title: May maternal anti-mullerian hormone levels predict adverse maternal and perinatal outcomes in preeclampsia?
abstract: BACKGROUND
  Prediction of preeclampsia and adverse maternal and perinatal outcomes with biomarkers has been proposed previously. Anti-mullerian hormone (AMH) is a growth factor, which is primarily responsible of the regression of the mullerian duct, but also used to predict ovarian reserve and decreases with age similar to the fertility.
  
  
  OBJECTIVE
  To evaluate the predictive role of maternal anti-mullerian hormone (mAMH) in adverse maternal and perinatal outcomes in preeclampsia.
  
  
  METHODS
  This prospective case-control study was conducted at current high-risk pregnancy department in a tertiary research hospital and 45 cases with preeclampsia classified as study group and 42 as control group. Data collected and evaluated were; age, body mass index (BMI), marriage duration (MD), gestational weeks (GW), gravidity, parity, mode of delivery, birth weight, newborn Apgar score, newborn gender, maternal complication, perinatal outcome, some laboratory parameters and mAMH. The association between mAMH levels and maternal and fetal outcomes were evaluated.
  
  
  RESULTS
  There were no statistically significant differences between groups in terms of age, BMI, MD, gravidity, parity and newborn gender (p > 0.05). GW, vaginal delivery, birth weight, newborn Apgar score, were statistically significantly lower in preeclamptic patients when compared with non-preeclamptic patients (p < 0.001). Adverse maternal and perinatal outcomes were statistically significantly higher in the study group (p < 0.001). The laboratory values [alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), creatinine, lactic dehydrogenase (LDH), uric acid and fibrinogen) were statistically significantly lower in the control group (p < 0.001). The mAMH level was significantly lower in the preeclamptic group (p: 0.035). There was no correlation between mAMH levels and demographic and clinical parameters. The area under the ROC curve (AUC) was 0.590 and the cut-off value was 0.365 ng/ml with sensitivity of 67.4% and specificity of 47.1% for mAMH. Logistic regression analysis showed a statistically insignificance between mAMH and maternal complication and perinatal outcome (p: 0.149).
  
  
  CONCLUSIONS
  According to this study, mAMH level was lower in preeclamptic patients than in normal pregnants, and is found to be a discriminative factor with low sensitivity and specificity. There was no relationship between mAMH and adverse maternal and perinatal outcomes. Further randomized controlled studies with more participants are needed to evaluate the accurate effects of mAMH levels on preeclampsia and should increase the power of mAMH levels in predicting the preeclampsia.
authors.affiliation: a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey and.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Tokmak
authors.forename: Gürhan
authors.initials: G
authors.lastname: Güney
authors.forename: Rıfat Taner
authors.initials: RT
authors.lastname: Aksoy
authors.forename: Ali Irfan
authors.initials: AI
authors.lastname: Guzel
authors.forename: Hasan Onur
authors.initials: HO
authors.lastname: Topcu
authors.forename: Tuğban Seçkin
authors.initials: TS
authors.lastname: Keçecioğlu
authors.forename: Dilek
authors.initials: D
authors.lastname: Uygur
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D001034:Apgar Score; D001724:Birth Weight; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Anti-mullerian hormone; fetal; maternal; outcomes; preeclampsia