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Serum Anti-Müllerian Hormone does not predict adverse perinatal outcomes in a cohort of women diagnosed with recurrent pregnancy loss

Year: 2024

Type: article

Abstract: BACKGROUND: The predictive value of serum Anti-Müllerian Hormone (AMH) for overall reproductive potential remains controversial, particularly with respect to obstetric and perinatal outcomes. The aim of this study was to evaluate the association between AMH levels and adverse maternal and neonatal outcomes in a large cohort of women diagnosed with recurrent pregnancy loss (RPL).METHODS: This retrospective observational cohort monocentric study included women assessed for RPL at a tertiary referral center between 2014 and 2023. Patients were stratified according to serum AMH levels (<0.7 vs. ≥0.7 ng/mL). Pregnancy and perinatal outcomes were evaluated using composite adverse neonatal outcomes (CANO), including birth weight <2500 g, neonatal intensive care unit admission, 5-minute Apgar score <7, birth weight below the 10th percentile, stillbirth and perinatal death. Composite adverse maternal outcomes (CAMO) included emergency cesarean section, operative vaginal delivery, postpartum hemorrhage, and intensive care unit admission. Descriptive and inferential statistical analyses were performed. Logistic regression models were used to investigate factors associated with adverse maternal and neonatal outcomes.RESULTS: During the study period, 453 women were evaluated for RPL. Serum AMH levels were available for 281 women (62.0%), and pregnancy outcome data were available for 123 women (44.1%). Among these, 11 women (8.7%) experienced a miscarriage, while 112 (90.3%) achieved a live birth. Women with AMH <0.7 ng/mL (N.=60; 13.25%) were significantly older (P<0.001), had a higher number of previous miscarriages (P=0.03), and a higher prevalence of hereditary thrombophilia (P=0.005). Among ongoing pregnancies, women with low AMH showed a higher prevalence of thyroid disorders (P=0.025) and lower antral follicle count (P=0.016). Multivariable analysis demonstrated no significant association between AMH levels and composite adverse neonatal or maternal outcomes, while labor induction was independently associated with a reduced risk of adverse neonatal outcomes.CONCLUSIONS: In women with recurrent pregnancy loss, low AMH levels were not associated with an increased risk of adverse maternal or neonatal outcomes. Labor induction appeared to exert a protective effect on neonatal outcomes. Prospective studies are warranted to confirm these findings and to support periconceptional counseling in this population.

Source: Minerva Obstetrics and Gynecology

DOI: 10.23736/s2724-606x.26.05887-2