title: Changes in antimüllerian hormone levels in early pregnancy are associated with preterm birth.
abstract: OBJECTIVE
  To determine the association of preterm birth with antimüllerian hormone (AMH) levels both in isolation and in combination with other markers of fetoplacental health commonly measured during integrated prenatal screening (IPS) for aneuploidy.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Pregnant women in Iowa who elected to undergo IPS and who subsequently delivered in Iowa, including women giving birth at <37 weeks' gestation and controls who delivered at ≥37 weeks' gestation.
  
  
  METHODS
  None.
  
  
  METHODS
  Probability of a preterm birth.
  
  
  RESULTS
  Second trimester AMH levels were not associated with preterm birth, either independently or after controlling for other markers of fetoplacental health. The AMH difference was not associated with preterm birth when modeled alone, but a statistically significant association was found after adjusting for maternal serum α-fetoprotein (MSAFP) and maternal weight change between the first and second trimesters. After stratifying the model by MSAFP level, most of the risk for preterm birth was identified in women with an MSAFP >1 multiple of the median and who had a stable or rising AMH level in early pregnancy.
  
  
  CONCLUSIONS
  A lack of decline in the AMH level in early pregnancy can be used to identify women with a high probability for preterm birth, especially when MSAFP levels are >1 multiple of the median. Monitoring changes in the AMH level between the first and second trimesters of pregnancy may help identify women who would benefit from interventional therapies such as supplemental progesterone.
authors.affiliation: Department of Epidemiology, College of Public Health, Iowa City, Iowa. Electronic address: barbara.stegmann@merck.com.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stegmann
authors.affiliation: Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, Iowa.
authors.forename: Mark
authors.initials: M
authors.lastname: Santillan
authors.affiliation: ReproSource, Woburn, Massachusetts.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Leader
authors.affiliation: Department of Epidemiology, College of Public Health, Iowa City, Iowa.
authors.forename: Elaine
authors.initials: E
authors.lastname: Smith
authors.affiliation: Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, Iowa.
authors.forename: Donna
authors.initials: D
authors.lastname: Santillan
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood* / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000379:methods / Q000639:trends*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: Antimüllerian hormone (AMH); maternal serum alpha-fetoprotein (MSAFP); ovarian biomarkers; placental biomarkers; preterm birth