Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa)
Abstract 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 cohor...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-023-02831-9 |
| _version_ | 1797850028526534656 |
|---|---|
| author | Robyn E. Wootton Rebecca B. Lawn Maria C. Magnus Jorien L. Treur Elizabeth C. Corfield Pål R. Njølstad Ole A. Andreassen Deborah A. Lawlor Marcus R. Munafò Siri E. Håberg George Davey Smith Ted Reichborn-Kjennerud Per Magnus Alexandra Havdahl |
| author_facet | Robyn E. Wootton Rebecca B. Lawn Maria C. Magnus Jorien L. Treur Elizabeth C. Corfield Pål R. Njølstad Ole A. Andreassen Deborah A. Lawlor Marcus R. Munafò Siri E. Håberg George Davey Smith Ted Reichborn-Kjennerud Per Magnus Alexandra Havdahl |
| author_sort | Robyn E. Wootton |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T18:53:44Z |
| format | Article |
| id | doaj.art-4ad7604523c249d485f97888a2f2d08c |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-09T18:53:44Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-4ad7604523c249d485f97888a2f2d08c2023-04-09T11:18:34ZengBMCBMC Medicine1741-70152023-04-0121111710.1186/s12916-023-02831-9Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa)Robyn E. Wootton0Rebecca B. Lawn1Maria C. Magnus2Jorien L. Treur3Elizabeth C. Corfield4Pål R. Njølstad5Ole A. Andreassen6Deborah A. Lawlor7Marcus R. Munafò8Siri E. Håberg9George Davey Smith10Ted Reichborn-Kjennerud11Per Magnus12Alexandra Havdahl13Nic Waals Institute, Lovisenberg Diaconal HospitalDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthCentre for Fertility and Health, Norwegian Institute of Public HealthDepartment of Psychiatry, Amsterdam UMC, University of AmsterdamNic Waals Institute, Lovisenberg Diaconal HospitalCenter for Diabetes Research, Department of Clinical Science, University of BergenNORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo University HospitalMRC Integrative Epidemiology Unit, University of BristolMRC Integrative Epidemiology Unit, University of BristolCentre for Fertility and Health, Norwegian Institute of Public HealthMRC Integrative Epidemiology Unit, University of BristolDepartment of Mental Disorders, Norwegian Institute of Public HealthCentre for Fertility and Health, Norwegian Institute of Public HealthNic Waals Institute, Lovisenberg Diaconal HospitalAbstract 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.https://doi.org/10.1186/s12916-023-02831-9FertilityReproductive outcomesAlcoholSmokingBMICaffeine |
| spellingShingle | Robyn E. Wootton Rebecca B. Lawn Maria C. Magnus Jorien L. Treur Elizabeth C. Corfield Pål R. Njølstad Ole A. Andreassen Deborah A. Lawlor Marcus R. Munafò Siri E. Håberg George Davey Smith Ted Reichborn-Kjennerud Per Magnus Alexandra Havdahl Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa) BMC Medicine Fertility Reproductive outcomes Alcohol Smoking BMI Caffeine |
| title | Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa) |
| title_full | Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa) |
| title_fullStr | Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa) |
| title_full_unstemmed | Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa) |
| title_short | Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa) |
| title_sort | associations between health behaviours fertility and reproductive outcomes triangulation of evidence in the norwegian mother father and child cohort study moba |
| topic | Fertility Reproductive outcomes Alcohol Smoking BMI Caffeine |
| url | https://doi.org/10.1186/s12916-023-02831-9 |
| work_keys_str_mv | AT robynewootton associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT rebeccablawn associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT mariacmagnus associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT jorienltreur associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT elizabethccorfield associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT palrnjølstad associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT oleaandreassen associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT deborahalawlor associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT marcusrmunafo associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT siriehaberg associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT georgedaveysmith associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT tedreichbornkjennerud associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT permagnus associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba AT alexandrahavdahl associationsbetweenhealthbehavioursfertilityandreproductiveoutcomestriangulationofevidenceinthenorwegianmotherfatherandchildcohortstudymoba |