Is in utero exposure to maternal socioeconomic disadvantage related to offspring ovarian reserve in adulthood?

Abstract

Background: Because the ovarian follicle pool is established in utero, adverse exposures during this period may be especially impactful on the size and health of the initial follicle endowment, potentially shaping trajectories of ovarian follicle loss and the eventual onset of menopause. Building on a robust literature linking socioeconomic status (SES) and menopausal timing, the current study examined adverse prenatal exposures related to maternal SES, hypothesizing that greater maternal socioeconomic disadvantage would be associated with lower ovarian reserve in the adult offspring. Methods: In a healthy, community-based sub-sample (n = 350) of reproductive age participants in the OVA Study (2006)(2007)(2008)(2009)(2010)(2011), prenatal maternal SES was examined in relation to two biomarkers of ovarian reserve, antimullerian hormone (AMH) and antral follicle count (AFC). Prenatal maternal SES was assessed indirectly using maternal addresses abstracted from participant birth certificates, geocoded, and linked to US Census-derived variables, including neighborhood-level characteristics: education (% of individuals with a HS diploma); poverty (% of families below the poverty line); unemployment (% of individuals > 16 years who are unemployed); and income (median family income). Results: In separate covariate-adjusted linear regression models (following the backward elimination of main effects with P > .10), greater maternal neighborhood education was related to higher ovarian reserve as marked by higher levels of offspring AMH (beta = .142, P < .001) and AFC (beta = .092, P < .10) with models accounting for 19.6% and 21. 5% of the variance in AMH and AFC, respectively. In addition, greater maternal neighborhood poverty was related to lower ovarian reserve as marked by lower offspring AMH (beta = −.144, P < .01), with the model accounting for 19.5% of the variance in AMH. Conclusions: Maternal socioeconomic disadvantage measured indirectly at the neighborhood level was associated with lower ovarian reserve among the adult offspring, independently of offspring SES and other potential confounding factors. This suggests SES-related adversity exposures may have a detrimental impact on the size or health of the initial follicle endowment, leading to accelerated follicle loss over time.

Variation in levels of AMH among Maya and non‐Maya women in Campeche, Mexico

“…Whether ethnic differences in levels of AMH are related to population variation or to differences in developmental environments that shape reproductive physiology (Begum et al, ; Bleil et al, ) remains a question for future research. There is no indication from our data that Maya and non‐Maya women in the city of Campeche experience different levels of socioeconomic stress.…”

Ethnic discordance in serum anti-Müllerian hormone in European and Indian healthy women and Indian infertile women

“…Estimates from metaanalyses for education and occupation level both demonstrate a dose-response for later age at natural menopause, with increasing education or occupation level associated with increasing age at natural menopause. SEP and overall measures of health have also been positively associated with AMH concentrations (Bleil et al, 2018;Vanni et al, 2022).…”

Association between neighborhood poverty and ovarian reserve: the ovarian aging study

“…[8][9][10][11][12][13][14][15][16][17][18] Few studies have considered whether SES at the neighborhood level may also impact the ovarian reserve. 26,27 The current study sought to fill this gap by leveraging a large sample of premenopausal women in the OVA Study to evaluate whether neighborhood SES is related to the ovarian reserve indexed by biomarkers, AMH and AFC. Neighborhood SES was assessed using US Census data to form an aggregate of exposure to neighborhood poverty over the period of adulthood.…”

“…Prior studies suggest that women from lower SES backgrounds have a lower ovarian reserve and an earlier age at menopause 8-18 . Few studies have considered whether SES at the neighborhood level may also impact the ovarian reserve 26,27 . The current study sought to fill this gap by leveraging a large sample of premenopausal women in the OVA Study to evaluate whether neighborhood SES is related to the ovarian reserve indexed by biomarkers, AMH and AFC.…”

“…[21][22][23][24] These same exposures have implications for women's reproductive health, 25 yet few studies have explored links between neighborhood-level SES and ovarian reserve specifically. One prior study showed that lower neighborhood-level SES among mothers was associated with lower ovarian reserve in their adult daughters, 26 indicating that SES-related exposures in utero may influence the size or health of offspring ovarian reserve. One other more recent study showed that, among obese or overweight women, those living in the most disadvantaged neighborhoods had a lower ovarian reserve compared with those living in less disadvantaged neighborhoods.…”