Tabernero-Rico Pedro M, Garcia-Velasco Juan A
Department of Obstetrics and Gynaecology, Fuenlabrada University Hospital, Rey Juan Carlos University, Madrid, Spain.
IVI RMA Madrid, Rey Juan Carlos University, Madrid, Spain.
J Hum Reprod Sci. 2019 Jul-Sep;12(3):240-246. doi: 10.4103/jhrs.JHRS_20_19.
Subfertility affects about 15% of couples worldwide. There are several factors that affect subfertility called social determinants of health (SDH): biological factors as age, ethnic origin, and body mass index; behavioral factors as alcohol intake, smoking, coffee, dietary restriction, physical activity, and psychological state; and contextual factors as education, work activity, and income level.
The aim of the study is to evaluate the distribution's relevance of the SDH in subfertile women versus nonsubfertile women.
A prospective comparative study with two groups of women recruited over 1 year at hospital consultation: one group with subfertile women excluding women without a male partner or with a previous child and another one formed by primigravidae, excluding those receiving assisted reproduction techniques to become pregnant.
We compare the different factors between subfertile and nonsubfertile women one by one. Second, a multivariate analysis was conducted with logistic regression. In all cases, informed consent was obtained.
Regular physical exercise 3-4 times/week (odds ratio [OR]: 0.33, 95% confidence interval [CI]: 0.15-0.71) or healthy food products such as fish 1-2 times/week (OR: 0.40, 95% CI: 0.17-0.95) were associated with nonsubfertile women.
The distribution of SDH in natural fertility is not altogether homogeneous. Weight control by means of restricting calorie intake, greater consumption of healthy foods such as fish, regular physical exercise, and lower age are positively associated with fertility. Population-level intervention is possible to improve women's health, as these are modifiable factors. Ethnic origin can be considered as a relevant factor, as it may condition the distribution of other determinants.
全球约15%的夫妇受生育力低下影响。有几个影响生育力低下的因素，称为健康的社会决定因素（SDH）：生物学因素，如年龄、种族和体重指数；行为因素，如饮酒、吸烟、喝咖啡、饮食限制、体育活动和心理状态；以及背景因素，如教育程度、工作活动和收入水平。
本研究的目的是评估SDH在不孕妇女与非不孕妇女中的分布相关性。
一项前瞻性比较研究，在医院咨询中对两组女性进行了为期1年的招募：一组为不孕妇女，排除没有男性伴侣或已有子女的妇女；另一组由初产妇组成，排除那些接受辅助生殖技术以怀孕的妇女。
我们逐一比较了不孕和非不孕女性之间的不同因素。其次，进行了逻辑回归的多变量分析。在所有情况下，均获得了知情同意。
每周进行3 - 4次规律体育锻炼（优势比[OR]：0.33，95%置信区间[CI]：0.15 - 0.71）或每周食用1 - 2次鱼类等健康食品（OR：0.40，95% CI：0.17 - 0.95）与非不孕女性相关。
SDH在自然生育中的分布并非完全均匀。通过限制热量摄入来控制体重、更多食用鱼类等健康食品、规律体育锻炼以及较低年龄与生育力呈正相关。由于这些是可改变的因素，因此有可能通过人群层面的干预来改善女性健康。种族可被视为一个相关因素，因为它可能影响其他决定因素的分布。
