Occupational lifting and adverse pregnancy outcome: a systematic review and meta-analysis

Abstract

This systematic review was conducted to help clarify the effect of lifting at work on pregnancy outcome, by focusing on specific exposure categories. A search in Medline and Embase identified 51 articles reporting association of spontaneous abortion (SA), preterm delivery (PTD) or small-for-gestational-age (SGA) infant with exposure to occupational lifting. A global validity score was assigned to each study and six potential sources of bias were considered in sensitivity analyses. For each exposure–outcome combination, a summary risk estimate (RE) was obtained from all studies and from a subset of studies with high validity score, this latter summary RE was selected as a final result. Statistical heterogeneity was measured with I2 and Q tests and the possibility of a publication bias was also assessed. For each meta-analysis, the strength of evidence was established from explicit criteria. Heavy (or ≥10 kg) loads often (or ≥10x/day) lifted were associated with increased risks of SA (summary RE=1.31, 95% CI 1.17 to 1.47) and PTD (summary RE=1.24, 95% CI 1.07 to 1.43), with good strength of evidence. No association was identified with SGA, nor with lower exposure levels and SA or PTD. These results are reassuring for lower levels of exposure; however, observed associations can guide health professionals’ recommendations aimed at the prevention of SA and PTD for pregnant women who frequently lift (or ≥10x/day) heavy (or ≥10 kg) loads at work.Résumé

Ergonomic demands and fetal loss in women in welding and electrical trades: A Canadian cohort study

“…Systematic reviews support a role for heavy or frequent occupational lifting 6,7 on miscarriage. In this study we asked how much of the time the participant used to lift, push, pull, or otherwise manipulate heavy materials or goods, thus covering a wider range of physical effort than simply lifting.…”

“…Multiple hazards to the fetus may be in play, including substantial ergonomic demands, from the welding itself, the manipulation of heavy components, and the body postures needed to reach parts to be welded. Recent systematic reviews and meta‐analyses have supported the role of heavy physical work in poor pregnancy outcomes 6,7 . In Western Canada, much of the demand for welders and other tradespeople has been in the oil fields, with exposure to harsh conditions, including long working schedules implicated in adverse pregnancy outcomes 8 …”

Evaluation of a blended care programme for caregivers and working pregnant women to prevent adverse pregnancy outcomes: an intervention study

“…1 2 Exposure to certain working conditions during pregnancy is associated with adverse pregnancy outcomes (preterm birth, low birth weight, fetal abnormalities) and pregnancy complications (hypertension, eclampsia, miscarriage). [3][4][5][6][7][8][9][10][11][12][13] Many working pregnant women, their healthcare professionals and employers are unaware of these risks and legal measures concerning maternity protection in the workplace. In the European Union, including the Netherlands, employers are responsible for providing work adjustments to pregnant employees where necessary.…”

Risk score to stratify miscarriage risk levels in preconception women

“…These include pre-pregnancy underweight, overweight or obesity, cigarette smoking, alcohol intake, caffeine intake and lack of dietary supplementation, such as folic acid and multivitamins, which have been found to increase the risk of miscarriage 2 , 4 , 7 . Shift work, particularly night shifts, and occupations requiring heavy lifting, have also been shown to increase the risk of miscarriage 8 , 9 .…”