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At least 19 recordsLinked to original sources

PubMed2000

Prostaglandins for prevention of postpartum haemorrhage.

BACKGROUND: Prostaglandins have mainly been used for postpartum haemorrhage when other measures fail. Misoprostol, a newer and cheaper prostaglandin E1 analogue, has sometimes been used for management of the third stage of labour. OBJECTIVES: The objective of this review was to assess the effects of prophylactic prostaglandin use in the third stage of labour. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Researchers in the field were also contacted. Date of the latest search: December 1999. SELECTION CRITERIA: Randomized or quasi-randomized trials comparing a prostaglandin agent with another uterotonic or no prophylactic uterotonic (nothing or placebo) as part of management of the third stage of labour. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality was assessed by one reviewer. MAIN RESULTS: Seven trials were included. There were six trials of injectable prostaglandins and one of rectal misoprostol. The main limitations of these studies are their small sample sizes and lack of blind assessment of the outcomes. Injectable prostaglandins were associated with decreased blood loss (weighted mean difference -72 millilitres, 95% confidence interval -70 to -75) and shortened duration of third stage when compared to other uterotonics. Severe postpartum haemorrhage (1000 millilitres or more blood loss) occurred in two of four studies and was seen in fewer women receiving prostaglandins, though the difference was not statistically significant. Adverse effects (vomiting, diarrhoea and abdominal pain) were more common with prostaglandins when compared to other uterotonic agents. REVIEWER'S CONCLUSIONS: Although injectable prostaglandins appear to be effective in preventing postpartum haemorrhage, concerns about safety and costs limit their suitability for routine prophylactic management of third stage of labour. However, injectable prostaglandins should continue to be used for the treatment of postpartum haemorrhage when other measures fail. Misoprostol is cheap, stable and seems to be safe. Trials addressing the effectiveness of misoprostol are continuing.

Female↗

PubMed1998

Postpartum psychosis and postpartum thyroiditis.

The term postpartum psychosis refers to a group of severe and heterogeneous disorders with psychotic symptoms that occur most frequently in the context of a mood disorder during the postpartum period. We report a case of 'postpartum psychosis' possibly associated with postpartum thyroiditis in a 29 year-old woman. The appearance of psychotic symptoms was chronologically related to the onset of postpartum thyroiditis and resolution of psychosis synchronized with the achievement of biochemical euthyroidism. The patient had typical symptoms of 'classic postpartum psychosis' (a historical term not included in DSM-IV, but used frequently by many physicians to describe diagnostic and therapeutic challenges posed by puerperal psychoses). Three months postpartum, the patient began to believe that she was pregnant with the Christ child, although she was not pregnant. Her delusions resolved around the 'pregnancy' and harm to her 'unborn' child. She also believed that her child (Jesus) was going to be killed. Other key symptoms included hallucinations, mixed mood symptoms, agitation and transient disorientation. Her DSM-IV diagnosis on admission was major depression with psychotic features and her discharge diagnosis (most likely diagnosis) was psychotic disorder due to thyrotoxicosis caused by postpartum thyroiditis. The differential diagnosis of co-occurring psychosis and postpartum thyroiditis can be examined relative to four possibilities: (1) psychosis due to thyrotoxicosis caused by postpartum thyroiditis; (2) a coincidence (no association between psychosis and postpartum thyroiditis); (3) precipitation of psychotic symptoms and disorientation related to a postpartum thyroiditis in a woman with a pre-existing mood disorder; or (4) both psychosis and thyroiditis caused by a pre-existing defect in autoimmunity. The authors stress the importance of early diagnosis and prompt treatment of postpartum psychosis. They discuss the indications for thyroid screening in postpartum psychoses. Further research is needed to clarify the nosology and mechanisms of severe postpartum disorders and to elucidate treatment-relevant and etiologically-distinct subsets of postpartum psychosis.

Adult↗

PubMed2001

The effects of postpartum stress and social support on postpartum women's health status.

