Path Analysis on the Biopsychosocial Determinants of Infertility among Reproductive Aged Women in Surakarta, Central Java

Background: Infertility is a multidimensional prob­­lem. This problem occurs not only because of health problems related to anatomic factors such as problems in the fallopian tubes, ovaries, and endo­­­metrium, but also there are more factors such as physiological, genetic, and environmental fac­tors. The purpose of this study was to analyze the factors that influence the incidence of infer­tility in women. Subjects and Method: A case control study was conducted at the Gynecology Obstetrics Poly­clinic and Sekar Fertility Clinic, Dr. Moewardi hos­pital, Surakarta, Central Java, from October to November 2019. A sample of 200 women rep­ro­­ductive age was selected by fixed disease samp­ling. The dependent variable was infertility. The inde­pen­dent variables were age, body mass index (BMI), physical activity, endo­metriosis, family his­tory, exposure to cigarette smoke, and stress. The data were obtained from medical record and question­naire. The data were analyzed by path analysis run on Stata 13. Results: Infertility in women was directly increased with age 35 years (b= 1.20; 95% CI= 0.18 to 2.22; p= 0.021), BMI <18 or ≥25 (b= 2.93; 95% CI= 1.95 to 3.91; p<0.001), high phy­sical activity (b= 1.30; 95% CI= 0.28 to 2.33; p= 0.013), endometriosis (b= 1.17; 95% CI= 0.20 to 2.13; p= 0.018), exposure to cigarette smoke (b= 1.19; 95% CI= 0.20 to 2.23; p= 0.023), and severe stress (b= 1.18; 95% CI= 0.27 to 2.08; p= 0.011). In­fer­­tility in women was indirectly increased with age, physical activity, and family history of infer­tile. Conclusion: Infertility in women is directly in­creas­ed with age 35 years, BMI <18 or ≥25, high phy­sical activity, endometriosis, exposure to ciga­ret­­­te smoke, and severe stress. Infertility in women is indirectly increased with age, physical acti­vity, and family history of infertile. Keywords: female infertility, risk factors, path analy­sis Correspondence: Luthfia Zauma. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia, 57126. Email:[email protected]. Mobile: 0813379 77377. Journal of Maternal and Child Health (2020), 5(2): 173-181 https://doi.org/10.26911/thejmch.2020.05.02.07