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Employment status and the risk of pregnancy complications: the Generation R Study
  1. Pauline W Jansen1,2,3,
  2. Henning Tiemeier3,4,
  3. Frank C Verhulst3,
  4. Alex Burdorf2,
  5. Vincent W V Jaddoe1,4,5,
  6. Albert Hofman4,
  7. Henriëtte A Moll5,
  8. Bero O Verburg6,
  9. Eric A P Steegers6,
  10. Johan P Mackenbach2,
  11. Hein Raat2
  1. 1The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
  2. 2Department of Public Health, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
  3. 3Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
  4. 4Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
  5. 5Department of Paediatrics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
  6. 6Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
  1. Correspondence to Pauline W Jansen, The Generation R Study Group, Erasmus MC-University Medical Centre Rotterdam, PO Box 2040 (Room Ae-029), 3000 CA Rotterdam, the Netherlands; p.w.jansen{at}erasmusmc.nl

Abstract

Objectives This study explored the relationships of employment status, type of unemployment and number of weekly working hours, with a wide range of pregnancy outcomes.

Methods Information on employment characteristics and pregnancy outcomes was available for 6111 pregnant women enrolled in a population-based cohort study in the Netherlands.

Results After adjustment for confounders, there were no statistically significant differences in risks of pregnancy complications between employed and unemployed women. Among unemployed women, women receiving disability benefit had an increased risk of preterm ruptured membranes (OR 3.16, 95% CI 1.49 to 6.70), elective caesarean section (OR 2.98, 95% CI 1.21 to 7.34) and preterm birth (OR 2.64, 95% CI 1.32 to 5.28) compared to housewives. Offspring of students and women receiving disability benefit had a significantly lower mean birth weight than offspring of housewives (difference: −93, 95% CI −174 to −12; and −97, 95% CI −190 to −5, respectively). In employed women, long working hours (≥40 h/week) were associated with a decrease of 45 g in offspring's mean birth weight (adjusted analysis; 95% CI −89 to −1) compared with 1–24 h/weekly working hours.

Conclusions We found no indications that paid employment during pregnancy effects the health of the mother and child. However, among unemployed and employed women, women receiving disability benefit, students and women with long working hours during pregnancy were at risk for some adverse pregnancy outcomes. More research is needed to replicate these results and explain these findings. Meanwhile, prenatal care providers should be made aware of the risks associated with specific types of unemployment and long working hours.

  • Employment
  • working hours
  • healthy worker effect
  • pregnancy
  • delivery
  • epidemiology
  • public health
  • female reproductive effects and adverse pregnancy outcomes

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Footnotes

  • Funding The first phase of the Generation R Study is made possible by financial support from Erasmus MC–University Medical Centre Rotterdam, Erasmus University Rotterdam and the Netherlands Organization for Health Research and Development (ZonMW). The present study was supported by an additional grant from the Netherlands Organization for Health Research and Development (ZonMW “Geestkracht” program 10.000.1003).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Medical Ethical Committee of the Erasmus Medical Centre, Rotterdam.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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