title: Evaluation of anti-Mullerian hormone in the first trimester as a predictor for hypertensive disorders of pregnancy and other adverse pregnancy outcomes.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Retrospective cohort study of women who delivered singleton fetuses ≥20 weeks' 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 + 6 weeks' 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 9.7 pmol/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 5.1 pmol/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 (1.5 pmol/L) in early pregnancy may have an increased risk of pregnancy hypertension. No other adverse pregnancy outcomes were identified.
authors.affiliation: School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia; Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, NSW, Australia; Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, Australia.
authors.forename: Antonia W
authors.initials: AW
authors.lastname: Shand
authors.forename: Katherine
authors.initials: K
authors.lastname: Whitton
authors.forename: Adam
authors.initials: A
authors.lastname: Pasfield
authors.forename: Natasha
authors.initials: N
authors.lastname: Nassar
authors.forename: Monika
authors.initials: M
authors.lastname: McShane
authors.forename: XuGuang
authors.initials: X
authors.lastname: Han
authors.forename: Amanda
authors.initials: A
authors.lastname: Henry
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone
keywords: anti-Mullerian hormone; pre-eclampsia; pregnancy hypertension; pregnancy outcome