Emotional Health, Obesity, and Time to Pregnancy Suzanne Tough PhD1,2, Jodi Siever MSc3, Monica Jack3
1Department of Paediatrics, University of Calgary, 2Department of Community Health Sciences, University of Calgary, 3Public Health Innovation and Decision Support, Alberta Health Services
Participants 1,044 urban women who had recently delivered
their first live-born infant
Data Collection A computer-assisted telephone interview
Primary Outcome self-reported time to pregnancy
Other Data socio-demographic characteristics self-esteem (Rosenberg Self-Esteem Scale) lifestyle factors medical and reproductive history factors considered before having children knowledge of factors related to reproduction self-reported emotional and physical health
Background
Women Included in Analysis
Bivariate Comparisons by Time to Pregnancy
Objective
Methods
Excluded from analysis
469 women
Completed the survey
1044 women
(72% of eligible women)
Included in analysis• Planning to get pregnant• Not using contraception• <35 years at the start of
trying to conceive
575 women
High body mass index, poor emotional health and a history of pregnancy complications independently delayed conception for women under 35 with no previous live-born births.
Women with good emotional health may become pregnant more quickly, or it may be that emotional health deteriorates as couples do not conceive within 6 months.
Public health strategies could highlight the influence of a healthy body weight and positive emotional health as factors that may influence time to pregnancy among women under 35, which may reduce the need for assistance to reproduction.
Conclusions
Cumulative Probability Distribution of Time to Pregnancy
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0 6 12 18 24 30 36 42 48 54 60 66 72 78 84 90 96 102 108 114 120Time to pregnancy (months)
Characteristic≤6
monthsN=351
>6 monthsN=224
OverallN=575
p-value
Well-Being & Lifestyle
Overweight/Obese pre-pregnancy BMI
24% 34% 28% 0.009
Poor/fair emotional health 6 months prior to pregnancy
5% 17% 10% <0.001
Drinking Behaviour 0.011
Non-drinker 52% 63% 56%
Drinker 38% 33% 36%
Binge drinker 10% 4% 8%
Events in Past 2 Years that Influenced Timing of This Pregnancy
Emotional health conditions 15% 25% 19% 0.005
Life events 26% 11% 20% <0.001
Personal goals 23% 11% 18% <0.001
Corporate/work goals 26% 15% 22% <0.001
Previous Pregnancies
First time pregnant 88% 77% 83% 0.001
History of pregnancy complications, abortion or miscarriage
11% 21% 15% 0.001
Past pregnancy problems made you afraid to get pregnant again
19% 44% 33% 0.009
Fertility Methods
Any prescription medication 1% 38% 15% <0.001
Artificial insemination 0% 38% 15% <0.001
In vitro fertilization (IVF) 0% 15% 6% <0.001
Intracytoplasmic sperm injection (ICSI)
0% 16% 6% <0.001
To determine factors related to becoming pregnant within six months of trying
To determine the relative impact of body mass index and emotional health on time to pregnancy
Among all women*
N=568
Hazard Ratio
(95% CI)
Among women who were not using any fertility
medications or treatments
N=480
Hazard Ratio
(95% CI)
Overweight/Obese pre-pregnancy BMI 1.34 (1.05, 1.72) 1.31 (1.02, 1.68)
History of pregnancy complications, history of miscarriage, history of abortion
1.42 (1.02, 1.99) 1.63 (1.17, 2.29)
Fair/poor self-rated emotional health at 6 months prior to pregnancy
2.02 (1.27, 3.22) 1.72 (1.08, 2.75)
Multivariate Proportional Hazards Model of Factors Determining Time to Pregnancy Greater Than 6 Months
* Among women planning to get pregnant, not using contraception, and under the age of 35 when they started trying to get pregnant
CharacteristicOverallN=575
>$40,000 Household Income 88%
Caucasian 85%
Education
Less than high school 2%
High school 23%
Post-secondary 64%
Post-graduate 10%
Married/common-law 99%
Working in 6 months before pregnancy
93%
Sociodemographic Characteristics
Understanding the factors that influence time to pregnancy can assist in preconception planning and inform interventions
