Association between ovarian reserve and preeclampsia: a cohort study

Hadi Erfani,Mohammad Ali Mansournia,Fereidoun Azizi,Seyed Ali Montazeri,Fahimeh Ramezani Tehrani,Alireza A Shamshirsaz,Maryam Rahmati

doi:10.1186/s12884-019-2578-y

Abstract

BackgroundThe 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).MethodsSubjects 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.ResultsPE 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 (OR1st vs 4th: 1.5, P-value: 0.1, CI: (0.9, 2.4)).ConclusionsAge-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.

Highlights

The risk of cardiovascular disease in women increases after menopause
A study by de Kat et al, in 2017 indicated that Anti-Mullerian hormone (AMH) trajectories in women are associated with cardiovascular risks; the decline of circulating AMH levels may be part of the pathophysiology of increased cardiovascular risk attributed to the early menopause [12]
Mean Waist Circumference (WC), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and smoking habit were different between the 2 groups (Table 1)

Summary

Introduction

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). In addition several studies have addressed the Erfani et al BMC Pregnancy and Childbirth (2019) 19:432 potential association of low ovarian reserve with cardiovascular risks [9,10,11]. A study by de Kat et al, in 2017 indicated that AMH trajectories in women are associated with cardiovascular risks; the decline of circulating AMH levels may be part of the pathophysiology of increased cardiovascular risk attributed to the early menopause [12]. In another study Kim et al, proposed belief that in midlife women with type 1 diabetes AMH has slight but significant association with subclinical measures of atherosclerosis [13]

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Conclusion