title: Lactational amenorrhea/anovulation and some of their determinants: a comparison of well-nourished and undernourished women.
abstract: OBJECTIVE
  To study the effect of maternal nutritional status and some other possible determinants on lactational amenorrhea/anovulation.
  
  
  METHODS
  Prospective matched-pairs study.
  
  
  METHODS
  Postpartum wards and community and academic settings.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Time of resumption of menstruation, regular and ovulatory.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Improved maternal nutritional status has no significant effect on fertility: ovulation is not advanced despite early resumption of regular menstruation.
authors.affiliation: University of Colombo, Sri Lanka.
authors.forename: S
authors.initials: S
authors.lastname: Wasalathanthri
authors.forename: K H
authors.initials: KH
authors.lastname: Tennekoon
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000503:physiopathology*; D000858:Anovulation / Q000503:physiopathology*; D015992:Body Mass Index; D001942:Breast Feeding; D015331:Cohort Studies; D004970:Estrone / Q000652:urine; D005260:Female; D005508:Food Deprivation; D006801:Humans; D007223:Infant; D007225:Infant Food; D007774:Lactation; D009752:Nutritional Status; D049590:Postpartum Period; D011276:Pregnanediol / Q000031:analogs & derivatives* / Q000652:urine; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies
chemical_list: C022270:pregnanediol-3 alpha-glucuronide; D004970:Estrone; D011388:Prolactin; D011276:Pregnanediol