Nydjie P Grimes1, Brian W Whitcomb2, Katherine W Reeves2, Lynnette L Sievert3, Alexandra Purdue-Smithe4, JoAnn E Manson5, Susan E Hankinson6, Bernard A Rosner7, Elizabeth R Bertone-Johnson8. 1. Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA. Electronic address: ngrimes@umass.edu. 2. Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA 01003, USA. 3. Department of Anthropology, University of Massachusetts Amherst, Amherst, MA 01003, USA. 4. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA. 5. 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. 6. 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. 7. 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. 8. 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.
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.
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.
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Authors: Christine R Langton; Brian W Whitcomb; Alexandra C Purdue-Smithe; Lynnette L Sievert; Susan E Hankinson; JoAnn E Manson; Bernard A Rosner; Elizabeth R Bertone-Johnson Journal: JAMA Netw Open Date: 2020-01-03