Early Anti-Müllerian Hormone Levels in Adverse Pregnancy Outcomes in Women without Polycystic Ovary Syndrome

Anti-Müllerian hormone (AMH) is commonly used in artificial reproductive treatments. Unfortunately, there is only limited data about AMH in adverse pregnancy outcomes. Here, we searched the role of first-trimester AMH to predict adverse pregnancy outcomes in women without polycystic ovary syndrome (PCOS).A total of 240 pregnant women were enrolled in this prospective study. The inclusion criteria were being in the first trimester of pregnancy, having AMH levels measured, not having PCOS, and having had regular antenatal visits. Adverse outcomes were preeclampsia, gestational hypertension, gestational diabetes, preterm birth, pregnancy loss, and stillbirth. Demographic features, obstetric outcomes, and AMH levels were recorded and compared for each adverse outcome. AMH levels were lower in preeclampsia, gestational hypertension, gestational diabetes, and pregnancy loss compared to the control group. In ROC analysis, a cut-off value of 2.14 ng/mL for predicting preeclampsia yielded a sensitivity of 84.2% and specificity of 55.5% (p=0.027, AUC=0.658). For gestational hypertension, a threshold of 2.65 ng/mL resulted in a sensitivity of 94.4% and specificity of 41.2% (p=0.004, AUC=0.662). In predicting gestational diabetes, a cut-off of 1.98 ng/mL achieved a sensitivity of 83.3% and specificity of 59.7% (p<0.001, AUC=0.723). For pregnancy loss, a cut-off value of 2.94 ng/mL showed a sensitivity of 93.8% and specificity of 33.6% (p=0.001, AUC=0.660). The study provides initial indications about the role of AMH in predicting adverse pregnancy outcomes in pregnant women without PCOS. We believe that our study, when supported by randomized controlled studies with a large population, could confirm first-trimester AMH as a biomarker that can be used to predict adverse pregnancy outcomes. By using this marker, patients can be informed about the complications that will develop in the later period of pregnancy and can be referred to appropriate centers.