Occupational physical activity and pregnancy outcome

doi:10.1016/S0301-2115(01)00419-5

European Journal of Obstetrics & Gynecology and Reproductive Biology

Volume 100, Issue 1, 10 December 2001, Pages 41-45

https://doi.org/10.1016/S0301-2115(01)00419-5 Get rights and content

Abstract

Objective: To determine the effect of occupational physical activities on the outcome of pregnancy. Methods: A case control study included two groups; the first one included 562 patients with spontaneous abortion as a case group, while the second one included 1200 ladies with full term deliveries as a matched control group. Occupational physical activity has been evaluated through the energy expenditure (fatigue score and intensity score) and the biomechanic load (abdominal pressure intensity score, relative chronic pressure and peak pressure scores) in both groups. Results: The group of spontaneous abortion had a significant higher intensity score, fatigue score, unfavourable working hours and high working speed than the group of favourable pregnancy outcome. The study showed a significantly higher biomechanic load among the group of spontaneous abortion represented by higher peak pressure score, chronic pressure score, lifting and bending activities. The group of spontaneous abortion had a significant (P<0.05) higher housekeeping working hours per day than that of the control group. Also they had a significant larger family size and had a significant lower helping in housekeeping activities than the group of favourable outcome. Conclusion: Excessive occupational physical activity has a definite detrimental effect on the outcome of pregnancy.

Introduction

In the last 50 years, many studies had been published investigating the relationship between various occupational exposures and pregnancy disturbances. Several specific occupational exposures are suspected of causing reproductive failures such as anaesthetics, solvents [1] and pharmaceutical products [2]. One of these risk factors is occupational physical exertion [3]. Strenuous work may cause reproductive disorders through high energy expenditure which may influence the uterine blood flow [4], [5]. Both factors can change the intra-uterine environment and may interfere with normal embryonic and fetal growth. Occupational activities, which include reaching, bending and heavy lifting, may over-load the spine and increase the intra-abdominal pressure, which in turn may predispose to miscarriage [6]. Attention has mainly been focused on late pregnancy outcome [7], [8], [9], [10], [11], [12]. To our knowledge, few studies have examined the relationship between occupational physical activity and spontaneous abortion [13], [14]. This shortage was the stimulus to undertake this study, taking into account the special circumstances of working and conditions in which women, in the Egyptian and similar communities, practice their occupational activities.

Section snippets

Subjects and methods

This case/control study included all women admitted to the Department of Obstetrics and Gynaecology in Mansoura University Hospitals, Egypt over the period of 1 year from 1 September 1998 to 31 August 1999 suffering spontaneous abortion. A matched group of women who had completed their pregnancies in the same period was included as a control group.

After taking a formal consent, all women in the study were subjected to a specifically designed fixed format questionnaire to evaluate the pattern of

Results

The study comprised 562 spontaneously aborted women among those admitted to Mansoura University Hospitals during the study period. The matched control group included 1200 women among those who completed their pregnancy. Table 1 shows the characteristics of women in the study and control group. There was no significant difference between both groups as regard age, parity, education, smoking habit, previous gynaecological problems, previous infertility treatment or previous spontaneous abortion.

Discussion

This case/control study on more than 560 women suffered from spontaneous abortion shows a clear association between the occupational physical activity and the occurrence of spontaneous abortion among Egyptian women. These women were under the specific working conditions and circumstances similar to those found in other developing communities.

The relationship between occupational physical exertion and the occurrence of spontaneous abortion was the primary objective only in two studies. McDonald

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Cited by (24)

