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Occupational lifting and adverse pregnancy outcome: a systematic review and meta-analysis
  1. Agathe Croteau
  1. Direction des risques biologiques et de la santé au travail [Biological Risks and Occupational Health Direction], Institut national de santé publique du Québec [National Public Health Institute of Quebec], Quebec, Quebec, Canada
  1. Correspondence to Agathe Croteau, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec G1V 5B3, Canada; agathe.croteau{at}inspq.qc.ca

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

  • occupational health practice
  • female reproductive effects and adverse pregnancy outcomes
  • meta-analysis
  • physical work
  • workload
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Footnotes

  • Contributors AC developed the methodology for the systematic review. AC selected studies, extracted data and assessed the methodological quality of studies. AC conducted the meta-analysis and wrote the manuscript.

  • Funding The Institut national de santé publique du Québec (INSPQ), a public health expertise and reference centre, has made possible the realisation of this work.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

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