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Employment status and the risk of pregnancy complications. The Generation R Study
  1. Pauline Jansen*,
  2. Henning Tiemeier,
  3. Frank Verhulst,
  4. Alex Burdorf,
  5. Vincent Jaddoe,
  6. Albert Hofman,
  7. Henriette Moll,
  8. Bero Verburg,
  9. Eric Steegers,
  10. Johan Mackenbach,
  11. Hein Raat
  1. 1 MC-University Medical Centre Rotterdam, Netherlands
  1. Correspondence to: Pauline Jansen, Generation R / Public health, Erasmus MC-University Medical Centre Rotterdam, PO Box 2040, Rotterdam, 3000 CA, Netherlands; p.w.jansen{at}


Objectives: The association between employment status during pregnancy and pregnancy outcome remains unclear. Therefore this study explored the relation between employment status, type of unemployment and number of weekly working hours, with a wide range of pregnancy outcomes.

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

Results: After adjustment for confounders, there were no statistically significant differences in risks of pregnancy complications between employed and unemployed women. In the subgroup of unemployed women, women receiving disability benefit had an increased risk of preterm ruptured membranes (OR=3.16, 95% CI: 1.49, 6.70), elective caesarean section (OR=2.98, 95% CI: 1.21, 7.34), and preterm birth (OR=2.64, 95% CI: 1.32, 5.28) as compared to housewives. Offspring of both students and women receiving disability benefit had a significantly lower mean birth weight than the offspring of housewives (difference: -93, 95% CI: -174, -12; and -97, 95% CI: -190, -5, respectively). In the subgroup of employed women, long working hours (i.e. ¡Ý40 h/week) were associated with a decrease of 54 g in offspring's mean birth weight (adjusted analysis; 95% CI: -89, -1) compared with 1 to 24 h/weekly working hours.

Conclusions: We found no indications that paid employment during pregnancy benefits or endangers the health of mother and child. Within the subgroups of unemployed and employed women we observed, however, that 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 to provide explanations for these findings. Meanwhile, prenatal care providers should be made aware of the risks associated with specific types of unemployment and long working hours.

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