BACKGROUND: Eastern sociocultural systems differ in many ways from Western ones, and these differences influence many aspects of the postpartum period. AIM: The purpose of this study was to determine postpartum women's health status in the wider social context of the Taiwanese family after women return home from the hospital or clinic. METHOD: A longitudinal study was conducted with data collected at the first, the third, and the fifth weeks of the postpartum period. Five hundred and twenty-six postpartum women were included in the study using stratified sampling from clinics and hospitals in Kaohsiung City in the southern part of Taiwan. The Hung Postpartum Stress Scale (HPSS), Smilkstein's Social Support Scale, and the Chinese Health Questionnaire were used to obtain information about the women's postpartum stress, social support, and health status at each time point. Data were analysed with factor analysis, repeated measures MANOVA, and multiple logistic regression. RESULTS: Three factors associated with postpartum stress were identified by factor analysis: (1) maternity role attainment, (2) lack of social support, and (3) body changes. Furthermore, the level of postpartum stress at the third and the fifth postnatal weeks was higher than at the first. Social support scores at this postnatal week were the highest among the three points in time. In addition, 29%, 41% and 41% of the women at the first, third, and fifth weeks, respectively, had minor psychiatric morbidity. CONCLUSIONS: Because the postpartum women's self-reported stress is relatively low whereas the social support is relatively high, especially from the family, this confirms Pillsbury's conclusion regarding the significance of social support during the Chinese women's postpartum period. The study also showed that the three factors associated with postpartum stress were important predictors of postpartum women's health status. Future studies should compare the level of postpartum stress, social support, and women's health status in both Western and Eastern cultures.

Adult↗

PubMed1994

[Postpartum adjustment of women who were home during the "traditional Chinese one month postpartum period of confinement" and those who were in maternity care centers].

The purpose of this study was to explore the difference in postpartum adjustment between women who were at home for there "doing the month" and those who stayed in a maternity care center. A repeated measures design was conducted, with data collected at 1 and 4 weeks postpartum. A total of 120 postpartum women participated in this study. Data were analyzed by factor analysis to determine the relationships within categories of postpartum strssors and depression. Then, the data were analyzed by 2 x 2 repeated measure MANOVA to determine the variations among groups and time. The results indicated that women who were in maternity centers for the "doing the month" perceived significantly higher stress than did the home group, and that women perceived higher stress at 4 weeks postpartum than at 1 week postpartum. Factor analysis of the data defined four categories of postpartum stress. It was found that women at maternity care centers perceived significantly higher stress from factors named, "stress from lacking of support system" and "stress from identifying maternal role". In addition, women doing the month at maternity care centers showed significantly higher depression level than women doing the month at home. However, there is no significant difference in postpartum stress and postpartum depression between time 1 (1 week postpartum) and time 2 (4 weeks postpartum).

Adaptation, Psychological↗

PubMed2000

Caregiver support for postpartum depression.

BACKGROUND: Supportive relationships during the perinatal period may enhance a mother's feeling of wellbeing and control. Support to women during labour and after birth has shown benefits and this may also be the case for mothers with postpartum depression. OBJECTIVES: The objective of this review was to assess the effect of professional and/or social support interventions for the treatment of postpartum depression. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing additional support from caregivers with usual forms of care in the postpartum period, in women who were clinically depressed in the six months after giving birth. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted by both reviewers. Study authors were contacted for additional information. MAIN RESULTS: Two studies involving 137 women were included. There is potential for bias in at least one study, due to large numbers of women refusing to take part in the trial as well as significant losses to follow-up during the trial. Treatment of postpartum depression with support was associated with a reduction in depression at 25 weeks after giving birth (odds ratio 0.34, 95% confidence intervals 0.17 to 0.69). REVIEWER'S CONCLUSIONS: There is some indication that professional and/or social support may help in the treatment of postpartum depression. The types of support should be investigated to assess which models are most effective.

Caregivers↗

PubMed1999

Postpartum mood and anxiety disorders: a guide for the nonpsychiatric clinician with an aside on thyroid associations with postpartum mood.

