The Impact of Occupational Shift Work and Working Hours During Pregnancy on Health Outcomes: A Systematic Review and Meta-analysis

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

doi:10.1097/01.aoa.0000693660.86124.b7

Cited by 20 publications

(34 citation statements)

References 0 publications

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“…Our results are not entirely consistent with the overall evidence between shift work and adverse pregnancy outcomes. While our analysis did not support an association with preterm birth, rotating shift and night shift work has previously been linked to approximately 13% and 21% increased odds of preterm birth in systematic reviews and meta-analyses (10,49). Additionally, our results differ from those of the one prior study of night shift work and GDM; this prospective birth cohort study in Japan reported no increased odds of GDM among fixed night shift workers (13).…”

Section: Discussioncontrasting

confidence: 99%

“…However, the evidence to support an association between shift work and adverse pregnancy outcomes is mixed. A recent systematic review and meta-analysis of shift work during pregnancy and adverse outcomes concluded that both night and rotating shift work were associated with increased odds for preterm birth, but there was little evidence to support an association with preeclampsia (10). Other recent cohort studies reported a null association (11) and a positive association (12) between night shift work and preterm birth.…”

Section: Introductionmentioning

confidence: 99%

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Associations between evening shift work, irregular sleep timing, and gestational diabetes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)

Wallace

Reid

Grobman

et al. 2022

Preprint

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Study Objectives: Shift work is a risk factor for cardiometabolic disease, possibly through effects on sleep-wake rhythms. We hypothesized that shift work during pregnancy is associated with increased odds of preeclampsia, preterm birth, and gestational diabetes mellitus (GDM), and that the association is mediated by irregular sleep timing. Methods: The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) is a prospective cohort study (n=10,038) designed to investigate risk factors for adverse pregnancy outcomes. Medical outcomes were determined with medical record abstraction and/or questionnaires; sleep midpoint was measured in a subset of participants with ≥5-day wrist actigraphy (ActiWatch). We estimated the association of shift work during pregnancy with preeclampsia, preterm birth, and GDM using logistic regression, adjusted for adversity (a cumulative variable for poverty, education, health insurance, and partner status), smoking, self-reported race/ethnicity, and age. Finally, we performed an analysis to explore the extent to which to the association between shiftwork and GDM was mediated by variability in sleep timing. Results: Evening shift work during pregnancy is associated with approximately 75% increased odds of developing GDM (adjusted OR=1.75, 95% CI:1.12-2.66); there was no association with preterm birth and no association with preeclampsia after adjustment. Pregnant evening shift workers were found to have approximately 45 minutes greater variability in sleep timing compared to day workers (p<0.005); mediation analysis estimated that 27% of the association between shift work and GDM was explained by sleep-timing variability. Conclusions: Evening shift work was associated with GDM, and this relationship may be mediated by variability in sleep timing.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between evening shift work, irregular sleep timing, and gestational diabetes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)

Wallace

Reid

Grobman

et al. 2022

Preprint

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“…Lastly, although the literature review thus far has focused on leisure-time PA, occupational PA must also be considered. Recent reviews have found that working more than 40 h per week, heavy lifting for a combined weight of !100 kg per day, prolonged standing, rotating shifts, and fixed night shifts were all associated with increased risk of preterm delivery [30][31][32].…”

Section: Type Of Physical Activitymentioning

confidence: 95%

Activity restriction and preterm birth prevention

Nuss

Sciscione

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewSince the 1900s, activity restriction (AR) has been widely prescribed as a strategy for preventing preterm birth (PTB). Over the past decade, the practice has been called into question as numerous studies have demonstrated that AR does not improve obstetrical and perinatal outcomes but does confer significant physical and psychological risks. The purpose of this review is to offer clinicians a summary of the latest data on the risks, benefits, and efficacy of AR for the prevention of PTB.Recent findingsBoth retrospective and prospective studies have demonstrated that AR does not significantly prolong pregnancy including those with multiple gestations, short cervices, ruptured membranes, and increased body mass indexes. Several studies have also shown that physical activity during pregnancy is associated with a higher incidence of vaginal delivery, a lower incidence of gestational diabetes mellitus, and a lower incidence of hypertensive disorders without increasing the risk of adverse neonatal outcomes.SummaryThe culmination of these data led to the Society for Maternal-Fetal Medicines’ release of an updated committee recommendation in August of 2020; AR should not be routinely prescribed as a treatment to prevent PTB.

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“…1 Supporting data suggests that working rotating shifts, night shifts, or longer hours can place a pregnant woman at higher risk of adverse outcomes. 6 Women surgeons take a shorter maternity leave and breastfeed for fewer months on average than their nonsurgeon counterparts. 1 Finally, several studies by Rangel et al have shown that childbearing surgical residents regard their maternity leave to be inadequate, wish that they could breastfeed for longer and perceive stigma related to pregnancy at work.…”

mentioning

confidence: 99%

“…Women surgeons report an overall higher complication rate during pregnancy as well as preterm delivery than that of the general population 1 . Supporting data suggests that working rotating shifts, night shifts, or longer hours can place a pregnant woman at higher risk of adverse outcomes 6 . Women surgeons take a shorter maternity leave and breastfeed for fewer months on average than their nonsurgeon counterparts 1 .…”

mentioning

confidence: 99%