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The association of parity and breastfeeding with anti-Müllerian hormone levels at two time points

  • Nydjie P. Grimes
    Correspondence
    Corresponding author: 715 North Pleasant Street, Amherst, MA, 01003, USA.
    Affiliations
    Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA
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  • Brian W. Whitcomb
    Affiliations
    Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA
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  • Katherine W. Reeves
    Affiliations
    Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA
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  • Lynnette L. Sievert
    Affiliations
    Department of Anthropology, University of Massachusetts Amherst, Amherst, MA 01003, USA
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  • Alexandra Purdue-Smithe
    Affiliations
    Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
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  • JoAnn E. Manson
    Affiliations
    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA

    Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA
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  • Susan E. Hankinson
    Affiliations
    Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA

    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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  • Bernard A. Rosner
    Affiliations
    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA

    Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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  • Elizabeth R. Bertone-Johnson
    Affiliations
    Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA

    Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA 01003, USA
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Published:September 19, 2021DOI:https://doi.org/10.1016/j.maturitas.2021.09.006

      Highlights

      • Anti-Müllerian hormone levels are strongly related to menopause timing.
      • Whether parity and breastfeeding are related to anti-Müllerian hormone is unknown.
      • We found breastfeeding to be positively associated with anti-Müllerian hormone.
      • Parity was not associated with anti-Müllerian hormone after adjustment.
      • Breastfeeding may largely explain observed relations of parity and menopause timing.

      Abstract

      Objective

      To evaluate the association between parity and breastfeeding and anti-Müllerian hormone levels (AMH) and change in AMH levels over time. Furthermore, we examined whether AMH levels mediate the relation of parity and breastfeeding with age at menopause.

      Study design

      Observational, prospective cohort study.

      Main outcome measures

      AMH levels were assessed in a subset of premenopausal participants in the Nurses’ Health Study II, including 1619 women who provided a blood sample in 1996-1999 and an additional 800 women who provided a second premenopausal sample in 2010-2012.

      Results

      In multivariable linear regression models adjusted for parity, body mass index, smoking, and other factors, mean log AMH levels in 1996-1999 were 39% higher in women reporting ≥25 months of total breastfeeding vs. <1 month (P for trend = 0.009). Parity was not associated with AMH levels after adjustment for breastfeeding. Neither parity nor breastfeeding was associated with decline in AMH levels over 11 to 15 years. Breastfeeding duration was positively associated with age at menopause (P for trend = 0.01), with evidence that the association was mediated via AMH.

      Conclusions

      Our results suggest that breastfeeding is associated with higher AMH levels and later onset of menopause, and support the hypothesis that observed relations of parity with AMH levels and menopause timing may be largely attributable to breastfeeding.

      Keywords

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