Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa).

Autor: Wootton RE; Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway. row@lds.no.; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK. row@lds.no.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. row@lds.no.; School of Psychological Science, University of Bristol, Bristol, UK. row@lds.no.; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway. row@lds.no., Lawn RB; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Magnus MC; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway., Treur JL; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Corfield EC; Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway., Njølstad PR; Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway.; Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway., Andreassen OA; NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, Oslo, Norway., Lawlor DA; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Munafò MR; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.; School of Psychological Science, University of Bristol, Bristol, UK., Håberg SE; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway., Davey Smith G; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Reichborn-Kjennerud T; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Magnus P; Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway., Havdahl A; Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.; Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
Jazyk: angličtina
Zdroj: BMC medicine [BMC Med] 2023 Apr 03; Vol. 21 (1), pp. 125. Date of Electronic Publication: 2023 Apr 03.
DOI: 10.1186/s12916-023-02831-9
Abstrakt: Background: Guidance to improve fertility includes reducing alcohol and caffeine consumption, achieving healthy weight-range and stopping smoking. Advice is informed by observational evidence, which is often biased by confounding.
Methods: This study primarily used data from a pregnancy cohort, the Norwegian Mother, Father and Child Cohort Study. First, we conducted multivariable regression of health behaviours (alcohol and caffeine consumption, body-mass index (BMI), and smoking) on fertility outcomes (e.g. time to conception) and reproductive outcomes (e.g. age at first birth) (n = 84,075 females, 68,002 males), adjusting for birth year, education and attention-deficit and hyperactive-impulsive (ADHD) traits. Second, we used individual-level Mendelian randomisation (MR) to explore possible causal effects of health behaviours on fertility/reproductive outcomes (n = 63,376 females, 45,460 males). Finally, we performed summary-level MR for available outcomes in UK Biobank (n = 91,462-1,232,091) and controlled for education and ADHD liability using multivariable MR.
Results: In multivariable regression analyses, higher BMI associated with fertility (longer time to conception, increased odds of infertility treatment and miscarriage), and smoking was associated with longer time to conception. In individual-level MR analyses, there was strong evidence for effects of smoking initiation and higher BMI on younger age at first birth, of higher BMI on increased time to conception, and weak evidence for effects of smoking initiation on increased time to conception. Age at first birth associations were replicated in summary-level MR analysis; however, effects attenuated using multivariable MR.
Conclusions: Smoking behaviour and BMI showed the most consistent associations for increased time to conception and a younger age at first birth. Given that age at first birth and time to conception are positively correlated, this suggests that the mechanisms for reproductive outcomes are distinct to the mechanisms acting on fertility outcomes. Multivariable MR suggested that effects on age at first birth might be explained by underlying liability to ADHD and education.
(© 2023. The Author(s).)
Databáze: MEDLINE
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