This article summarizes the considerable progress that has been made in recent years in our understanding of the risks of pregnancy-associated mood and anxiety disorders, effective somatic and nonsomatic treatments for those disorders, and the risks and benefits of psychotropic medications during pregnancy and breast-feeding. Ten to 15% of women develop syndromal depressions within the first 2 to 3 months postpartum, making this the most common serious medical complication of the puerperium. Prior history of depressive disorders, lack of social support, and stressful life events all increase the risk of postpartum depression. Psychotic mood disorders (commonly called postpartum psychosis) occur after approximately 1 to 2 deliveries per 1000. To ensure safety, women who develop postpartum psychotic symptoms should be hospitalized. History of bipolar illness increases the risk of postpartum psychosis to as much as 25%. Prior episodes of postpartum psychosis further increase the risk to 50%-75%. The risk of first onset or exacerbation of panic disorder or obsessive-compulsive disorder appears to increase during pregnancy and the puerperium. Postpartum mood and anxiety disorders are highly responsive to psychotherapy and in more serious cases, to medication. Fortunately, several classes of psychotropic medications, especially tricyclic and selective serotonin reuptake inhibitor antidepressants, appear to be reasonable safe during pregnancy and breast-feeding. Electroconvulsive therapy is the most effective treatment for very severe postpartum mood disorders, including postpartum psychosis. Preliminary results are also presented that suggest that lower range total and free thyroxine concentrations during late pregnancy are related to postpartum depressive symptoms.

Anxiety Disorders↗

PubMed2002

Depression in postpartum and non-postpartum women: prevalence and risk factors.

OBJECTIVE: The aim of the study was to assess the prevalence of depression in postpartum women as compared with non-postpartum women, and to identify risk factors of depression in both groups. METHOD: A population based questionnaire study was performed among women 18-40 years in two municipalities in Norway in 1998-1999. A total of 2,730 women were included, of whom 416 were in the postpartum period. RESULTS: The prevalence of depression was higher in non-postpartum as compared with postpartum women. High scores on the life event scale, a history of depression and a poor relationship to the partner were associated with depression in both postpartum and non-postpartum women. When controlling for the identified risk factors of depression the odds-ratio for depression in the postpartum period was 1.6 (95% CI: 1.0-2.6). CONCLUSION: The risk for depression was increased in the postpartum period, when controlling for the uneven distribution of risk factors.

Adult↗

PubMed2003

Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum.

OBJECTIVES: (1) To describe the relative importance of gestational weight gain, postpartum exercise, food intake and breastfeeding to weight change from early pregnancy to 1 y postpartum; and (2) to identify subgroups of women at greatest risk for major weight gain surrounding childbearing. DESIGN: A prospective cohort study of women who registered for obstetrical care in a hospital and primary care clinic system serving a 10 county area of upstate New York. SUBJECTS: A total of 540 healthy adult women who gave birth to full-term singleton infants. MEASUREMENTS: Sociodemographic characteristics, exercise, food-related behaviors and breastfeeding were assessed using the medical record and a mailed questionnaire. Body weight was measured at prenatal visits and 1 y postpartum. Weight retained and major weight gain (4.55 kg) at 1 y postpartum were the main outcomes. ANALYSIS: Linear and logistic regression analyses were conducted. RESULTS: Women were on average 1.51+/-5.95 kg heavier at 1 y postpartum than they were in early pregnancy. Nearly 25% of women experienced a major weight gain of 4.55 kg or more at 1 y postpartum. Gestational weight gain, exercise frequency, change in food intake and breastfeeding were each significantly related to postpartum weight retention. With the exception of breastfeeding, all of these factors were also associated with major weight gain. Women under 20 y or over 40 y at delivery, and single women retained significantly more weight. Lower income women with gestational weight gains above the Institute of Medicine (IOM) range retained 3.73 kg more than lower income women who gained within the range. They were also 4.7 times more likely to experience major weight gain with childbearing. The impact of exceeding the IOM gestational weight gain guidelines was three times greater in lower income women than it was in higher income women. CONCLUSION: Gestational weight gain, postpartum exercise frequency, and food intake are significantly associated with weight change from early pregnancy to 1 y postpartum and major weight gain with childbearing. Lower income women who gain more weight in pregnancy than the IOM recommends are at high risk for major weight gain with childbearing.

Adult↗

PubMed2001

Postpartum thyroid dysfunction and postpartum depression: are they two linked disorders?

