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  • Title: Lactational amenorrhea/anovulation and some of their determinants: a comparison of well-nourished and undernourished women.
    Author: Wasalathanthri S, Tennekoon KH.
    Journal: Fertil Steril; 2001 Aug; 76(2):317-25. PubMed ID: 11476779.
    Abstract:
    OBJECTIVE: To study the effect of maternal nutritional status and some other possible determinants on lactational amenorrhea/anovulation. DESIGN: Prospective matched-pairs study. SETTING: Postpartum wards and community and academic settings. PATIENT(S): Thirty matched pairs of otherwise healthy, well-nourished (body mass index > or = 26.00 kg/m2) and undernourished (body mass index < or = 19.00 kg/m2) postpartum women were selected. INTERVENTION(S): Infant feeding pattern was recorded weekly, and infant weights, maternal body mass index, and maternal PRL levels were estimated every 4 weeks until resumption of menstruation. Ovulatory activity was determined using urinary estrone and pregnanediol glucuronide concentrations. MAIN OUTCOME MEASURE(S): Time of resumption of menstruation, regular and ovulatory. RESULT(S): Well-nourished women resumed regular menstruation significantly earlier than undernourished women but resumed ovulatory menstruation at almost the same time. Undernourished women had fewer anovulatory cycles preceding first postpartum ovulation and a higher prevalence of formula feeding. Effect of body mass index on lactational amenorrhea became nonsignificant when nonintroduction of formula feeds, maternal age, and socioeconomic status were controlled for. CONCLUSION(S): Improved maternal nutritional status has no significant effect on fertility: ovulation is not advanced despite early resumption of regular menstruation.
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