Evaluation of anti-Mullerian hormone in the first trimester as a predictor for hypertensive disorders of pregnancy and other adverse pregnancy outcomes
Evaluation of anti-Mullerian hormone in the first trimester as a predictor for hypertensive disorders of pregnancy and other adverse pregnancy outcomes
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DOI：
10.1111/ajo.12183
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发表时间：
2014-06-01
影响因子：
1.7
通讯作者：
Henry, Amanda
中科院分区：
文献类型：
--
作者：
Shand, Antonia W.;Whitton, Katherine;Henry, Amanda
背景 已经提出用生物标志物预测先兆子痫和不良妊娠结局。 AMH 是一种卵巢特异性生长因子，用于预测卵巢储备功能，其随着年龄的变化而变化，类似于与年龄相关的生育力的变化。目的 本研究的目的是确定妊娠前三个月检测的 AMH 是否与妊娠高血压或不良妊娠结局相关。材料和方法 对在澳大利亚悉尼皇家妇女医院分娩 20 周单胎胎儿的妇女进行回顾性队列研究 (n=331)。 2011 年，通过 Beckman-Coulter Gen II ELISA 方法对早孕期非整倍体筛查（妊娠 10-13+6 周）时收集的冷冻血清进行了 AMH 测试。结果数据来自医院数据库（ObstetriX）。主要结局指标是妊娠高血压（先兆子痫和妊娠高血压）和复合不良妊娠结局。结果AMH中位水平为9.7pmol/L（四分位距（IQR）3.9-17.3）。患有妊娠高血压的女性的 AMH 水平有低于无妊娠高血压女性的趋势（中位数 5.1pmol/L，IQR 1.5-13.2 vs 9.4 IQR 3.9-17.3；P=0.06）。在对 BMI 25、产次 1 和年龄 35 进行调整后，AMH 低于第 10 个百分位的女性患妊娠高血压的风险增加 3.3 倍（OR 3.3，95% CI 1.2-8.7，P=0.01）。低 AMH 浓度与不良孕产妇或新生儿结局之间没有其他关联。结论 妊娠早期AMH极低（1.5pmol/L）的女性发生妊娠期高血压的风险可能增加。没有发现其他不良妊娠结局。
Background 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. Aims 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. Materials and Methods Retrospective cohort study of women who delivered singleton fetuses 20weeks' gestation at Royal Hospital for Women, Sydney, Australia (n=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+6weeks' 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. Results 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; P=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, P=0.01). There were no other associations between low AMH concentration and adverse maternal or neonatal outcomes. Conclusions Women with a very low AMH (1.5pmol/L) in early pregnancy may have an increased risk of pregnancy hypertension. No other adverse pregnancy outcomes were identified.