OBJECTIVE: Postpartum has been considered as a period of risk for developing postpartum depression (PD) by some but not all authors, and this PD has been linked with postpartum thyroid dysfunction (PPTD). The major aim of this study was to evaluate the relation between the presence of PPTD and PD. DESIGN AND PATIENTS: Six hundred and forty-one healthy Caucasian women recruited between their 36th week of pregnancy and fourth day postpartum underwent clinical and laboratory evaluation and were checked again at 1 (n = 605), 3 (n = 552), 6 (n = 574), 9 (n = 431), and 12 (n = 444) months postpartum. MEASUREMENTS: At baseline and at each clinical evaluation, Beck Depression Inventory (BDI) was administered to screen PD. The definitive diagnoses of PD was performed by a psychiatrist according to the DSM-III-R criteria. At each visit, we determined serum free T4 and TSH concentrations. Thyroperoxidase and thyroglobulin antibodies were determined only in patients with abnormal hormone concentrations. Postpartum thyroiditis (PPT) was considered to be present in women with overt or subclinical transient hyperthyroidism between 1 and 3 months postpartum and/or overt or subclinical hypothyroidism between 3 and 6 months postpartum. RESULTS: Fifty-six women developed postpartum thyroid dysfunction (PPTD), corresponding to an incidence rate of 11%: 45 with PPT [incidence rate 7.8%; confidence interval (CI) 5.6-10%], eight with Graves' disease (incidence rate 1.5%; CI 0.5-2.5%) and three with nonpalpable toxic thyroid adenoma (incidence rate 0.5%; CI 0-1.5%). Five hundred and eighty of the evaluated women (incidence rate 90.5%; CI 95% 88.2-92.8) presented BDI scores below 21 and therefore the PD diagnoses was excluded. In 50 cases (incidence rate 7.8%; Cl 95% 5.7-9.8), we detected a BDI score over 21 in some evaluations, but the PD diagnosis was not confirmed. Another 11 (incidence rate 1.7%; CI 95% 0.7-2.7) were diagnosed as having PD and required psychiatric treatment. None of the PPTD was diagnosed as having PD. The BDI scores frequency over 21 was similar between healthy women and those with PPTD. Patients with a previous history of depression developed PD more often (P < 0.0001). One hundred and ninety women breast fed their babies for more than 2 months, without observing a higher PD rate or BDI scores over 21 (P = 0.5). CONCLUSIONS: We found a general PD incidence rate of 1.7% in our group of patients. This figure is not higher in women with hormone abnormalities caused by PPTD. Women with a past history of depression present a higher risk of PD while those who breast fed did not have an increased risk.

Adenoma↗

PubMed2002

Postpartum thyroiditis in India: prevalence of postpartum thyroiditis in Kashmir Valley of Indian sub-continent.

Various studies have reported a spectrum of thyroid dysfunction in the postpartum period. Postpartum thyroiditis is a syndrome of thyroid dysfunction that occurs in the first year after parturition. Prevalence of postpartum thyroiditis has been reported to vary from 3 to 6 percent in different regions of the world. Kashmir Valley is inhabited by a relatively homogeneous racial group and the Valley has been documented to have significant iodine deficiency. We studied the prevalence and pattern of postpartum thyroiditis in an urban region of this Valley. 120 women were registered within first month of postpartum period for the study along with one hundred controls. Of these 120 women, 104 reported for follow-up at 3 months postpartum and 106 reported for follow-up at 6 months postpartum. Initial and subsequent clinical details at follow-up were recorded on a pre-determined questionnaire. Overall, postpartum thyroiditis (PPT) was seen in 8 (7%) study subjects. Of these 8 patients with PPT, 4 had biochemical evidence of thyrotoxicosis at first month, 3 developed biochemical thyrotoxicosis at 3-month follow-up while as one study subject developed thyrotoxicosis at 6 months. Most of these subjects were antithyroid antibodies (anti-microsomal and anti-thyroglobulin) positive. We conclude that iodine deficient status of the community doesn't seem to influence the incidence of PPT.

Antibodies, Antinuclear↗

PubMedDate not supplied

Postpartum depression and postpartum adaptation: overlapping constructs?

