Employment, working conditions, and preterm birth: results from the Europop case-control survey

Abstract

Study objective: To analyse the relation between preterm birth and working conditions in Europe using common measures of exposure and to test whether employment related risks varied by country of residence. Design: A case-control study in which cases included all consecutive singleton preterm births and controls included one of every ten singleton term births in each participating maternity unit. Data about working conditions were obtained by interview from women after delivery. Setting: Sixteen European countries. Participants: The analysis included 5145 preterm and 7911 term births of which 2369 preterm and 4098 term births were to women employed during pregnancy. Analyses of working conditions were carried out for women working through at least the third month of pregnancy. Main results: Employed women did not have an excess risk of preterm birth. Among working women, a moderate excess risk was observed for women working more than 42 hours a week (OR = 1.33, CI = 1.1 to 1.6), standing more than six hours a day (OR = 1.26, CI = 1.1 to 1.5), and for women with low job satisfaction (OR = 1.27, CI = 1.1 to 1.5). There were stronger links in countries with a lower overall level of perinatal health and a common practice of long prenatal leaves. Conclusion: These findings show that specific working conditions affect the risk of preterm birth. They also suggest employment related risks could be mediated by the social and legislative context. S tudies on the relation between employment and preterm delivery have yielded contradictory results.1 The decision to work during pregnancy reflects a large variety of factors such as education, social support, and health status that are independently linked to the risks of preterm birth. [2][3][4] In many studies, women who are employed have a lower risk of preterm birth than women who are not employed.

Influencia de la situación laboral materna en recién nacidos pretérmino y/o con bajo peso

“…El área de conocimiento del primer firmante se adscribe con mayor frecuencia a pediatría-neonatología, con 8 (33,3%) estudios 19,21,22,24-28, seguidos de salud pública con 6 (25%) estudios 14,20,[29][30][31][32] y obstetricia-ginecología con 4 (19%) estudios 23,[33][34][35] .…”

“…En 12 (57%) estudios 14,19,20,28,29,31,34,36,37 se utiliza el diseño epidemiológico de tipo transversal (encuestas basadas en registros hospitalarios), en 6 (28%) estudios 23,27,30,32,33,35 22,27,29,30 se encuentra que las amas de casa tienen más riesgo de bajo peso. En el caso de los recién nacidos pretérmino, en 8 artículos 22,23,26,31,32,34,35,37,38 no se halla asociación y en 1 se describe también más riesgo en amas de casa 22 .…”

“…En el caso de los recién nacidos pretérmino, en 8 artículos 22,23,26,31,32,34,35,37,38 no se halla asociación y en 1 se describe también más riesgo en amas de casa 22 .…”

“…Respecto a las ocupaciones con más riesgo (tabla 3), de los 11 artículos que valoran este asociación, en 3 se encuentra más probabilidad de parto pretérmino en trabajadoras manuales 23,30,36 , y en otro artículo se observa más riesgo en el sector servicios 33 . Sólo uno muestra mayor riesgo de bajo peso en trabajadoras manuales 36 .…”

“…PT: OR = 1,1 (0,3-3,9) Pierre-Yves et al, 1999 30 Casos y controles PT: OR = 2,05 (1,66-2,53) 1.675 Hanke et al, 2001 31 Transversal BP: OR = 1,92 (1,01-3,64) 2.080 Henrich et al, 2003 34 Transversal PT: 34% amas de casa; 707 32% empleadas; p = 0,52 Saurel-Cubizolles et al, 2004 23 Casos y controles PT: OR = 0,85 (0,80-0,92) 13.710 BP: bajo peso; IC: intervalo de confianza; OR: odds ratio; RR: riesgo relativo; PT: pretérmino.…”