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1.1.3 A babaváró életút általunk kidolgozott, lehetséges 3 fő szakasza
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1.1.3.1.1 Életmódszűrés - Életmódbeli és környezeti kockázati tényezők feltérképezése kérdőív segítségével.

i. 1.sz. Melléklet - Életmód szűrő kérdőívek

Az Uppsala Egyetem munkatársai által a Swedish Pregnancy Planning (SWEPP) study keretében kidolgozott, kifejezettem az életmód és a fertilitás kapcsolatának feltérképezésére alkalmas kérdőív eredeti kérdései:


Your lifestyle just now

22. What type of food do you eat just now?
(Tick the option which best describes your diet) An all-round diet (You eat most things and do not avoid any specific type of food)
Vegetarian food
Vegan food
I avoid certain foodstuffs because of food hypersensitivity
I avoid certain foodstuffs for religious reasons
LCHF-diet (Low carbohydrate, high fat diet)
GI-food (You eat food with a low GI i.e. glycemic index)
Other diet, describe ______________________________________________________________________

23.a. Do you take folic acid supplements just now?
Yes
No -> Go to question 24
b. If you take folic acid supplements just now, when did you begin taking them?
0-2 weeks ago
3-4 weeks ago
1-2 months ago
3-4 months ago
5-6 months ago
7-12 months ago
1-2 years ago
3-4 years ago
More than 4 years ago
c. How often have you taken folic acid supplements during this period?
At least 5 times/week
3 - 4 times/week
1 - 2 times/week
2 - 3 times/month
1 time/month
1 - 6 times/year

24.a. Do you take multivitamin supplements for women just now?
Yes
No → Go to question 25
b. If you are taking multivitamin supplements for women just now, when did you begin to take them?
(Answer in weeks, months, or years.)
0-2 weeks ago
3-4 weeks ago
1-2 months ago
3-4 months ago
5-6 months ago
7-12 months ago
1-2 years ago
3-4 years ago
More than 4 years ago
c. How often have you taken the multivitamin supplements for women during this period?
At least 5 times/week
3 - 4 times/week
1 - 2 times/week
2 - 3 times/month
1 time/month
1 - 6 times/year

25. Do you use any pharmaceutical products or naturopathic drugs below?
(Tick all relevant options)
Nose drops
Medicines for colds
Diuretics
Medicine for pain or inflammation relief
Relaxants
Sleeping pills
Medicines for allergies
Anti-smoking products (e.g. nicotine chewing gum)
Other prescription free drugs
Other naturopathic drugs
No, I only use prescription drugs
No, I use neither medicines nor naturopathic drugs

26. How much coffee do you drink on average a day (1cup = 1.5dl)?
(Answer in number of cups a day)
Less than 1 cup a day
1 cup/d.
2 cups/d.
3 cups/d.
4 cups/d.
5 cups/d.
6 cups/d.
7 cups/d.
8 or more cups/d.
I don’t drink coffee

The following questions are about your alcohol consumption. In these questions we use the term ”standard glass of alcohol”. A STANDARD GLASS OF ALCOHOL is defined as follows:
50 cl medium strong beer
33 cl strong beer/ strong cider
15 cl wine
8 cl strong wine
4 cl spirit

27.a. Do you drink alcohol at present?
(Tick the option that describes your habits best)
Yes, I drink every week.
Yes, but not every week.
No, I stopped drinking alcohol when I started trying to get pregnant this time
No, I had stopped drinking alcohol before I started trying to get pregnant this time
No, I have never drunk alcohol
b. How many standard glasses of alcohol a week do you drink on average just now?
Less than 1 glass/w.
1 glass/w.
2 glasses/w.
3 glasses/w.
4 glasses/w.
5 glasses/w.
6 glasses/w.
7 glasses/w.
8 or more glasses/w.
c. How many times during the last six months have you drunk five standard glasses or more at one sitting?
0 times
1 time
2 times.
3 times.
4 times.
5 times.
6 times.
7 times.
8 or more times

28.a. Do you smoke just now?
(Tick the option that best describes you)
Yes, I smoke every day.
Yes, but not every day.
No, I have stopped smoking → Go to question 29
No, I have never smoked → Go to question 29
b. How many cigarettes a day do you smoke on average?
Fewer than 1 cig/day
1 cig/day
2 - 3 cig/day
4 - 5 cig/day
6 - 9 cig/day
10 - 14 cig/day
15 - 20 cig/day
21 - 30 cig/day
31 or more cig/day

29.a. Do you use Swedish snuff tobacco (Sw. ’snus’) at present?
Yes, every day
Yes, but not every day
No, I had stopped using it earlier →Go to question 30
No, I have never used it → Go to question 30
b. How many portions of ’snus’ a day do you use on average just now?
Less than 1 port/day
1 port/day
2 - 3 port/day
4 - 5 port/day
6 - 9 port/day
10 - 14 port/day
15 - 20 port/day
21 - 30 port/day
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