Page 94 - Fertility in Women with Rheumatoid Arthritis Vruchtbaarheid van vrouwen met reumatoïde artritis

Chapter 6
sulfasalazine use, or past use of methotrexate. A multivariable linear regression of log-transformed AMH levels including all of the above covariates, showed a signi cant negative association with the presence of ACPA, both corrected for age (β= -0.47 (95%CI -0.89 ‒ -0.051), p=0.028), as well as uncorrected for age (β= -0.57 (95%CI -0.99 ‒ -0.14), p=0.009) (table 2).
Figure 3 – Preconception serum AMH levels in 209 women with rheumatoid arthritis trying to conceive, plotted against the 10th, 50th and 90th percentile of serum AMH values in healthy controls.12
AMH and time to pregnancy (TTP)
For the Cox proportional hazard analysis, the preconceptional study visit at which the rst serum was drawn was considered as the start of follow-up. Of the 209 women, 205 women were included in the analysis. Four women were excluded because it was unknown whether pregnancy had occurred (n=3) or what the exact follow-up time was (n=1). Log-transformed AMH levels, corrected for age, were not signi cantly associated with TTP (HR 1.09 (95%CI: 0.94 – 1.27), p=0.26). A longer TTP was associated with older age (HR 0.96 per year (95%CI: 0.91 – 1.00), p=0.052), never having been pregnant before (HR 0.43 (95%CI: 0.30 ‒ 0.62), p<0.001), increasing disease activity (HR 0.85 per point of DAS28 (95%CI 0.73 ‒ 0.98), p=0.026), and preconceptional NSAIDs use (HR 0.5(95%CI: 0.40 ‒ 0.81), p=0.002) (table 3). An interaction term between age and AMH was not signi cant (p=0.20), and was not included in the model. When leaving age out of the model, the uncorrected AMH levels also showed no signi cant association with TTP (HR 1.14 (95%CI: 0.98 – 1.33), p=0.093) (data not shown).
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