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Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
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Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
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Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark
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Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
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characteristics of the disorders, and possible mechanisms involved regarding disease outcomes. Thus, in nonpregnant as well as pregnant individuals the exact underlying mechanisms regarding adverse outcomes of thyroid disease are debated ( 3 ). Another
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Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Objective
The primary objective of this study is to establish maternal reference values of anti‐Müllerian hormone (AMH) in a fertile multi-ethnic urban pregnant population and to evaluate the effect of gestational age. The secondary objective of this study is to explore the association between AMH and placental biomarkers.
Design
This study was embedded in the Generation R Study, an ongoing population-based prospective cohort study from early pregnancy onwards.
Setting
City of Rotterdam, the Netherlands, out of hospital setting.
Patients
In 5806 women, serum AMH levels were determined in early pregnancy (median 13.5 weeks; 95% range 10.5–17.2).
Intervention(s)
None.
Main outcome measures
Maternal AMH levels in early pregnancy and its association with placental biomarkers, including human chorionic gonadotrophin (hCG), soluble fms-like tyrosine kinase-1 (sFLT), and placental growth factor (PLGF).
Results
A nomogram of AMH in early pregnancy was developed. Serum AMH levels showed a decline with advancing gestational age. Higher AMH levels were associated with a higher level of the placental biomarkers hCG and sFLT in early pregnancy. This last association was predominantly mediated by hCG. AMH levels were negatively associated with PLGF levels.
Conclusion
In this large study, we show that AMH levels in early pregnancy decrease with advancing gestational age. The association between AMH and the placental biomarkers hCG, sFLT, and PLGF suggests a better placental development with lower vascular resistance in mothers with higher AMH levels. Hence, AMH might be useful in predicting adverse pregnancy outcomes due to impaired placental development.
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, menarche, advanced bone age and pubic hair; (3) the PLH after GnRH simulation < 5 IU/L. In addition, girls with thyroid disease, central organic brain disease, congenital adrenal hyperplasia or a history of treatment may affect gonadotropins were excluded
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hyperandrogenemia or ovulatory dysfunction (such as nonclassical congenital adrenal hyperplasia, Cushing syndrome, androgen-secreting tumors of the ovary or adrenal gland, thyroid disease, hyperprolactinemia, hypogonadism, functional hypothalamic amenorrhea, and
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thyroid disease ( 49 ). Davis and colleagues measured AMH levels, a marker of ovarian reserve for it reflects the primordial follicle pool ( 43 ). It is produced by the granulosa cells of the maturing follicles and thus is an index of the remaining
