The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis

Cai, Chenxi; Vandermeer, Ben; Khurana, Rshmi; Nerenberg, Kara; Featherstone, Robin; Sebastianski, Meghan; Davenport, Margie H.

doi:10.1016/j.ajog.2019.08.059

Cited by 89 publications

(82 citation statements)

References 103 publications

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“…Even pregnancies without exposure to occupational risk factors may face symptoms such as nausea and vomiting, headaches, back pain, and fatigue [6], though even these diseases have been shown to decrease health-related quality of life in pregnant women [7]. Evidence demonstrates the relation between occupational exposures and health effects during pregnancy, such as an increase in the number of low birth weight and prematurity in relation to a heavy physical workload [8]. To deal with this situation, and protect both the health of working women and the fetus, as well as support continuity in their employment, many countries, including Spain, have developed specific social protection benefits.…”

Section: Introductionmentioning

confidence: 99%

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

et al. 2020

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This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses. Methods Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25-34 years old), middle-reproductive (35-44) and late-reproductive (45-54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin. Results Younger women show a higher incidence of overall sickness absence compared to latereproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain. Discussion The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.

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Section: Introductionmentioning

confidence: 99%

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

et al. 2020

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“…Data were analyzed statistically in two stages using STATA 15 software: Often 17Nearly always/always (10) Frequency of prescription of sick leave during normal pregnancies Never/rarely (13) Sometimes 24Often (34) Nearly always/always (15) When OBGYNs prescribe sick leave instead of preventive leave, it is "nearly always" or "always" because of:…”

Section: Discussionmentioning

confidence: 99%

“…Several studies highlight negative effects of certain occupational exposures for the health of pregnant workers and for their future children. For example, two recent meta-analysis [10,11], carried out on 80 studies (with a total of 853'149 women) show that physically demanding job expose pregnant workers to higher risks of adverse pregnancy outcomes, such as preterm delivery (<37 weeks' of gestation), low-birth-weight (birth weight <2,500 grams), small-forgestational-age (SGA, birth weight < 10th percentile for the gestational age), miscarriage (loss of the fetus prior to 20 weeks' of gestation), gestational hypertension and pre-eclampsia.…”

Section: Discussionmentioning

confidence: 99%

“…From the public health and health promotion perspectives, pregnancy-related care is essential given that the health of future generations is already determined by babies' lives within the womb [1]. Although the international medical literature agrees that work in and of itself poses no risk to pregnancy [2,3], several publications [2][3][4][5][6][7][8][9][10][11][12] show that occupational exposure (biological, chemical) or arduous activity (physical, psychological) can affect pregnancy outcomes (miscarriage, preterm birth, small for gestational age) and child development (malformation, cognitive faculties).…”

Section: Introductionmentioning

confidence: 99%

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Implementation of maternity protection legislation: Gynecologists’ perceptions and practices in French-speaking Switzerland

Abderhalden-Zellweger¹,

Probst²,

Mercier³

et al. 2020

PLoS ONE

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Background In several countries, maternity protection legislations (MPL) confer an essential role to gynecologist-obstetricians (OBGYNs) for the protection of pregnant workers and their future children from occupational exposures. This study explores OBGYNs' practices and difficulties in implementing MPL in the French-speaking part of Switzerland. Methods An online survey was sent to 333 OBGYNs. Data analysis included: 1) descriptive and correlational statistics and 2) hierarchical cluster analysis to identify patterns of practices. Results OBGYNs evoked several problems in MPL implementation: absence of risk analysis in the companies, difficult collaboration with employers, lack of competencies in the field of occupational health. Preventive leave was underused, with sick leave being prescribed instead. Training had a positive effect on OBGYNs' knowledge and implementation of MPL. Hierarchical cluster analysis highlighted three main types of practices: 1) practice in line with legislation; 2) practice on a case-by-case basis; 3) limited practice. OBGYNs with good knowledge of MPL more consistently applied its provisions. Conclusion The implementation of MPL appears challenging for OBGYNs. Collaboration with occupational physicians and training might help OBGYNs to better take on their role in maternity protection. MPL in itself could be improved.

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“…Accommodations to limit standing and lifting may be indicated in physically demanding professions, as there are data to suggest lifting cumulative weight over 100 kg per day and standing for over three hours per day increases the risk of PTB 9,10 . Many of the participants in our study reported positive experiences with employers who proactively made simple accommodations to facilitate continued safe and comfortable employment during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy vs. Paycheck: A qualitative study of patient’s experience with employment during pregnancy at high risk for preterm birth

Wheeler

Massengale

Adewumi

et al. 2020

Preprint

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Background: Pregnant women with a history of preterm birth are at risk for recurrence, often requiring frequent prenatal visits for close monitoring and/or preventive therapies. Employment demands can limit uptake and adherence to recommended monitoring and preterm birth prevention therapies. Method: We conducted a qualitative descriptive study using in-depth interviews (IDIs) of pregnant women with a history of preterm birth. IDIs were conducted by trained qualitative interviewers following a semi-structured interview guide focused on uncovering barriers and facilitators to initiation of prenatal care, including relevant employment experiences, and soliciting potential interventions to improve prompt prenatal care initiation. The IDIs were analyzed via applied thematic analysis. Results: We described the interview findings that address women’s employment experiences. The current analysis includes 27 women who are majority self-described as non-Hispanic Black (74%) and publically insured (70%). Participants were employed in a range of professions; food services, childcare and retail were the most common occupations. Participants described multiple ways that being pregnant impacted their earning potential, ranging from voluntary work-hour reduction, involuntary duty hour reductions by employers, truncated promotions, and termination of employment. Participants also shared varying experiences with workplace accommodations to their work environment and job duties based on their pregnancy. Some of these accommodations were initiated by a collaborative employee/employer discussion, others were initiated by the employer’s perception of safe working conditions in pregnancy, and some accommodations were based on medical recommendations. Participants described supportive and unsupportive employer reactions to requests for accommodations. Conclusions: Our findings provide novel insights into women’s experiences balancing a pregnancy at increased risk for preterm birth with employment obligations. While many women reported positive experiences, the most striking insights came from women who described negative situations that ranged from challenging to potentially unlawful. Many of the findings suggest profound misunderstandings likely exist at the patient, employer and clinical provider level about the laws surrounding employment in pregnancy, safe employment responsibilities during pregnancy, and the range of creative accommodations that often allow for continued workplace productivity even during high risk pregnancy.

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The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis

Cited by 89 publications

References 103 publications

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

Implementation of maternity protection legislation: Gynecologists’ perceptions and practices in French-speaking Switzerland

Pregnancy vs. Paycheck: A qualitative study of patient’s experience with employment during pregnancy at high risk for preterm birth

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