HYPERPROLACTINEMIA, INSULIN RESISTANCE AND METABOLIC PROFILE IN POSTPARTUM WOMEN WITH DELAYED LACTATION: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Delayed lactation, defined as the onset of lactogenesis beyond three days postpartum, is a common postpartum concern. This study investigates the relationship between prolactin levels, insulin resistance, and metabolic parameters in mothers with delayed versus normal lactation. Methods: This prospective observational study included 320 postpartum mothers, categorized into delayed lactation (n=185) and normal lactation (n=135) groups. Serum prolactin, insulin and lipid profile parameters were assessed. Anthropometric measurements, blood pressure, and maternal age were recorded. Statistical analysis was conducted using Chi-square tests and ANOVA. Results: Delayed lactation was most prevalent in mothers aged 26–35 years (70.2%) and was significantly associated with increasing maternal age (p < 0.0001). Mean prolactin levels were higher in the delayed lactation group (1915.18 ± 2233.67 mIU/L) compared to the normal group (1543.93 ± 1532.16 mIU/L), though statistically weakly significant (p = 0.0967). However, prolactin status (hyper-, hypo-, normal) showed significant association with lactation outcome (p = 0.0017). No significant association was found between prolactin status and insulin levels, BMI, or blood pressure. Lipid abnormalities, particularly elevated cholesterol and LDL, were more prevalent in hyperprolactinemia cases, with some associations reaching statistical significance. Conclusion: Prolactin levels were not associated with markers of insulin resistance or metabolic parameters. However, higher prolactin levels were significantly associated with delayed lactation, indicating a reflex compensatory rise in prolactin to stimulate milk synthesis. Hyperprolactinemia in this context appears to be a physiological response rather than a pathological state.