Emerging Trends in Preconception Behaviours: A Cross-Sectional Analysis
of Lifestyle Factors in 235,311 UK-Based Women
Abstract
Objective To assess preconception lifestyle behaviours between
individuals actively trying to conceive (TTC) and planning for future
pregnancies (PFF). Design Retrospective cross-sectional study.
Setting UK-based women. Population 235,311 women who
completed an online reproductive health questionnaire between September
2020 and November 2024. Methods Self-reported data on
reproductive intent as well as smoking, vaping, alcohol, and drug use
were analysed. Logistic regression models adjusted for age, BMI, and
lifestyle factors compared behavioural differences between TTC and PFF
groups. Main Outcome Measures Prevalence of modifiable
lifestyle factors (smoking, vaping, alcohol, and drug use) in TTC vs.
PFF groups, stratified by age and TTC duration. Results TTC
individuals smoked more than PFF individuals (9.1% vs. 7.3%; aOR =
1.76, 95% CI: 1.68–1.84, p < 0.001). Although vaping was
more prevalent among PFF individuals (13.7% vs. 12.3%), TTC
individuals had higher adjusted odds of vaping (aOR = 1.14, 95% CI:
1.10–1.18, p < 0.001). TTC individuals were more likely to
abstain from alcohol (48.8% vs. 30.5%, p <0.001), however,
many still exceeded the UK’s recommended low-risk limit of 14 units per
week. Smoking, vaping, and drug use were highest in those under 25,
while alcohol use peaked in those over 35. Smoking and vaping rates were
significantly higher among those TTC for >12 months.
Conclusions Findings show continued engagement in high-risk
behaviours despite TTC, underscoring the need for targeted
interventions, particularly vaping cessation and age-specific
counselling, to mitigate risks earlier in the reproductive timeline and
improve fertility outcomes.