Article Text

Download PDFPDF
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}


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.


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

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • 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.