Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak,, P.O. Box:19395-4763, Tehran, 1985717413, Iran.
BMC Pregnancy Childbirth. 2019 Nov 21;19(1):432. doi: 10.1186/s12884-019-2578-y.
The risk of cardiovascular disease in women increases after menopause. It has been shown that women with lower pre-menopausal ovarian reserve may experience increased cardiovascular risk. We sought to determine whether there is any association between ovarian reserve, as assessed by Anti-Mullerian hormone (AMH), and preeclampsia (PE).
Subjects of this study were selected from among participants of the Tehran Lipid and Glucose Study (TLGS), a population-based cohort with a 15-year follow-up (1998-2014). Out of 2412 women aged 20-50 years, there were 781 women who met eligibility criteria, including having comprehensive data on their reproductive assessment and ovarian reserve status, identified based on age-specific AMH levels according to the exponential-normal three-parameter model that was measured before pregnancy. There were 80 and 701 participants in the preeclampsia and non-PE groups, respectively. The association between dichotomous outcome variable PE and age-specific AMH quartiles was evaluated using pooled logistic regression.
PE was observed in 23 (11.1%), 12 (6.4%), 26 (13.3%) and 19 (10%) women in the 1st, 2nd, 3rd and 4th quartiles of pre-pregnancy age-specific AMH, respectively (P = 0.16). Median and inter-quartile range of serum AMH levels was 1.05 (0.36-2.2) mg/L in women who experienced PE compared with 0.85 (0.28-2.1) mg/L in women with normotensive pregnancies (P = 0.53). Based on the pooled logistic regression analysis, the effect of age-specific AMH quartiles on PE progression (adjusted for age, BMI, smoking status, and family history of hypertension) were not significant (OR: 1.5, P-value: 0.1, CI: (0.9, 2.4)).
Age-specific AMH may not be a suitable marker for prediction of PE. Further longitudinal studies, considering pre-conception measurement of AMH, are recommended for better interpretation of the association between ovarian reserve status and PE.
女性绝经后心血管疾病的风险增加。已经表明，卵巢储备功能较低的绝经前女性可能会增加心血管风险。我们试图确定卵巢储备功能（通过抗苗勒管激素（AMH）评估）与子痫前期（PE）之间是否存在任何关联。
本研究的受试者选自德黑兰脂质和血糖研究（TLGS）的参与者，这是一个具有 15 年随访（1998-2014 年）的基于人群的队列。在 2412 名 20-50 岁的女性中，有 781 名女性符合入选标准，包括对其生殖评估和卵巢储备状态进行全面评估，根据妊娠前基于年龄的 AMH 水平，通过指数正态三参数模型确定，该模型根据年龄特异性 AMH 水平进行测量。PE 组和非 PE 组分别有 80 名和 701 名参与者。使用汇总逻辑回归评估二分类结局变量 PE 与年龄特异性 AMH 四分位组之间的关联。
PE 分别在第 1、2、3 和 4 个四分位数中观察到 23（11.1%）、12（6.4%）、26（13.3%）和 19（10%）名妇女中，第 1、2、3 和第 4 个四分位数中分别有 23（11.1%）、12（6.4%）、26（13.3%）和 19（10%）名妇女（P=0.16）。PE 组妇女血清 AMH 水平的中位数和四分位数间距为 1.05（0.36-2.2）mg/L，而正常血压妊娠妇女为 0.85（0.28-2.1）mg/L（P=0.53）。基于汇总逻辑回归分析，年龄特异性 AMH 四分位数对 PE 进展的影响（调整年龄、BMI、吸烟状况和高血压家族史）并不显著（OR：1.5，P 值：0.1，CI：（0.9，2.4））。
年龄特异性 AMH 可能不是预测 PE 的合适标志物。建议进行进一步的前瞻性研究，考虑在受孕前测量 AMH，以更好地解释卵巢储备状态与 PE 之间的关联。
