Associations between Disability and Infertility among U.S. Reproductive-Aged Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data and Participants
2.2. Exposure Assessment
2.3. Outcome Assessment
2.4. Covariates
2.5. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | All N (% CI) a | Infertility a | No Infertility | pb | |||
---|---|---|---|---|---|---|---|
N = 3789 | % and CI | n = 402 | % and CI 11.5 (10.1–12.9) | n = 3387 | % and CI 88.5 (87.1–89.9) | ||
Any disability | 0.002 | ||||||
No | 3170 | 84.8 (82.8–86.7) | 304 | 10.6 (9.1–12.0) | 2866 | 89.4 (88.0–90.9) | |
Yes | 619 | 15.2 (13.3–17.2) | 98 | 16.6 (13.2–20.1) | 521 | 83.4 (79.9–86.9) | |
Physical disability | 0.087 | ||||||
No | 3586 | 95.3 (94.2–96.3) | 368 | 11.2 (9.7–12.6) | 3218 | 88.8 (87.4–90.3) | |
Yes | 203 | 4.7 (3.7–5.8) | 34 | 17.7 (10.1–25.4) | 169 | 82.3 (74.6–89.9) | |
Sensory disability | 0.002 | ||||||
No | 3596 | 95.4 (94.5–96.4) | 363 | 11.0 (9.5–12.4) | 3233 | 89.0 (87.6–90.5) | |
Yes | 193 | 4.6 (3.6–5.5) | 39 | 21.9 (15.5–28.4) | 154 | 78.1 (71.6–84.5) | |
Cognitive disability | 0.014 | ||||||
No | 3433 | 91.0 (89.7–92.2) | 347 | 11.0 (9.6–12.4) | 3086 | 89.0 (87.6–90.4) | |
Yes | 356 | 9.0 (7.8–10.3) | 55 | 16.6 (12.3–20.9) | 301 | 83.4 (79.1–87.7) | |
Self-care disability | 0.164 | ||||||
No | 3725 | 98.6 (98.1–99) | 390 | 11.4 (9.9–12.8) | 3335 | 88.6 (87.2–90.1) | |
Yes | 64 | 1.4 (1.0–1.9) | 12 | 20.1 (7.1–33.1) | 52 | 79.9 (66.9–92.9) | |
Independent living disability | 0.180 | ||||||
No | 3591 | 94.8 (93.7–95.8) | 376 | 11.3 (9.8–12.7) | 3215 | 88.7 (87.3–90.2) | |
Yes | 198 | 5.2 (4.2–6.3) | 26 | 15.5 (9.5–21.4) | 172 | 84.5 (78.6–90.5) | |
Age (years, mean, CI) | - | 33.1 (32.6–33.5) | - | 36.9 (35.9–37.9) | - | 32.6 (32.1–33.0) | <0.0001 |
Race | 0.303 | ||||||
Non-Hispanic White | 1224 | 57 (52.2–61.7) | 152 | 12.4 (10–14.8) | 1072 | 87.6 (85.2–90.0) | |
Non-Hispanic Black | 839 | 13.3 (10.7–16.0) | 88 | 11.1 (8.9–13.4) | 751 | 88.9 (86.6–91.1) | |
Hispanic | 1058 | 19.4 (15.8–22.9) | 97 | 9.9 (7.9–11.9) | 961 | 90.1 (88.1–92.1) | |
Non-Hispanic Asian | 486 | 6.1 (4.9–7.2) | 45 | 9.0 (6.8–11.2) | 441 | 91.0 (88.8–93.2) | |
Others | 182 | 4.3 (3.5–5.0) | 20 | 10.8 (5–16.7) | 162 | 89.2 (83.3–95.0) | |
Education | <0.0001 | ||||||
High school or less | 1176 | 28.3 (25.2–31.5) | 133 | 12.3 (9.5–15.0) | 1043 | 87.7 (85.0–90.5) | |
At least some college | 2291 | 66.9 (63.6–70.2) | 265 | 11.9 (10.3–13.6) | 2026 | 88.1 (86.4–89.7) | |
Unknown | 322 | 4.8 (3.9–5.6) | 4 | 0.6 (0–1.2) | 318 | 99.4 (98.8–100) | |
Marital status | <0.0001 | ||||||
Divorced/single/widow | 1414 | 37.2 (34.6–39.9) | 109 | 7.1 (5.7–8.5) | 1305 | 92.9 (91.5–94.3) | |
Married/cohabitating | 1958 | 56.5 (53.7–59.3) | 286 | 15.5 (13.3–17.7) | 1672 | 84.5 (82.3–86.7) | |
Unknown | 417 | 6.3 (5.3–7.3) | 7 | 1.2 (0.1–2.2) | 410 | 98.8 (97.8–99.9) | |
Insurance | 0.472 | ||||||
No | 852 | 18.1 (16.0–20.1) | 96 | 12.9 (10.1–15.8) | 756 | 87.1 (84.2–89.9) | |
Yes | 2931 | 81.8 (79.7–83.9) | 305 | 11.2 (9.7–12.6) | 2626 | 88.8 (87.4–90.3) | |
Unknown | 6 | 0.1 (0–0.3) | 1 | 11.7 (0–35.2) | 5 | 88.3 (64.8–100) | |
Income to poverty ratio | 0.028 | ||||||
<1 | 1230 | 24.7 (22.3–27.2) | 107 | 9.1 (6.9–11.3) | 1123 | 90.9 (88.7–93.1) | |
1–2 | 905 | 20.4 (18.5–22.3) | 94 | 10.8 (8.4–13.2) | 811 | 89.2 (86.8–91.6) | |
>2 | 1654 | 54.9 (51.7–58.1) | 201 | 12.8 (10.8–14.8) | 1453 | 87.2 (85.2–89.2) | |
Parity | <0.0001 | ||||||
Nulliparous | 873 | 28.1 (25.7–30.6) | 58 | 5.5 (3.9–7.0) | 815 | 94.5 (93.0–96.1) | |
Parous | 2498 | 65.5 (63.2–67.9) | 336 | 15.0 (13.1–16.9) | 2162 | 85.0 (83.1–86.9) | |
Unknown | 418 | 6.3 (5.3–7.3) | 8 | 1.4 (0.3–2.4) | 410 | 98.6 (97.6–99.7) | |
Body Mass Index Categories | 0.0003 | ||||||
Underweight | 117 | 2.3 (1.7–2.9) | 13 | 14.2 (5.2–23.3) | 104 | 85.8 (76.7–94.8) | |
Normal weight | 1296 | 36.1 (33.3–38.9) | 111 | 8.7 (7–10.4) | 1185 | 91.3 (89.6–93.0) | |
Overweight | 895 | 24 (22.3–25.7) | 67 | 8.3 (5.7–10.8) | 828 | 91.7 (89.2–94.3) | |
Obese | 1481 | 37.6 (35.3–39.9) | 211 | 16.0(13.1–18.9) | 1270 | 84.0 (81.1–86.9) | |
Smoking status | 0.045 | ||||||
Never | 2773 | 69.6 (66.8–72.3) | 259 | 10.4 (8.9–11.9) | 2514 | 89.6 (88.1–91.1) | |
Ever | 394 | 12.8 (10.8–14.7) | 60 | 14.9 (11.1–18.7) | 334 | 85.1 (81.3–88.9) | |
Current | 622 | 17.7 (15.7–19.7) | 83 | 13.3 (9.8–16.7) | 539 | 86.7 (83.3–90.2) | |
Health status | 0.039 | ||||||
Good or excellent | 3009 | 83.8 (82–85.6) | 303 | 10.9 (9.4–12.3) | 2706 | 89.1 (87.7–90.6) | |
Poor, fair, unsure | 780 | 16.2 (14.4–18) | 99 | 14.7 (11.2–18.2) | 681 | 85.3 (81.8–88.8) | |
Arthritis | <0.0001 | ||||||
No | 3006 | 83.6 (81.7–85.5) | 333 | 11.4 (9.9–13.0) | 2673 | 88.6 (87.0–90.1) | |
Yes | 360 | 10.0 (8.5–11.4) | 60 | 18.5 (13.2–23.7) | 300 | 81.5 (76.3–86.8) | |
Unknown | 423 | 6.4 (5.4–7.4) | 9 | 1.5 (0.6–2.4) | 414 | 98.5 (97.6–99.4) | |
Thyroid problems | <0.0001 | ||||||
No | 3068 | 84.6 (83.0–86.3) | 345 | 11.7 (10.4–13.0) | 2723 | 88.3 (87.0–89.6) | |
Yes | 299 | 8.9 (7.6–10.1) | 50 | 17.0 (10.5–23.5) | 249 | 83.0 (76.5–89.5) | |
Unknown | 422 | 6.5 (5.4–7.6) | 7 | 1.1 (0.1–2.1) | 415 | 98.9 (97.9–99.9) | |
Cardiovascular diseases | 0.105 | ||||||
No | 3710 | 98.2 (97.8–98.7) | 389 | 11.3 (10.0–12.6) | 3321 | 88.7 (87.4–90) | |
Yes | 79 | 1.8 (1.3–2.2) | 13 | 21.0 (8.6–33.5) | 66 | 79.0 (66.5–91.4) | |
Cancer | <0.0001 | ||||||
No | 3276 | 90.4 (89.2–91.7) | 374 | 11.6 (10.1–13.2) | 2902 | 88.4 (86.8–89.9) | |
Yes | 97 | 3.3 (2.6–4.1) | 21 | 26.6 (15.8–37.4) | 76 | 73.4 (62.6–84.2) | |
Unknown | 416 | 6.3 (5.3–7.3) | 7 | 1.2 (0.1–2.2) | 409 | 98.8 (97.8–99.9) |
Characteristics | Sought Reproductive Healthcare | Did not Seek Reproductive Healthcare | pb | ||
---|---|---|---|---|---|
na | % and 95% CI | n | % and CI | ||
219 | 58.9 (54.1–63.7) | 183 | 41.1 (36.3–45.9) | ||
Any disability | 0.154 | ||||
No | 170 | 61.7 (55.7–67.6) | 134 | 38.3 (32.4–44.3) | |
Yes | 49 | 49.0 (34.7–63.3) | 49 | 51 (36.7–65.3) | |
Physical disability | 0.201 | ||||
No | 202 | 59.7 (54.8–64.6) | 166 | 40.3 (35.4–45.2) | |
Yes | 17 | 48.7 (32.5–64.9) | 17 | 51.3 (35.1–67.5) | |
Sensory disability | 0.353 | ||||
No | 198 | 59.8 (54.8–64.9) | 165 | 40.2 (35.1–45.2) | |
Yes | 21 | 49.3 (28.9–69.6) | 18 | 50.7 (30.4–71.1) | |
Cognition disability | 0.565 | ||||
No | 191 | 59.6 (54–65.2) | 156 | 40.4 (34.8–46) | |
Yes | 28 | 54.1 (37.7–70.4) | 27 | 45.9 (29.6–62.3) | |
Self-care disability | 0.326 | ||||
No | 211 | 58.5 (53.6–63.4) | 179 | 41.5 (36.6–46.4) | |
Yes | 8 | 72.7 (46.0.–99.3) | 4 | 27.3 (0.7–54.0) | |
Independent living disability | 0.840 | ||||
No | 203 | 58.8 (53.7–63.8) | 173 | 41.2 (36.2–46.3) | |
Yes | 16 | 60.6 (43.8–77.4) | 10 | 39.4 (22.6–56.2) | |
Age (years, mean, CI) | 38.4 (37.4–39.3) | 34.7 (33.3–36.1) | <0.0001 | ||
Race | |||||
Non-Hispanic White | 88 | 62.1 (56.4–67.8) | 64 | 37.9 (32.2–43.6) | 0.001 |
Non-Hispanic Black | 36 | 42.6 (30.5–54.6) | 52 | 57.4 (45.4–69.5) | |
Hispanic | 44 | 48.3 (35.7–60.8) | 53 | 51.7 (39.2–64.3) | |
Non-Hispanic Asian | 38 | 84.0 (71.9–96.1) | 7 | 16.0 (3.9–28.1) | |
Others | 13 | 76.9 (59.5–94.3) | 7 | 23.1 (5.7–40.5) | |
Education | <0.0001 | ||||
High school or less | 53 | 39.0 (29.9–48.0) | 80 | 61.0 (52–70.1) | |
At least some college | 165 | 67.7 (62.3–73.1) | 100 | 32.3 (26.9–37.7) | |
Unknown | 1 | 20.9 (0–56.7) | 3 | 79.1 (43.3–100) | |
Marital status | 0.002 | ||||
Divorced/single/widow | 45 | 47.3 (38.9–55.7) | 64 | 52.7 (44.3–61.1) | |
Married/cohabitating | 173 | 62.8 (56.7–68.9) | 113 | 37.2 (31.1–43.3) | |
Unknown | 1 | 7.9 (0–23.4) | 6 | 92.1 (76.6–100) | |
Insurance | |||||
No | 36 | 36.5 (29.1–43.9) | 60 | 63.5 (56.1–70.9) | |
Yes | 183 | 64.7 (59.2–70.3) | 122 | 35.3 (29.7–40.8) | |
Unknown | 0 | 0 | 1 | 100 (100–100) | |
Income to poverty ratio | <0.0001 | ||||
<1 | 42 | 42.0 (30.4–53.7) | 65 | 58.0 (46.3–69.6) | |
1–2 | 41 | 39.2 (29.1–49.2) | 53 | 60.8 (50.8–70.9) | |
>2 | 136 | 70.5 (64.8–76.1) | 65 | 29.5 (23.9–35.2) | |
Gravidity | 0.014 | ||||
Nulliparous | 27 | 50.0 (34.4–65.5) | 31 | 50.0 (34.5–65.6) | |
Parous | 191 | 60.7 (55.7–65.8) | 145 | 39.3 (34.2–44.3) | |
Unknown | 1 | 6.7 (0–21.7) | 7 | 93.3 (78.3–100) | |
Body Mass Index Categories | 0.718 | ||||
Underweight | 5 | 59.6 (28.6–90.6) | 8 | 40.4 (9.4–71.4) | |
Normal weight | 68 | 64.9 (54–75.7) | 43 | 35.1 (24.3–46.0) | |
Overweight | 35 | 55.5 (42.3–68.8) | 32 | 44.5 (31.2–57.7) | |
Obese | 111 | 56.8 (49.2–64.4) | 100 | 43.2 (35.6–50.8) | |
Smoking status | 0.006 | ||||
Never | 154 | 64.0 (57.7–70.4) | 105 | 36.0 (29.6–42.3) | |
Ever | 36 | 65.1 (51.8–78.3) | 24 | 34.9 (21.7–48.2) | |
Current | 29 | 38.0 (26.5–49.4) | 54 | 62.0 (50.6–73.5) | |
Health status | 0.065 | ||||
Good or excellent | 172 | 61.8 (55.9–67.7) | 131 | 38.2 (32.3–44.1) | |
Poor, fair, unsure | 47 | 47.9 (37.2–58.6) | 52 | 52.1 (41.4–62.8) | |
Arthritis | 0.254 | ||||
No | 185 | 60.1 (54.5–65.7) | 148 | 39.9 (34.3–45.5) | |
Yes | 31 | 53.9 (40.1–67.7) | 29 | 46.1 (32.3–59.9) | |
Unknown | 3 | 30.9 (0–68.0) | 6 | 69.1 (32–100) | |
Thyroid problems | 0.004 | ||||
No | 181 | 56.6 (51.8–61.5) | 164 | 43.4 (38.5–48.2) | |
Yes | 37 | 76.2 (59.4–93.0) | 13 | 23.8 (7–40.6) | |
Unknown | 1 | 7.9 (0–23.4) | 6 | 92.1 (76.6–100) | |
CVD | 0.642 | ||||
No | 211 | 58.7 (53.8–63.6) | 178 | 41.3 (36.4–46.2) | |
Yes | 8 | 65.1 (39.8–90.4) | 5 | 34.9 (9.6–60.2) | |
Cancer | 0.015 | ||||
No | 203 | 58.2 (53.1–63.4) | 171 | 41.8 (36.6–46.9) | |
Yes | 15 | 70.7 (48.1–93.3) | 6 | 29.3 (6.7–51.9) | |
Unknown | 1 | 7.9 (0–23.4) | 6 | 92.1 (76.6–100) |
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Ha, S.; Martinez, V. Associations between Disability and Infertility among U.S. Reproductive-Aged Women. Int. J. Environ. Res. Public Health 2021, 18, 3202. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063202
Ha S, Martinez V. Associations between Disability and Infertility among U.S. Reproductive-Aged Women. International Journal of Environmental Research and Public Health. 2021; 18(6):3202. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063202
Chicago/Turabian StyleHa, Sandie, and Valerie Martinez. 2021. "Associations between Disability and Infertility among U.S. Reproductive-Aged Women" International Journal of Environmental Research and Public Health 18, no. 6: 3202. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063202