Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA, United States of America.
PLoS One. 2018 Nov 27;13(11):e0207932. doi: 10.1371/journal.pone.0207932. eCollection 2018.
Over 12% of women in the United States have reduced fertility and/or fecundity. Environmental factors, such as temperature, and socioeconomic factors have been implicated in reducing female fecundity. The purpose of this study is to investigate the effect of environmental factors coupled with socioeconomic factors on birth rate at the country-level. We use birth rate as a proxy for female fecundity. This will enable us to identify the most important factors affecting female fecundity.
Using country-specific data from 182 countries, we constructed a regression model of the effects of environmental and socioeconomic factors on birth rate at the country-level. Our model assesses the role of temperature, Gross Domestic Product (GDP) per capita, fine air particulate matter (PM 2.5), and prevalence of male and female Body Mass Index (BMI) > = 25 (age-standardized) on birth rate per country. Because many of these factors are inter-dependent, we include all possible two-way interaction terms to assess the role of individual factors and interactions between multiple factors in the model.
In the full regression model, we found that GDP per capita along with 5 interaction terms were significant after adjusting for multiple testing. Female BMI was only nominally significant. GDP per capita was independently associated with birth rate (adjusted p-value <0.001). Prevalence of BMI > = 25 age-standardized in males and females were also significant when interacting with air pollution or GDP on female fecundity (birth rate). Temperature did not affect birth rate either independently or as an interaction unless BMI was removed from the model.
A country's economic wealth was the most significant factor in predicting birth rate in a statistical model that includes environmental and socioeconomic variables. This is important for future studies investigating environmental factors involved in increasing or decreasing female fecundity.
美国超过 12%的女性生育力和/或生育能力下降。环境因素,如温度,以及社会经济因素已被牵连,以减少女性生育能力。本研究的目的是调查环境因素与社会经济因素相结合对国家一级出生率的影响。我们使用出生率作为女性生育能力的替代指标。这将使我们能够确定影响女性生育能力的最重要因素。
使用来自 182 个国家的特定国家数据,我们构建了一个国家一级环境和社会经济因素对出生率影响的回归模型。我们的模型评估了温度、人均国内生产总值 (GDP)、细颗粒物 (PM 2.5)、以及男性和女性体重指数 (BMI) > = 25 (年龄标准化) 的流行程度对每个国家出生率的作用。由于这些因素中有许多是相互依存的,我们包括所有可能的双向交互项,以评估个体因素和模型中多个因素之间相互作用的作用。
在全回归模型中,我们发现 GDP 人均水平以及 5 个相互作用项在经过多次测试调整后具有统计学意义。女性 BMI 仅具有名义上的显著性。GDP 人均水平与出生率独立相关(调整后的 p 值<0.001)。当与空气污染或 GDP 相互作用时,标准化男性和女性 BMI > = 25 的流行率对女性生育力(出生率)也具有显著意义。除非从模型中去除 BMI,否则温度不会独立影响出生率或作为相互作用的影响。
在包括环境和社会经济变量的统计模型中,一个国家的经济财富是预测出生率的最重要因素。这对于未来研究调查涉及增加或减少女性生育能力的环境因素非常重要。