Socioeconomic status and fecundability in a Danish preconception cohort.
Socioeconomic status and fecundability in a Danish preconception cohort.
复制标题
丹麦孕前队列的社会经济地位和生育能力。
DOI：
10.1093/humrep/dead077
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Laursen,AnneSofieDam
中科院分区：
文献类型：
--
作者：
Jørgensen,MarieDahl;Mikkelsen,EllenM;Hatch,ElizabethE;Rothman,KennethJ;Wise,LaurenA;Sørensen,HenrikToft;Laursen,AnneSofieDam
研究问题在一群想要怀孕的丹麦夫妇中，社会经济地位(SES)(以教育程度和家庭收入来衡量)与受孕能力有多大的关联？在这个先入为主的队列中，在调整潜在的混杂因素后，受教育程度和家庭收入较低与较低的受孕能力相关。这是已知的大约15%的夫妇受到不孕不育的影响。健康方面的社会经济差距是根深蒂固的。然而，人们对社会经济差距及其与生育力的关系知之甚少。这是一项对2007年至2021年间18-49岁的丹麦女性进行的队列研究，这些女性试图怀孕。通过基线和每两个月一次的跟踪问卷收集信息，持续12个 月或直到报告怀孕。在最多12个周期的随访中，10名475名参与者提供了38至629个月经周期和6554次妊娠。我们使用比例概率回归模型来估计受孕率(FR)和95%CI。主要结果和CHANCE的作用与高等教育(最高水平)相比，小学和中学(FR：0.73，95%CI：0.62-0.85)、高中(FR：0.89，95%CI：0.79-1.00)、职业教育(FR：0.81，95%CI：0.75-0.89)和较低高等教育(FR：0.87，95%CI：0.80-0.95)的受孕率显著较低，而不是中等以上学历(FR：0.98，95%CI：0.93-1.03)。与家庭月收入65,000丹麦克朗相比，家庭收入25,000丹麦克朗(FR：0.78，95%CI：0.72-0.85)、25,000-39,000丹麦克朗(FR：0.88，95%CI：0.82-0.94)和40,000-65,000丹麦克朗(FR：0.94，95%CI：0.88-0.99)的受精率较低。在对潜在混杂因素进行调整后，结果没有明显变化。限制，原因我们使用教育程度和家庭收入作为SES的指标。然而，SES是一个复杂的概念，这些指标可能不能反映SES的所有方面。这项研究招募了计划怀孕的夫妇，包括从生育能力较差的个体到生育能力较高的个体的全部生育范围。我们的结果可能会推广到大多数试图怀孕的夫妇。FINDINGSOR结果的广泛影响与文献一致，表明社会经济群体中健康方面的不平等得到了很好的证明。考虑到丹麦的福利国家，收入的关联性令人惊讶地强烈。研究资金/竞争利益(S)这项研究得到了奥胡斯大学和奥胡斯大学医院临床流行病学系以及国家儿童健康和人类发展研究所的支持(RO1-HD086742，R21-HD050264和R01-HD060680)。作者声明没有利益冲突。三个注册号A。
STUDY QUESTIONTo what extent is socioeconomic status (SES), as measured by educational attainment and household income, associated with fecundability in a cohort of Danish couples trying to conceive?SUMMARY ANSWERIn this preconception cohort, lower educational attainment and lower household income were associated with lower fecundability after adjusting for potential confounders.WHAT IS KNOWN ALREADYApproximately 15% of couples are affected by infertility. Socioeconomic disparities in health are well established. However, little is known about socioeconomic disparity and its relation to fertility.STUDY DESIGN, SIZE, DURATIONThis is a cohort study of Danish females aged 18–49 years who were trying to conceive between 2007 and 2021. Information was collected via baseline and bi-monthly follow-up questionnaires for 12 months or until reported pregnancy.PARTICIPANTS/MATERIALS, SETTING, METHODSOverall, 10 475 participants contributed 38 629 menstrual cycles and 6554 pregnancies during a maximum of 12 cycles of follow-up. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% CIs.MAIN RESULTS AND THE ROLE OF CHANCECompared with upper tertiary education (highest level), fecundability was substantially lower for primary and secondary school (FR: 0.73, 95% CI: 0.62–0.85), upper secondary school (FR: 0.89, 95% CI: 0.79–1.00), vocational education (FR: 0.81, 95% CI: 0.75–0.89), and lower tertiary education (FR: 0.87, 95% CI: 0.80–0.95), but not for middle tertiary education (FR: 0.98, 95% CI: 0.93–1.03). Compared with a monthly household income of >65 000 DKK, fecundability was lower for household income <25 000 DKK (FR: 0.78, 95% CI: 0.72–0.85), 25 000–39 000 DKK (FR: 0.88, 95% CI: 0.82–0.94), and 40 000–65 000 DKK (FR: 0.94, 95% CI: 0.88–0.99). The results did not change appreciably after adjustment for potential confounders.LIMITATIONS, REASONS FOR CAUTIONWe used educational attainment and household income as indicators of SES. However, SES is a complex concept, and these indicators may not reflect all aspects of SES. The study recruited couples planning to conceive, including the full spectrum of fertility from less fertile to highly fertile individuals. Our results may generalize to most couples who are trying to conceive.WIDER IMPLICATIONS OF THE FINDINGSOur results are consistent with the literature indicating well-documented inequities in health across socioeconomic groups. The associations for income were surprisingly strong considering the Danish welfare state. These results indicate that the redistributive welfare system in Denmark does not suffice to eradicate inequities in reproductive health.STUDY FUNDING/COMPETING INTEREST(S)The study was supported by the Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, and the National Institute of Child Health and Human Development (RO1-HD086742, R21-HD050264, and R01-HD060680). The authors declare no conflict of interest.TRIAL REGISTRATION NUMBERN/A.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
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DOI：
10.1093/ajcn/nqac213
发表时间：
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期刊：
The American journal of clinical nutrition
影响因子：
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作者：
Willis,SydneyK;Hatch,ElizabethE;Laursen,AnneSd;Wesselink,AmeliaK;Mikkelsen,EllenM;Tucker,KatherineL;Rothman,KennethJ;Mumford,SunniL;Wise,LaurenA
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影响因子：
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作者：
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