Obstet Gynecol 2000 Apr;95(4):623-35

Mozurkewich EL, Luke B, Avni M, Wolf FM
Division of Maternal-Fetal Medicine, Department of Obstetrics and
Gynecology, University of Michigan Medical School, Ann Arbor, MI
48109-0264, USA. mozurk@umich.edu


OBJECTIVE: To evaluate the association between working conditions and adverse pregnancy outcomes by performing a meta-analysis of published
studies.

DATA SOURCES: We searched the English-language literature in MEDLINE through August 1999 using the terms standing, posture, work, workload, working conditions, shift, occupational exposure, occupational, diseases, lifting, pregnancy complications, pregnancy, small for gestational age (SGA), fetal growth retardation (FGR), preterm, and
labor.

METHODS OF STUDY SELECTION: We included observational studies evaluating the effect of one or more of the following work-related exposures on adverse pregnancy outcome: physically demanding work, prolonged standing, long work hours, shift work, and cumulative work fatigue score. Outcomes of interest were preterm birth, hypertension or preeclampsia, and SGA.We conducted a meta-analysis based on 160,988 women in 29 studies to evaluate the association of physically demanding work, prolonged standing, long working hours, shift work, and cumulative work fatigue score with preterm birth. Also analyzed were the associations of physically demanding work with hypertension or preeclampsia and SGA infants. The data were analyzed using the Peto-modified Mantel-Haenszel method to estimate the pooled odds ratios (ORs) and 95% confidence intervals (CIs).

TABULATION, INTEGRATION, AND RESULTS: Physically demanding work was significantly associated with preterm birth (OR 1.22, 95% CI 1.16, 1. 29), SGA (OR 1.37, 95% CI 1.30, 1.44), and hypertension or preeclampsia (OR 1.60, 95% CI 1.30, 1.96). Other occupational exposures significantly associated with preterm birth included prolonged standing (OR 1.26, 95% CI 1.13, 1.40), shift and night work (OR 1.24, 95% CI 1.06, 1.46), and high cumulative work fatigue score (OR 1.63, 95% CI 1.33, 1.98). We found no significant association between long work hours and preterm birth (OR 1.03, 95% CI 0.92, 1.16).

CONCLUSION: Physically demanding work may significantly increase a woman's risk of adverse pregnancy outcome.





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Bailey Anne and Caroline Elizabeth

"Thank you for contributing to the lives of our babies. We appreciate your initiative in getting us the Foundation's book. It served as our best resource throughout our pregnancy. We are very fortunate to have a successful outcome. Getting information early in the pregnancy was the difference between life and loss. I feel that a combination of diet, hydration, iron supplementation and bed rest are all accountable for our success. We did not receive any outside intervention at all! Our daughters were born at 37 weeks.
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