Antimüllerian hormone and pregnancy loss from the Effects of Aspirin in Gestation and Reproduction trial.
Antimüllerian hormone and pregnancy loss from the Effects of Aspirin in Gestation and Reproduction trial.
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DOI：
10.1016/j.fertnstert.2015.12.003
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发表时间：
2016-04
影响因子：
6.7
通讯作者：
Schisterman EF
中科院分区：
文献类型：
--
作者：
Zarek SM;Mitchell EM;Sjaarda LA;Mumford SL;Silver RM;Stanford JB;Galai N;Schliep KC;Radin RG;Plowden TC;DeCherney AH;Schisterman EF
评估抗苗勒管激素（AMH）是否与妊娠丢失相关。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。4家美国临床研究中心（2006-2012年）。女性（n=1228）年龄在18-40岁之间，有1 - 2次流产史，在未接受生育治疗的情况下积极尝试怀孕。没有。流产。使用对数二项模型评估检测到hCG和临床妊娠丢失的相对风险（和95% CI），该模型具有稳健方差和逆概率权重，根据年龄、人种、BMI、收入、试验治疗分配、产次、既往丢失次数和自最近一次丢失以来的时间进行调整。AMH水平定义为：低（<1.00 ng/mL）（n=124）、正常（参考值; 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损失，而AMH水平正常的女性为61名（11.4%），AMH水平高的女性为50名（11.8%）。相对于正常AMH（参照物）的低或高AMH水平与临床损失无关（低AMH：RR，1.13，95% CI 0.74，1.72;高AMH：RR 1.13，95% CI 0.82，1.56）。hCG检测妊娠丢失的结果反映了临床丢失的结果。AMH值与hCG检测或有1 - 2次流产史的妇女在无辅助受孕中的临床妊娠丢失无关。我们的数据不支持常规AMH检测预测妊娠丢失。
To evaluate if anti-Müllerian hormone (AMH) is associated with pregnancy loss. A prospective cohort study within a block-randomized, double-blind, placebo-controlled trial of low dose aspirin. Four U.S.A. clinical sites (2006-2012). Women (n=1228) were aged 18-40 years with a history of one to two pregnancy losses and were actively attempting pregnancy without fertility treatment. None. Pregnancy loss. Relative risks (and 95% CI) of hCG detected and clinical pregnancy loss were assessed using log binomial models with robust variance and inverse probability weights adjusted for age, race, BMI, 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 to 3.5 ng/mL) (n=595), and high (>3.5 ng/mL) (n=483). Of the 1202 women with baseline AMH data, 19 (17.3%) women with a low AMH experienced a clinical loss, compared to 61 (11.4%) with normal AMH and 50 (11.8%) with a high AMH level. Low or high AMH levels relative to normal AMH (referent) were not associated with clinical loss (Low AMH: RR, 1.13, 95% CI 0.74, 1.72; High AMH: RR 1.13, 95% CI 0.82, 1.56). Results for hCG detected pregnancy loss mirrored those of clinical loss. AMH values were not associated with hCG detected or clinical pregnancy loss in unassisted conceptions in women with a history of one to two prior losses. Our data do not support routine AMH testing for prediction of pregnancy loss.