General obstetrics and gynecology
The association between occupational factors and preterm birth: A United States nurses' study

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Abstract

OBJECTIVE: Our purpose was to evaluate factors associated with preterm birth among a national sample of U.S. nurses.

STUDY DESIGN: We conducted a case-control study of 210 nurses whose infants were delivered prematurely (<37 weeks) (cases) and 1260 nurses whose infants were delivered at term (≥37 weeks) (controls). An occupational fatigue score was constructed from four sources and varied from 0 to 4. The relation between occupational activity (including hours working and fatigue score) and preterm birth was analyzed with the use of Pearson χ2 tests, estimates of odds ratios with 95% confidence intervals, and multivariate logistic regression; we controlled for confounding factors.

RESULTS: Factors significantly associated with preterm birth included hours worked per week (p < 0.002), per shift (p < 0.001), and while standing (p < 0.001); noise (p = 0.005); physical exertion (p = 0.01); and occupational fatigue score (p < 0.002). The adjusted odds ratios were 1.6 (p = 0.006) for hours worked per week (≤36 vs >36) and 1.4 (p = 0.02) for fatigue score <3 vs ≥3.

CONCLUSIONS: Preterm birth among working women may be related to hours worked per day or week and to adverse working conditions.

Keywords

Working women
occupational activity
fatigue
preterm birth

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Supported in part by the Hanger Foundation, Bethesda, Maryland; the Emil Noval Fund, and The Johns Hopkins University, Baltimore, Maryland; the Center for the Study of Multiple Birth, Chicago, Illinois; the National Institute for Health and Medical Research, Lyon, France; and the Association for the Prevention of Birth Accidents, Paris, France.