title: The influence of maternal and paternal factors on time to pregnancy--a Dutch population-based birth-cohort study: the GECKO Drenthe study.
abstract: BACKGROUND
  Both maternal and paternal factors have been suggested to influence a couple's fecundity. To investigate this, we examined the role of several maternal and paternal lifestyle and socio-demographic factors as determinants of time to pregnancy (TTP) in a Dutch birth-cohort.
  
  
  METHODS
  Groningen Expert Center for Kids with Obesity (GECKO) Drenthe is a population-based birth-cohort study of children born between April 2006 and April 2007 in Drenthe, a province of The Netherlands. Both partners received extensive questionnaires during pregnancy. Univariable and multivariable Cox regression analyses were used to determine the impact of the investigated factors on TTP.
  
  
  RESULTS
  A total of 4778 children were born, and the parents of 2997 children (63%) gave their consent to participate. After excluding unintended pregnancies and pregnancies as a result of fertility treatment, the data of 1924 couples were available for analysis. Hazards ratios and 95% confidence intervals of factors influencing TTP in multivariable Cox regression analysis were: maternal age 1.23 (0.98-1.54) for age <25 years, 1.17 (1.03-1.32) for age 25-30 years and 0.72 (0.61-0.85) for age >35 years (reference category: 30-35 years); paternal age: 1.31 (0.94-1.82) for age <25 years, 1.11 (0.97-1.28) for age 25-30 years and 0.91 (0.80-1.04 for age >35 years (reference category: 30-35 years); nulliparity: 0.76 (0.68-0.85) versus multiparity; menstrual cycle length: 1.12 (0.95-1.30) for 3 weeks, 0.72 (0.62-0.83) for 4-6 weeks, 0.68 (0.40-1.16) for >6 weeks and 0.66 (0.54-0.81) for irregular cycle (reference category: 4 weeks); prior contraceptive use: 0.78 (0.67-0.91) for no contraception, 1.68 (1.45-1.95) for condom use, 1.08 (0.89-1.33) for condom use combined with oral contraception, 1.40 (1.16-1.70) for intrauterine device and 0.50 (0.25-1.01) for contraceptive injection (reference category: oral contraception); and maternal educational level 0.75 (0.62-0.92) for low education level and 0.81 (0.73-0.90) for medium educational level (reference category: high educational level).
  
  
  CONCLUSIONS
  This population-based birth-cohort study performed in fertile couples who had conceived revealed neither maternal nor paternal modifiable lifestyle factors were significantly associated with TTP after adjustment for confounding by socio-demographic factors. In contrast, several non-modifiable maternal socio-demographic factors are significant predictors of a couple's fecundity.
authors.affiliation: Department of Obstetrics and Gynaecology, Groningen University Medical Center Groningen, University of Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands. m.a.q.mutsaerts@umcg.nl
authors.forename: M A Q
authors.initials: MA
authors.lastname: Mutsaerts
authors.forename: H
authors.initials: H
authors.lastname: Groen
authors.forename: H G
authors.initials: HG
authors.lastname: Huiting
authors.forename: W K H
authors.initials: WK
authors.lastname: Kuchenbecker
authors.forename: P J J
authors.initials: PJ
authors.lastname: Sauer
authors.forename: J A
authors.initials: JA
authors.lastname: Land
authors.forename: R P
authors.initials: RP
authors.lastname: Stolk
authors.forename: A
authors.initials: A
authors.lastname: Hoek
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D006293:Health Promotion; D006801:Humans; D007247:Infertility, Female / Q000209:etiology* / Q000517:prevention & control; D007248:Infertility, Male / Q000209:etiology* / Q000517:prevention & control; D008019:Life Style; D008297:Male; D009426:Netherlands; D011247:Pregnancy; D018873:Pregnancy Rate; D016016:Proportional Hazards Models; D060728:Reproductive Health; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult