ArticleBMC pregnancy and childbirth2026
Mendelian randomization study on the effects of women's reproductive traits and socioeconomic traits on pregnancy complications.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPregnancy complications are influenced by a complex interplay of socioeconomic and reproductive factors. Observational studies have suggested associations with socioeconomic traits-such as educational attainment (EDU), household income (INC), and physically demanding work (PDW)-as well as reproductive traits including age at first sexual intercourse (AFS) and age at first birth (AFB). However, observational findings are prone to confounding and reverse causation, making it difficult to establish causality. Therefore, this study applies Mendelian randomization (MR) to investigate the causal relationships between reproductive and socioeconomic traits and the risk of pregnancy complications.
methodsWe conducted univariable and multivariable MR analyses to assess the causal effects of reproductive traits and socioeconomic traits on pregnancy complications. Genetic instruments reaching genome-wide significance (P < 5 × 10⁻
resultsUnivariable MR analysis identified significant associations, including AFB-PD(OR = 0.90, 95% CI: 0.81-0.98, P = 0.024 ), AFS-SA(OR = 0.77, 95% CI: 0.62-0.96, P = 0.020 ), AFS-PD(OR = 0.46, 95% CI: 0.36-0.59, P < 0.001 ), AFS-GD(OR = 0.62, 95% CI: 0.48-0.82, P < 0.001 ), AFS-PRM (OR = 0.68, 95% CI: 0.48-0.94, P = 0.020 ), EDU-SA (OR = 0.83, 95% CI: 0.71-0.97, P = 0.020 ), EDU-PD (OR = 0.55, 95% CI: 0.46-0.67, P < 0.001 ), EDU-GD (OR = 0.68, 95% CI: 0.56-0.83, P < 0.001 ), EDU-PRM (OR = 0.72, 95% CI: 0.56-0.94, P = 0.010 ), INC-PD (OR = 0.58, 95% CI: 0.48-0.70, P < 0.001 ), INC-GD (OR = 0.65, 95% CI: 0.43-0.97, P = 0.030 ), PDW-PD (OR = 2.00, 95% CI: 1.06-3.77, P = 0.030 ), and PDW-PE (OR = 2.80, 95% CI:1.09-7.18, P = 0.030 ). Multivariable MR analysis confirmed independent protective effects of higher EDU on PD (OR = 0.58, 95% CI: 0.37-0.91, P = 0.020 ), GD (OR = 0.58, 95% CI: 0.35-0.96, P = 0.030 ), and PRM (OR = 0.44, 95% CI: 0.24-0.81, P = 0.010 ). AFS was independently associated with an increased risk of PSP(OR = 1.86, 95% CI: 1.03-3.36, P = 0.040).Two-step MR mediation indicated that AFS partially mediates the EDU-outcome relationship for SA, PD, GD, and PSP (proportions mediated ~ 55-65% ), while the reverse pathway (EDU as mediator of AFS) showed smaller but directionally consistent mediation (~ 24-29% ).
conclusionLower EDU is causally associated with increased risks of PD, PE, and PRM. Educational level may influence reproductive timing, such as AFS, which in turn affects the likelihood of pregnancy complications. These findings highlight the potential benefits of targeted educational and social interventions in mitigating adverse pregnancy outcomes.
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