title: Serum AMH levels in women with a history of preeclampsia suggest a role for vascular factors in ovarian aging.
abstract: BACKGROUND
  The association between early menopause and vascular disease as a possible causative factor has recently received attention. Preeclampsia (PE) is associated with future cardiovascular risk factors, and this premature vascular aging potentially modifies the ovarian aging process.
  
  
  OBJECTIVE
  The purpose of this study was to assess whether women with a history of PE have lower anti-Müllerian hormone (AMH) levels than women with normotensive pregnancies.
  
  
  METHODS
  This was a retrospective cohort study.
  
  
  METHODS
  The study was conducted in a tertiary referral center.
  
  
  METHODS
  Clinical data and blood samples of participants in the Preeclampsia Risk EValuation in FEMales study were used (336 women with a history of PE and 329 women after a normotensive pregnancy).
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  The relative decrease in AMH levels was assessed after a median follow-up of 10.5 years.
  
  
  RESULTS
  The mean AMH level was 2.00 ± 1.87 μg/L in the PE group compared with 2.26 ± 2.56 μg/L in the reference group. Linear regression analysis with censoring for undetectable AMH levels, adjusted for age, smoking, and hormonal contraceptive use, showed a relative reduction in AMH levels of 20.9% at any age (fold change 0.79, 95% confidence interval, 0.67-0.94).
  
  
  CONCLUSIONS
  We demonstrate that women with a history of PE have significantly lower AMH levels than women with normotensive pregnancies. Calculations based on a reference population indicate advancement of reproductive age of approximately 1.5 years. Because PE is considered a manifestation of impaired vascular health, these results support the hypothesis that compromised vascular health could act as a causative mechanism in early ovarian aging.
authors.affiliation: Department of Reproductive Medicine (F.Y., F.J.M.B.), Department of Obstetrics (A.F., B.B.v.R.), and Julius Center for Health Sciences and Primary Care (M.J.C.E., Y.T.v.d.S.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Cardiology (A.H.E.M.M.), University Medical Center St. Radboud, 6500 HB Nijmegen, The Netherlands; Department of Cardiology (J.T.D.) and Department of Gynaecology and Obstetrics (J.v.E.), Isala Klinieken Zwolle, 8025 AB Zwolle, The Netherlands; and Academic Unit of Human Development and Health (B.B.v.R.), University of Southampton, Southampton SO16 6YD, United Kingdom.
authors.forename: F
authors.initials: F
authors.lastname: Yarde
authors.forename: A H E M
authors.initials: AH
authors.lastname: Maas
authors.forename: A
authors.initials: A
authors.lastname: Franx
authors.forename: M J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: J T
authors.initials: JT
authors.lastname: Drost
authors.forename: B B
authors.initials: BB
authors.lastname: van Rijn
authors.forename: J
authors.initials: J
authors.lastname: van Eyck
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: F J M
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D000328:Adult; D000375:Aging / Q000097:blood*; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D054304:Anti-Mullerian Hormone