In order to examine the course of normal postpartum adjustment compared to the symptomatology of postpartum depression, 25 postpartum women who met Research Diagnostic Criteria for either major or minor depression were compared to 24 non-depressed postpartum women. The Schedule for Affective Disorders and Schizophrenia (SADS) and the Beck Depression Inventory (BDI) were administered to all subjects. Results suggest that sleep disturbances and loss of sexual interest are common concomitants of normal postpartum adjustment. A discriminant function analysis indicated that the cognitive-affective symptoms of loss of energy, guilt, difficulties in concentration, and loss of interest in usual activities discriminated between depressed and non-depressed women most efficiently. Finally, there was a lack of concordance between the BDI and the SADS interviews, which suggests that the BDI may not be an appropriate instrument for diagnosing depression in a postpartum sample.

Adaptation, Psychological↗

PubMed1991

Changes in natural killer cell activity in normal pregnant and postpartum women: increases in the first trimester and postpartum period and decrease in late pregnancy.

Changes in the activity and number of natural killer (NK) cells in peripheral blood in normal pregnant and postpartum women were examined. NK activity was measured in a 4-h 51Cr-release assay and evaluated by conventional relative lytic units and absolute lytic units which represent the total NK activity within a fixed volume of circulating blood. The number of NK cells was analyzed with FITC-conjugated monoclonal antibodies and by use of an automated flow cytometer. Unexpectedly, the relative NK activity increased in the first trimester and also for 1 month postpartum compared to the activity in normal non-pregnant controls. On the other hand, absolute NK activity decreased in the third trimester compared to the activity in normal non-pregnant controls. The percentage of CD57+ cells decreased in the second trimester, but the percentage of CD16+ cells did not change during pregnancy or the postpartum period. The absolute counts of CD57+ cells and CD16+ cells decreased in the second and third trimesters and increased transiently in the postpartum period. These findings indicate that the increased NK activity in the first trimester and at 1 month postpartum is induced by increased cytotoxic activity of individual NK cells, and that the decreased NK activity in late pregnancy is induced by a decrease in the numbers of NK cells. These physiological changes may play an important role in implantation in early pregnancy, protection of the fetal allograft in late pregnancy and in the natural defense against infection during the puerperal period.

Adult↗

PubMed2002

A controlled study of postpartum depression among Nepalese women: validation of the Edinburgh Postpartum Depression Scale in Kathmandu.

OBJECTIVES: To measure the prevalence of depression amongst postpartum and non-postpartum Nepalese women in Kathmandu using the Edinburgh Postpartum Depression Scale (EPDS) and to assess the ease of use and validity of the scale compared with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression. METHODS: We screened 100 women 2-3 months post-delivery and 40 control women using the EPDS. All those who screened positive for depression and 20% of the negatives also underwent a structured interview to assess depression by DSM-IV criteria. RESULTS: Predictive errors were minimized by using an EPDS score > or =13 to define depression. Using this threshold, there was no difference in depression prevalence between postpartum women (12%) and the control group (12.5%) (Fisher's exact test, P > 0.05). Compared with DSM-IV, the sensitivity, specificity and positive predictive values were 100, 92.6 and 41.6%, respectively. CONCLUSIONS: The prevalence of postpartum depression (PPD) in Nepalese women and the validity and ease of use of the EPDS in the setting of a postnatal clinic in Kathmandu are all surprisingly similar to the results of numerous studies in developed countries. Despite poor living conditions, PPD is no more common than the background depression rate amongst Nepalese women. It can be reliably detected by trained clinical nurses using the EPDS screening test. These results may have implications for the planning of mental health resources for women in other developing countries.

Case-Control Studies↗

PubMed1991

The comparison of postpartum with non-postpartum depression: a rose by any other name.

A strong tradition exists in the psychiatric literature to consider postpartum depression a distinct diagnosis. However, the empirical evidence indicates that, in terms of etiology and relapse rates, postpartum depression is indistinguishable from non-postpartum depression. Symptomatically, postpartum depression seems to involve a milder disturbance, suggesting that it is best seen as an adjustment disorder. This paper summarizes the empirical evidence relevant to the distinct diagnosis question, and considers the benefits to be derived from challenging the traditional view of postpartum depression.

Adjustment Disorders↗

PubMed2003

Measurement issues in postpartum depression part 1: anxiety as a feature of postpartum depression.

