1. Emotional Health, Obesity, and Time to Pregnancy Suzanne Tough PhD 1,2, Jodi Siever MSc 3, Monica Jack 3 1 Department of Paediatrics, University of Calgary, 2 Department of Community Health Sciences, University of Calgary, 3 Public Health Innovation and Decision Support, Alberta Health Services Participants  1,044 urban women who had recently delivered their first live-born infant Data Collection  A computer-assisted telephone interview Primary Outcome  self-reported time to pregnancy Other Data  socio-demographic characteristics  self-esteem (Rosenberg Self-Esteem Scale)  lifestyle factors  medical and reproductive history  factors considered before having children  knowledge of factors related to reproduction  self-reported emotional and physical health Background Women Included in Analysis Bivariate Comparisons by Time to Pregnancy Objective Methods Excluded from analysis 469 women Completed the survey 1044 women (72% of eligible women) Included in analysis Planning to get pregnant Not using contraception <35 years at the start of trying to conceive 575 women  High body mass index, poor emotional health and a history of pregnancy complications independently delayed conception for women under 35 with no previous live-born births.  Women with good emotional health may become pregnant more quickly, or it may be that emotional health deteriorates as couples do not conceive within 6 months.  Public health strategies could highlight the influence of a healthy body weight and positive emotional health as factors that may influence time to pregnancy among women under 35, which may reduce the need for assistance to reproduction. Conclusions Cumulative Probability Distribution of Time to Pregnancy Characteristic ≤6 months N=351 >6 months N=224 Overall N=575 p- value Well-Being & Lifestyle Overweight/Obese pre-pregnancy BMI 24%34%28%0.009 Poor/fair emotional health 6 months prior to pregnancy 5%17%10%<0.001 Drinking Behaviour0.011 Non-drinker52%63%56% Drinker38%33%36% Binge drinker10%4%8% Events in Past 2 Years that Influenced Timing of This Pregnancy Emotional health conditions15%25%19%0.005 Life events26%11%20%<0.001 Personal goals23%11%18%<0.001 Corporate/work goals26%15%22%<0.001 Previous Pregnancies First time pregnant88%77%83%0.001 History of pregnancy complications, abortion or miscarriage 11%21%15%0.001 Past pregnancy problems made you afraid to get pregnant again 19%44%33%0.009 Fertility Methods Any prescription medication1%38%15%<0.001 Artificial insemination0%38%15%<0.001 In vitro fertilization (IVF)0%15%6%<0.001 Intracytoplasmic sperm injection (ICSI) 0%16%6%<0.001  To determine factors related to becoming pregnant within six months of trying  To determine the relative impact of body mass index and emotional health on time to pregnancy Among all women* N=568 Hazard Ratio (95% CI) Among women who were not using any fertility medications or treatments N=480 Hazard Ratio (95% CI) Overweight/Obese pre-pregnancy BMI1.34 (1.05, 1.72)1.31 (1.02, 1.68) History of pregnancy complications, history of miscarriage, history of abortion 1.42 (1.02, 1.99)1.63 (1.17, 2.29) Fair/poor self-rated emotional health at 6 months prior to pregnancy 2.02 (1.27, 3.22)1.72 (1.08, 2.75) Multivariate Proportional Hazards Model of Factors Determining Time to Pregnancy Greater Than 6 Months * Among women planning to get pregnant, not using contraception, and under the age of 35 when they started trying to get pregnant Characteristic Overall N=575 >$40,000 Household Income88% Caucasian85% Education Less than high school2% High school23% Post-secondary64% Post-graduate10% Married/common-law99% Working in 6 months before pregnancy 93% Sociodemographic Characteristics  Understanding the factors that influence time to pregnancy can assist in preconception planning and inform interventions