was associated with an increased odds of early life fracture in female participants (OR 1.86
95 % CI 1.17-2.95) but not male participants (OR 1.16
95 % CI 0.81-1.65), while a paternal fracture was associated with an increased odds of early life fracture in males (OR 1.47
95 % CI 1.01-2.14) but not females (OR 1.61
95 % CI 0.98-2.64). CONCLUSION: Parental fracture history appears to have sex-specific associations with offspring early life fracture risk. Whereby maternal fracture history is associated with an increased risk of early life fracture in females, while paternal fracture history is associated with early life fracture risk in males.