Evaluation of anti‐Mullerian hormone in the first trimester as a predictor for hypertensive disorders of pregnancy and other adverse pregnancy outcomes. (3rd March 2014)

• Record Type: Journal Article
• Authors: Shand, Antonia W.; Whitton, Katherine; Pasfield, Adam; Nassar, Natasha; McShane, Monika; Han, XuGuang; Henry, Amanda
• Is Part Of: Australian and New Zealand journal of obstetrics and gynaecology. Volume 54:Number 3(2014)
• Page Start: 244
• Page End: 249
• Publication Date: 2014-03-03
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618.05
• DOI: 10.1111/ajo.12183
• Languages: English
• ISSNs: 0004-8666

Abstract

<abstract abstract-type="main" id="ajo12183-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajo12183-sec-0001" sec-type="section"> <title>Background</title> <p>Prediction of pre‐eclampsia and adverse pregnancy outcomes with biomarkers has been proposed. AMH is an ovary‐specific growth factor, used to predict ovarian reserve, which changes with age similar to the change in age‐related fertility.</p> </sec> <sec id="ajo12183-sec-0002" sec-type="section"> <title>Aims</title> <p>The aim of the study was to determine whether AMH tested in the first trimester of pregnancy was associated with pregnancy hypertension or adverse pregnancy outcomes.</p> </sec> <sec id="ajo12183-sec-0003" sec-type="section"> <title>Materials and Methods</title> <p>Retrospective cohort study of women who delivered singleton fetuses ≥20 weeks' gestation at Royal Hospital for Women, Sydney, Australia (<italic>n</italic> = 331). AMH was tested in 2011 via Beckman‐Coulter Gen II ELISA method on frozen serum collected at the time of first trimester aneuploidy screening (10–13 + 6 weeks' gestation). Outcome data were obtained from the hospital database (ObstetriX). Main outcome measures were pregnancy hypertension (pre‐eclampsia and gestational hypertension) and composite adverse pregnancy outcome.</p> </sec> <sec id="ajo12183-sec-0004" sec-type="section"> <title>Results</title> <p>The median AMH level was 9.7pmol/L (interquartile range (IQR) 3.9–17.3). There was a trend towards women with pregnancy hypertension having lower AMH levels than women without pregnancy hypertension (median 5.1pmol/L, IQR 1.5–13.2 vs 9.4 IQR 3.9–17.3; <italic>P</italic> = 0.06). After adjusting for BMI ≥25, parity ≥1 and age ≥35, women with an AMH less than the 10th centile had a 3.3‐fold increased risk of pregnancy hypertension (OR 3.3, 95% CI 1.2–8.7, <italic>P</italic> = 0.01). There were no other associations between low AMH concentration and adverse maternal or neonatal outcomes.</p> </sec> <sec id="ajo12183-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Women with a very low AMH (1.5 pmol/L) in early pregnancy may have an increased risk of pregnancy hypertension. No other adverse pregnancy outcomes were identified.</p> </sec> </abstract>