Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan.
J Womens Health (Larchmt). 2019 Dec;28(12):1711-1720. doi: 10.1089/jwh.2018.7382. Epub 2019 Jan 14.
Ovarian toxic exposures during early development may contribute to reduced ovarian reserve in adulthood. We explored a range of intrauterine, infant, and childhood factors in relation to a biomarker of ovarian reserve, anti-Müllerian hormone (AMH) concentrations, in adulthood. We conducted a cross-sectional exploratory study of 1600 African American women 23-35 years of age residing in the Detroit, Michigan metropolitan area, who had serum AMH measurements (Ansh Labs PicoAMH enzyme-linked immunosorbent assay) and no previous polycystic ovarian syndrome diagnosis. Information on 32 intrauterine, infant, and childhood factors was ascertained by self-administered questionnaires, with 87% of participants receiving assistance from mothers. The percent differences in AMH concentrations in relation to early-life factors and 95% confidence intervals (CIs) were estimated using multivariable linear regression, adjusting for age, current hormonal contraceptive use, and body mass index. Of the early-life factors evaluated in this study, two maternal pregnancy factors were associated with lower AMH concentrations in adult participants. Participants whose mothers lived or worked on a farm (vs. neither lived nor worked on a farm) when pregnant with the participant had 42% lower AMH concentrations (95% CI = -62 to -9). Among participants whose mothers lived in Michigan when pregnant with the participant ( = 1238), maternal residence in Detroit for at least a month was associated with 22% lower AMH concentrations (95% CI = -34 to -8) in the participant. Further research is merited to replicate our findings and identify the aspects of maternal farm exposure and Detroit residence that may be associated with lower AMH concentrations.
早期发育过程中的卵巢毒性暴露可能导致成年后卵巢储备减少。我们探讨了一系列与卵巢储备生物标志物抗苗勒管激素(AMH)浓度相关的子宫内、婴儿期和儿童期因素。我们对居住在密歇根州底特律大都市区的 1600 名年龄在 23-35 岁之间的非裔美国女性进行了一项横断面探索性研究,这些女性的血清 AMH 测量值(Ansh Labs PicoAMH 酶联免疫吸附测定)和以前没有多囊卵巢综合征的诊断。通过自我管理问卷获得了 32 个子宫内、婴儿期和儿童期因素的信息,87%的参与者得到了母亲的帮助。使用多变量线性回归估计了 AMH 浓度与生命早期因素的百分比差异及其 95%置信区间(CI),调整了年龄、当前激素避孕使用和体重指数。在本研究评估的生命早期因素中,有两个母亲妊娠因素与成年参与者的 AMH 浓度较低有关。与母亲在怀孕期间既不住在农场也不在农场工作的参与者相比,母亲在怀孕期间住在农场(而不是既不住在农场也不在农场工作)的参与者的 AMH 浓度低 42%(95%CI=-62 至-9)。在参与者的母亲在怀孕期间居住在密歇根州的参与者中(n=1238),母亲在底特律居住至少一个月与参与者的 AMH 浓度低 22%(95%CI=-34 至-8)相关。需要进一步的研究来复制我们的发现,并确定与 AMH 浓度降低相关的母体农场暴露和底特律居住的方面。