We investigated the contribution of anxiety symptoms to scores on the Edinburgh Postnatal Depression Scale (EPDS) between 36 weeks gestation and 16 weeks postpartum in 150 women. The 3-item anxiety subscale of the EPDS accounted for 47% of the total score in late pregnancy, and 38% of the total score in the postpartum period. Two categories of anxiety were common in the perinatal period: subsyndromal, situational anxiety (in particular during the last weeks of pregnancy); and clinically significant comorbid anxiety, which was experienced by nearly 50% of clinically depressed pregnant and postpartum women. The close relationship between anxiety and depression raises questions about whether symptoms of anxiety might be more common in the perinatal period than in other depressions. A strong role for anxiety symptoms in postpartum depression, and implications for its etiology and treatment, are discussed.

Adult↗

PubMed1987

Breastfeeding: its relationship with postpartum amenorrhea and postpartum sexual abstinence in a Nigerian community.

Breastfeeding, together with its two related postpartum variables--amenorrhea and abstinence--govern both the tempo and quantum of fertility in traditional African societies. Decline in breastfeeding also implies decline in postpartum amenorrhea and abstinence practice. Changes in breastfeeding practices in tropical Africa, therefore, has fertility implications and consequences. This paper examines how breastfeeding is functionally related to postpartum amenorrhea and abstinence in Ilorin, an urban community in Nigeria. Results indicated that the effect of breastfeeding on fertility, through its relationship with postpartum abstinence, might be more important than its effect through lactational amenorrhea in this society. This is more true among women with little or no education than among women with secondary or higher education. The population or family planning implications of these relationships are discussed.

Amenorrhea↗

PubMed2002

Uterine involution, day and variance of first postpartum ovulation in mares treated with progesterone and estradiol-17beta for 1 or 2 days postpartum.

The effects of a single or double regimen of exogenous progesterone and estradiol-17beta (P/E, total dose 300 mg P/20 mg E) were investigated in 50 postparturient Quarter Horse mares. In Trial 1, at 1 and 24 h after foaling, mares were injected with progesterone (150 mg) and estradiol-17beta (10 mg) (n = 7) or 0.9% NaCl (control, n = 13). In Trial 2, within 12 h after foaling, mares were injected with progesterone (300 mg) and estradiol-17beta (20 mg) (n = 13) or 0.9% NaCl (control, n = 17). Mares were examined daily by palpation per rectum and transrectal ultrasonography to determine the day of ovulation. The largest cross sectional diameters of each uterine horn and uterine body were measured ultrasonographically on Day 15 postpartum. Mean uterine diameters did not differ between treatment groups (P > 0.05) in Trial 1, Trial 2 or for combined data for both Trials 1 and 2. For mares bred on the first postpartum estrus pregnancy rates did not differ (P > 0.05) between treatment groups (16/18, 89%) and controls (22/30, 81%) nor was there a difference in mean day to first postpartum ovulation (P > 0.05) between treated and control groups in Trial 1, Trial 2 or Trials 1 and 2 combined. However, fewer (P < 0.05) total P/E treated mares (0/20) ovulated prior to Day 10 postpartum than did control mares (6/30). Variance in days to ovulation was lower (P < 0.05) for P/E treated mares (var = 3.73 days) than for control mares (var = 7.64 days) for data combined from Trials 1 and 2.

Animals↗

PubMed1992

Weight changes prepartum and presence of bulls postpartum interact to affect duration of postpartum anestrus in cows.

Our hypothesis was that cows with greater body condition at parturition would respond to the presence of bulls (biostimulation) by having shorter periods of postpartum anestrus than cows with a lesser body condition. Multiparous cows in good body condition at the initiation of the study were either maintained on a high dietary regimen or switched to a low dietary regimen during the 90 d preceding parturition. After parturition, half of the cows from each group were placed in pastures with sterile bulls, and the remaining half were placed in pastures without bulls. This study was replicated during a 2nd yr. Blood samples were collected twice weekly and assayed for concentrations of progesterone to estimate time of onset of luteal function after parturition. There was a significant interaction (P less than .05) between body condition at parturition and presence of bulls postpartum on the duration of postpartum anestrus. Cows of lesser body condition that were in the presence of bulls after calving initiated estrous cycles 14 d earlier than cows with lesser body condition that were isolated from bulls. In cows with a greater body condition, presence of bulls after calving only shortened postpartum anestrus by 6 d. Thus, we reject our initial hypothesis.

Anestrus↗