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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Article info
Publication history
Published online: September 19, 2021
Accepted:
September 17,
2021
Received in revised form:
September 8,
2021
Received:
June 25,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
