Work and pregnancy: The role of fatigue and the “second shift” on antenatal morbidity☆,☆☆
Section snippets
Study sample
Women were recruited for the study when they first registered for prenatal care at the University of Michigan Health System between March 1997 and November 1997. Women were contacted by telephone several days before their first appointment for prenatal care to introduce the study and to identify those individuals interested in participating. Women were then enrolled in person during their prenatal visit. The first interview was conducted either at that time or subsequently by telephone, at the
Results
The description of the study population is given in Table I. There were no significant differences between women with or without medically ordered work reduction or bed rest by age, parity, race, medical history, pregravid body mass index, gestational weight gain, smoking or alcohol habits, or cesarean birth. Women who had neither medically ordered work reduction nor bed rest were significantly better educated, had higher
Comment
These findings suggest that fatigue and stress, whether from work or home factors and particularly during the second trimester, contribute significantly to antenatal morbidity. Previous studies, particularly those conducted with women in the military,6, 7, 8, 9 have linked physically demanding work to increased antenatal morbidity. Adams et al9 reported that 23% of enlisted women had ≥1 antenatal admissions and 15% had prolonged hospitalizations that immediately preceded delivery. Ramirez et al,
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Cited by (21)
Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts Outcomes Study of Assisted Reproductive Technology
2017, American Journal of Obstetrics and GynecologyCitation Excerpt :Fourth, attainment of plurality-specific gestational weight gain, with a nutritionally balanced diet, is associated with better perinatal results.85-87 Other factors, not available in the data sets used in this study, such as stress and occupational fatigue, may also adversely affect infertility therapy and the course and outcome of pregnancy and should be evaluated during treatment.88-91 Pregnancy complications may have long-term deleterious effects on women’s health, including increased risks for hypertension, diabetes, and cardiovascular disease,92-102 which may be even greater in women with chronic conditions before pregnancy, including infertility.
Clinical guidelines for occupational lifting in pregnancy: Evidence summary and provisional recommendations
2013, American Journal of Obstetrics and GynecologyCitation Excerpt :For a more detailed summary of the epidemiological evidence related to fetal health outcomes, we recommend the systematic reviews conducted by Bonzini et al (2007)20 and the 2009 Guideline Development Group of the Royal College of Physicians.12 Fewer studies have investigated the association between maternal health outcomes and heavy physical work load, despite evidence showing a higher use of antenatal sick leave21,22 and hospital visits23 among those employed in heavy work. One previous study showed a positive association between heavy lifting (10-20 kg or 22-44 lb) in early pregnancy (occurring more than 20 times per week) and preeclampsia.24
Environmental and occupational hazards to pregnancy
2003, Primary Care Update for Ob/GynsThe problem of preterm birth: Effective primary prevention
2003, Primary Care Update for Ob/GynsOccupational fatigue and preterm premature rupture of membranes
2001, American Journal of Obstetrics and GynecologyCitation Excerpt :Measures of both physical exertion and mental stress in the home were also missing in this study. Many employed women retain a large share of the responsibility for their families and households, the so-called “second shift.”22 By including women who did not work outside the home in the analysis, we established a baseline on which the potential impact of paid employment could be assessed.
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Reprint requests: Barbara Luke, ScD, MPH, Department of Obstetrics and Gynecology, University of Michigan Medical School, 1500 E Medical Center Dr, F4866 Mott, Ann Arbor, MI 48109-0264.
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