Zarek Shvetha M, Mitchell Emily M, Sjaarda Lindsey A, Mumford Sunni L, Silver Robert M, Stanford Joseph B, Galai Noya, Schliep Karen C, Radin Rose G, Plowden Torie C, DeCherney Alan H, Schisterman Enrique F
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Fertil Steril. 2016 Apr;105(4):946-952.e2. doi: 10.1016/j.fertnstert.2015.12.003. Epub 2015 Dec 17.
To evaluate if antimüllerian hormone (AMH) is associated with pregnancy loss.
Prospective cohort study within a block-randomized, double-blind, placebo-controlled trial of low-dose aspirin.
Not applicable.
PATIENT(S): Women (n = 1,228) were of ages 18-40 years with a history of one to two pregnancy losses and were actively attempting pregnancy without fertility treatment.
INTERVENTION(S): Not applicable.
MAIN OUTCOME MEASURE(S): Pregnancy loss.
RESULT(S): Relative risks (and 95% confidence interval [CIs]) of human chorionic gonadotropin (hCG)-detected and clinical pregnancy loss were assessed with the use of log binomial models with robust variance and inverse probability weights adjusted for age, race, body mass index, income, trial treatment assignment, parity, number of previous losses, and time since most recent loss. AMH levels were defined as: low (<1.00 ng/mL; n = 124), normal (referent; 1.00-3.5 ng/mL; n = 595), and high (>3.5 ng/mL; n = 483). Of the 1,202 women with baseline AMH data, 19 (17.3%) with low AMH experienced a clinical loss, compared with 61 (11.4%) with normal AMH and 50 (11.8%) with high AMH levels. Low or high AMH levels, compared with normal AMH, were not associated with clinical loss. Results for hCG-detected pregnancy loss mirrored those of clinical loss.
CONCLUSION(S): AMH values were not associated with hCG-detected or clinical pregnancy loss in unassisted conceptions in women with a history of one to two previous losses. Our data do not support routine AMH testing for prediction of pregnancy loss.
NCT00467363.
评估抗苗勒管激素(AMH)与妊娠丢失是否相关。
在一项低剂量阿司匹林的区组随机、双盲、安慰剂对照试验中的前瞻性队列研究。
不适用。
年龄在18 - 40岁之间、有一至两次妊娠丢失史且正在积极尝试自然受孕而非接受生育治疗的女性(n = 1228)。
不适用。
妊娠丢失。
使用对数二项式模型评估人绒毛膜促性腺激素(hCG)检测到的妊娠丢失和临床妊娠丢失的相对风险(及95%置信区间[CI]),该模型具有稳健方差,并对年龄、种族、体重指数、收入、试验治疗分配、产次、既往丢失次数以及距最近一次丢失的时间进行了逆概率加权调整。AMH水平定义为:低(<1.00 ng/mL;n = 124)、正常(对照;1.00 - 3.5 ng/mL;n = 595)和高(>3.5 ng/mL;n = 483)。在1202名有基线AMH数据的女性中,19名(17.3%)AMH水平低的女性经历了临床妊娠丢失,相比之下,595名AMH水平正常的女性中有61名(11.4%),483名AMH水平高的女性中有50名(11.8%)。与正常AMH水平相比,低或高AMH水平与临床妊娠丢失无关。hCG检测到的妊娠丢失结果与临床妊娠丢失结果相似。
在有一至两次既往妊娠丢失史的女性自然受孕中,AMH值与hCG检测到的或临床妊娠丢失无关。我们的数据不支持常规进行AMH检测以预测妊娠丢失。
NCT00467363。