Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort

Abstract Introduction Allostatic load (AL) is a practical index that reflects multi‐system physiological changes which occur in response to chronic psychosocial stress. This study investigated the association between female pre‐pregnancy allostatic load and time to pregnancy. Material and methods We...

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Main Authors: Xiang Hong, Jiechen Yin, Fanqi Zhao, Wei Wang, Xiaoling Ding, Hong Yu, Bei Wang
Format: Article
Language:English
Published: Wiley 2022-11-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14443
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author Xiang Hong
Jiechen Yin
Fanqi Zhao
Wei Wang
Xiaoling Ding
Hong Yu
Bei Wang
author_facet Xiang Hong
Jiechen Yin
Fanqi Zhao
Wei Wang
Xiaoling Ding
Hong Yu
Bei Wang
author_sort Xiang Hong
collection DOAJ
description Abstract Introduction Allostatic load (AL) is a practical index that reflects multi‐system physiological changes which occur in response to chronic psychosocial stress. This study investigated the association between female pre‐pregnancy allostatic load and time to pregnancy. Material and methods We enrolled 444 women who met the inclusion criteria and were attempting to achieve pregnancy. Their allostatic load scores at baseline were evaluated by nine indicators (systolic blood pressure, diastolic blood pressure, fasting plasma glucose, plasma cortisol, noradrenaline, interleukin‐6, hypersensitive C‐reactive protein, high density lipoprotein cholesterol and body mass index). The participants were followed up and their pregnancy outcome ascertained 1 year later; we then calculated time‐to‐pregnancy. Cox models were used to estimate fecundability ratios and their 95% confidence intervals (95% CI) for different allostatic load scores. Results The median allostatic load score was 1 with a range of 0–6. The females were divided into four groups according to allostatic load score: group A (allostatic load = 0, 150/444, 33.8%), group B (allostatic load = 1–2, 156/444, 35.1%), group C (allostatic load = 3–4, 100/444, 22.5%) and group D (allostatic load = 5–6, 38/444, 8.6%). The cumulative pregnancy rate over 12 months for the four groups (A–D) was 55.4%, 44.5%, 50.9% and 26.9%, respectively (log‐rank test, p = 0.042). After adjusting for potential confounding factors, group D showed a 59% reduction of fecundability compared with group A (fecundability ratio = 0.41, 95% CI 0.21–0.83). Conclusions Women with a higher allostatic load score may have lower fecundability. Our findings suggest that the assessment of allostatic load during pre‐conception consultation would be highly prudent.
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spelling doaj-art-e44fa8ef9c3240b3918fc360f8965b132025-08-20T02:36:39ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-11-01101111300130710.1111/aogs.14443Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohortXiang Hong0Jiechen Yin1Fanqi Zhao2Wei Wang3Xiaoling Ding4Hong Yu5Bei Wang6Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics School of Public Health, Southeast University Nanjing ChinaKey Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics School of Public Health, Southeast University Nanjing ChinaKey Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics School of Public Health, Southeast University Nanjing ChinaKey Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics School of Public Health, Southeast University Nanjing ChinaMaternal and Child Health Center of Gulou District Nanjing ChinaDepartment of Obstetrics and Gynecology, Zhong Da Hospital, School of Medicine Southeast University Nanjing ChinaKey Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics School of Public Health, Southeast University Nanjing ChinaAbstract Introduction Allostatic load (AL) is a practical index that reflects multi‐system physiological changes which occur in response to chronic psychosocial stress. This study investigated the association between female pre‐pregnancy allostatic load and time to pregnancy. Material and methods We enrolled 444 women who met the inclusion criteria and were attempting to achieve pregnancy. Their allostatic load scores at baseline were evaluated by nine indicators (systolic blood pressure, diastolic blood pressure, fasting plasma glucose, plasma cortisol, noradrenaline, interleukin‐6, hypersensitive C‐reactive protein, high density lipoprotein cholesterol and body mass index). The participants were followed up and their pregnancy outcome ascertained 1 year later; we then calculated time‐to‐pregnancy. Cox models were used to estimate fecundability ratios and their 95% confidence intervals (95% CI) for different allostatic load scores. Results The median allostatic load score was 1 with a range of 0–6. The females were divided into four groups according to allostatic load score: group A (allostatic load = 0, 150/444, 33.8%), group B (allostatic load = 1–2, 156/444, 35.1%), group C (allostatic load = 3–4, 100/444, 22.5%) and group D (allostatic load = 5–6, 38/444, 8.6%). The cumulative pregnancy rate over 12 months for the four groups (A–D) was 55.4%, 44.5%, 50.9% and 26.9%, respectively (log‐rank test, p = 0.042). After adjusting for potential confounding factors, group D showed a 59% reduction of fecundability compared with group A (fecundability ratio = 0.41, 95% CI 0.21–0.83). Conclusions Women with a higher allostatic load score may have lower fecundability. Our findings suggest that the assessment of allostatic load during pre‐conception consultation would be highly prudent.https://doi.org/10.1111/aogs.14443allostatic loadcohort studyfecundabilityinfertilitypsychosocial stresstime to pregnancy
spellingShingle Xiang Hong
Jiechen Yin
Fanqi Zhao
Wei Wang
Xiaoling Ding
Hong Yu
Bei Wang
Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort
Acta Obstetricia et Gynecologica Scandinavica
allostatic load
cohort study
fecundability
infertility
psychosocial stress
time to pregnancy
title Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort
title_full Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort
title_fullStr Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort
title_full_unstemmed Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort
title_short Female fecundability is associated with pre‐pregnancy allostatic load: Analysis of a Chinese cohort
title_sort female fecundability is associated with pre pregnancy allostatic load analysis of a chinese cohort
topic allostatic load
cohort study
fecundability
infertility
psychosocial stress
time to pregnancy
url https://doi.org/10.1111/aogs.14443
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