Bleil Maria E, English Paul, Valle Jhaqueline, Woods Nancy F, Crowder Kyle D, Gregorich Steven E, Cedars Marcelle I
1Department of Family and Child Nursing, University of Washington, Box 357262, Seattle, WA 98195 USA.
California Department of Public Health, California Environmental Health Tracking Program, Richmond, CA 94804 USA.
Womens Midlife Health. 2018 Mar 16;4:5. doi: 10.1186/s40695-018-0033-2. eCollection 2018.
Because the ovarian follicle pool is established in utero, adverse exposures during this period may be especially impactful on the size and health of the initial follicle endowment, potentially shaping trajectories of ovarian follicle loss and the eventual onset of menopause. Building on a robust literature linking socioeconomic status (SES) and menopausal timing, the current study examined adverse prenatal exposures related to maternal SES, hypothesizing that greater maternal socioeconomic disadvantage would be associated with lower ovarian reserve in the adult offspring.
In a healthy, community-based sub-sample ( = 350) of reproductive age participants in the OVA Study (2006-2011), prenatal maternal SES was examined in relation to two biomarkers of ovarian reserve, antimullerian hormone (AMH) and antral follicle count (AFC). Prenatal maternal SES was assessed indirectly using maternal addresses abstracted from participant birth certificates, geocoded, and linked to US Census-derived variables, including neighborhood-level characteristics: education (% of individuals with a HS diploma); poverty (% of families below the poverty line); unemployment (% of individuals > 16 years who are unemployed); and income (median family income).
In separate covariate-adjusted linear regression models (following the backward elimination of main effects with > .10), greater maternal neighborhood education was related to higher ovarian reserve as marked by higher levels of offspring AMH (beta = .142, < .001) and AFC (beta = .092, < .10) with models accounting for 19.6% and 21.5% of the variance in AMH and AFC, respectively. In addition, greater maternal neighborhood poverty was related to lower ovarian reserve as marked by lower offspring AMH (beta = -.144, < .01), with the model accounting for 19.5% of the variance in AMH.
Maternal socioeconomic disadvantage measured indirectly at the neighborhood level was associated with lower ovarian reserve among the adult offspring, independently of offspring SES and other potential confounding factors. This suggests SES-related adversity exposures may have a detrimental impact on the size or health of the initial follicle endowment, leading to accelerated follicle loss over time.
由于卵巢卵泡池在子宫内就已建立，此期间的不良暴露可能对初始卵泡储备的大小和健康产生特别重大的影响，有可能影响卵巢卵泡丢失的轨迹以及最终绝经的发生时间。基于大量将社会经济地位（SES）与绝经时间联系起来的文献，本研究调查了与母亲SES相关的不良产前暴露情况，假设母亲社会经济劣势越大，成年后代的卵巢储备就越低。
在OVA研究（2006 - 2011年）中一个基于社区的健康育龄参与者子样本（n = 350）中，研究了产前母亲SES与两种卵巢储备生物标志物，即抗苗勒管激素（AMH）和窦卵泡计数（AFC）之间的关系。产前母亲SES通过从参与者出生证明中提取的母亲住址进行间接评估，进行地理编码，并与美国人口普查得出的变量相关联，这些变量包括邻里层面的特征：教育程度（高中文凭个体的百分比）；贫困率（低于贫困线家庭的百分比）；失业率（16岁以上失业个体的百分比）；以及收入（家庭收入中位数）。
在单独的协变量调整线性回归模型中（在主效应的向后消除，p >.10之后），母亲邻里教育程度越高，后代AMH水平越高（β = 0.142，p <.001）以及AFC越高（β = 0.092，p <.10），这表明母亲邻里教育程度越高与卵巢储备越高相关，模型分别解释了AMH和AFC变异的19.6%和21.5%。此外，母亲邻里贫困率越高，后代AMH越低（β = -0.144，p <.01），这表明母亲邻里贫困率越高与卵巢储备越低相关，该模型解释了AMH变异的19.5%。
在邻里层面间接测量的母亲社会经济劣势与成年后代较低的卵巢储备相关，独立于后代SES和其他潜在混杂因素。这表明与SES相关的不良暴露可能对初始卵泡储备的大小或健康产生有害影响，导致随着时间推移卵泡加速丢失。
