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Life Course Financial Hardship and Fecundability in a North American Preconception Cohort Study.

Molly N Hoffman1, Collette N Ncube1, Eleanor J Murray1

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Summary

Financial hardship at any life stage can slightly reduce fertility. Experiencing hardship in adulthood, especially after childhood or adolescence, significantly lowers fecundability, indicating a sensitive period for reproductive health.

Keywords:
Cohort StudiesEconomic FactorsFinancial StressLife Course PerspectiveTime-to-Pregnancy

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Area of Science:

  • Reproductive Health
  • Socioeconomic Factors
  • Human Fertility

Background:

  • Life course socioeconomic factors, specifically financial hardship, are understudied in relation to fertility.
  • Understanding the impact of financial stress across different life stages on reproductive capacity is crucial for public health.

Purpose of the Study:

  • To investigate the association between financial hardship experienced at various life stages (childhood, adolescence, adulthood) and fecundability.
  • To determine if cumulative financial hardship influences fertility outcomes.

Main Methods:

  • Utilized data from the Pregnancy Study Online (PRESTO) cohort study (N=6,377) of U.S. and Canadian pregnancy planners.
  • Employed inverse probability-weighted proportional probabilities models to analyze the relationship between self-reported financial hardship and fecundability over 12 months.
  • Accounted for time-dependent confounding and selection bias in the analysis.

Main Results:

  • Financial hardship during any life stage was linked to a slight decrease in fecundability (FR=0.93).
  • Adulthood financial hardship showed a stronger negative association with fecundability (FR=0.83).
  • Cumulative financial hardship, particularly in adulthood following earlier hardship, demonstrated the most significant reduction in fecundability (FR=0.77).

Conclusions:

  • Adulthood represents a critical period where financial hardship can significantly impact a woman's ability to conceive.
  • The cumulative effect of financial hardship across the lifespan is associated with progressively lower fecundability.