Plasma prolactin/oestradiol ratio at 38 weeks gestation predicts the duration of lactational amenorrhoea.
BACKGROUND
Fully breastfeeding women experience an amenorrhoea of variable duration. Our aim was to identify in pregnancy, endocrine markers that could predict the duration of subsequent lactational amenorrhoea.


METHODS
We studied 17 healthy women at 34 and 38 weeks gestation, and 1 and 3 months post-partum. The women fully breastfed until 6 months post-partum. During pregnancy, prolactin (PRL), oestrogens (total oestradiol, unconjugated oestrone, unconjugated oestriol), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEA-S), progesterone and placental lactogen, and during post-partum PRL, oestrogens and SHBG, were measured. Free oestradiol in pregnancy and post-partum was calculated.


RESULTS
Ten women experienced long (>6 months) and seven experienced short (<6 months) lactational amenorrhoea. At 38 weeks gestation, the women who experienced a long lactational amenorrhoea had twice as much PRL, about half the total oestradiol, lower SHBG concentration (P < 0.05, Student's t-test, Bonferroni modification) and similar free oestradiol concentration, compared with those who experienced short lactational amenorrhoea. The difference in PRL concentration persisted in post-partum postsuckling samples.


CONCLUSIONS
At 38 weeks gestation, the ratio PRL/oestradiol identified all individual women according to the subsequent duration of their lactational amenorrhoea, suggesting that duration of lactational amenorrhoea is conditioned during pregnancy.
Campino
C
C
Department of Endocrinología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.
Torres
C
C
Rioseco
A
A
Poblete
A
A
Pugin
E
E
Valdés
V
V
Catalán
S
S
Belmar
C
C
Serón-Ferré
M
M
D000328:Adult; D000568:Amenorrhea; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood*; D004964:Estriol / Q000097:blood; D004970:Estrone / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D010928:Placental Lactogen / Q000097:blood; D049590:Postpartum Period; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013997:Time Factors
D012738:Sex Hormone-Binding Globulin; D004970:Estrone; D011374:Progesterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D011388:Prolactin; D010928:Placental Lactogen; D004964:Estriol