The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis
2020, American Journal of Obstetrics and Gynecology
Citation Excerpt :
A Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram of the study search and selection process is shown in Figure 1. Eighty published observational studies (24 prospective cohort studies,7–9,32–52 25 cross-sectional,53–77 and 31 case-control studies78-108; N=853,149 women) from 30 countries were included in this review. Four corresponding authors were sent email messages that requested additional information or clarification of data from 4 studies.109–112
Data: An increasing number of studies suggest that exposure to physically demanding work during pregnancy could be associated with increased risks of adverse pregnancy outcomes, but the results remain conflicted and inconclusive. The purpose of this study was to examine the influence of occupational activities during pregnancy on maternal and fetal health outcomes.
Studies of all designs (except case studies and reviews) that contained information on the relevant population (women who engaged in paid work during pregnancy), occupational exposures (heavy lifting, prolonged standing, prolonged walking, prolonged bending, and heavy physical workload), comparator (no exposure to the listed physical work demands), and outcomes (preterm birth, low birthweight, small for gestational age, miscarriage, gestational hypertension, preeclampsia, gestational diabetes mellitus, stillbirth, and intrauterine growth restriction) were included.
Five electronic databases and 3 gray literature sources were searched up to March 15, 2019.
Eighty observational studies (N=853,149) were included. Low-to-very low certainty evidence revealed that lifting objects ≥11 kg was associated with an increased odds ratio of miscarriage (odds ratio, 1.31; 95% confidence interval, 1.08–1.58; I²=79%), and preeclampsia (odds ratio, 1.35; 95% confidence interval, 1.07–1.71; I²=0%). Lifting objects for a combined weight of ≥100 kg per day was associated with an increased odds of preterm delivery (odds ratio, 1.31; 95% confidence interval, 1.11–1.56; I²=0%) and having a low birthweight neonate (odds ratio, 2.08; 95% confidence interval, 1.06–4.11; I²=73%). Prolonged standing was associated with increased odds of preterm delivery (odds ratio, 1.11; 95% confidence interval, 1.02–1.22; I²=30%) and having a small-for-gestational-age neonate (odds ratio, 1.17; 95% confidence interval, 1.01–1.35; I²=41%). A heavy physical workload was associated with increased odds of preterm delivery (odds ratio, 1.23; 95% confidence interval, 1.07–1.41; I²=32%) and having a low birthweight neonate (odds ratio, 1.79; 95% confidence interval, 1.11–2.87; I²=87%). All other associations were not statistically significant. Dose-response analysis showed women stand for >2.5 hours per day (vs no standing) had a 10% increase in the odds of having a preterm delivery.
Physically demanding work during pregnancy is associated with an increased risk of adverse pregnancy outcomes.
The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis
2019, American Journal of Obstetrics and Gynecology
Citation Excerpt :
The certainty of evidence was downgraded from “low” to “very low” because of serious risk of bias, inconsistency, and imprecision. However, pregnant women who worked fixed night shifts had higher rates of miscarriage than women who worked regular day shifts (10 studies, n = 62,877; OR, 1.23; 95% CI, 1.03–1.47, I2 = 33%; “very low” certainty, downgraded because of serious risk of bias; Figure 4).44,49,50,59,66,69,77,79,82,94 Meanwhile, women who worked >40 hours per week had a 38% increase in the odds of miscarriage compared to women who did not (8 studies, n = 73,855; OR, 1.38; 95% CI, 1.08–1.77, I2 = 73%; “very low” certainty, downgraded due to serious risk of bias and inconsistency; see online supplement Figure 3).57,59,62,65,67,69,79,94
An increasing number of original studies suggest that exposure to shift work and long working hours during pregnancy could be associated with the risk of adverse pregnancy outcomes, but the results remain conflicting and inconclusive.
To examine the influences of shift work and longer working hours during pregnancy on maternal and fetal health outcomes.
Five electronic databases and 3 gray literature sources were searched up to March 15, 2019.
Studies of all designs (except case studies and reviews) were included, which contained information on the relevant population (women who engaged in paid work during pregnancy); exposure (rotating shift work [shifts change according to a set schedule], fixed night shift [typical working period is between 11:00 pm and 11:00 am] or longer working hours [>40 hours per week]);comparator (fixed day shift [typical working period is between 8:00 am and 6:00 pm] or standard working hours [≤40 hours per week]); and outcomes (preterm delivery, low birthweight [birthweight <2500 g], small for gestational age, miscarriage, gestational hypertension, preeclampsia, intrauterine growth restriction, stillbirth, and gestational diabetes mellitus).
From 3305 unique citations, 62 observational studies (196,989 women) were included. “Low” to “very low” certainty evidence from these studies revealed that working rotating shifts was associated with an increased odds of preterm delivery (odds ratio, 1.13; 95% confidence interval, 1.00–1.28, I² = 31%), an infant small for gestational age (odds ratio, 1.18, 95% confidence interval, 1.01–1.38, I² = 0%), preeclampsia (odds ratio, 1.75, 95% confidence interval, 1.01–3.01, I² = 75%), and gestational hypertension (odds ratio, 1.19, 95% confidence interval, 1.10–1.29, I² = 0%), compared to those who worked a fixed day shift. Working fixed night shifts was associated with an increased odds of preterm delivery (odds ratio, 1.21; 95% confidence interval, 1.03–1.42; I² = 36%) and miscarriage (odds ratio, 1.23; 95% confidence interval, 1.03–1.47; I² = 37%). Compared with standard hours, working longer hours was associated with an increased odds of miscarriage (odds ratio, 1.38; 95% confidence interval, 1.08–1.77; I² = 73%), preterm delivery (odds ratio, 1.21; 95% confidence interval, 1.11–1.33; I² = 30%), an infant of low birthweight (odds ratio, 1.43; 95% confidence interval, 1.11–1.84; I² = 0%), or an infant small for gestational age (odds ratio, 1.16, 95% confidence interval, 1.00–1.36, I² = 57%). Dose–response analysis showed that women working more than 55.5 hours (vs 40 hours) per week had a 10% increase in the odds of having a preterm delivery.
Pregnant women who work rotating shifts, fixed night shifts, or longer hours have an increased risk of adverse pregnancy outcomes.
Shift work and adverse reproductive outcomes among men and women
2003, Clinics in Occupational and Environmental Medicine
Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review
2023, BMJ Open
The effects of desert dust storms, air pollution, and temperature on morbidity due to spontaneous abortions and toxemia of pregnancy: 5-year analysis
2021, International Journal of Biometeorology
Health and Safety in Nail Salons: A Cross-Sectional Survey
2021, Annals of Work Exposures and Health

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Occupational physical activity and pregnancy outcome

Abstract

Introduction

Section snippets

Subjects and methods

Results

Discussion

Am. J. Obstet. Gynecol.

Clin. Biomech.

Exposure to solvents and outcome of pregnancy in university laboratory employees

Br. J. Indust. Med.

Spontaneous abortion among women working in the pharmaceutical industry

Br. J. Indust. Med.

Association between spontaneous abortion and ergonomic factors: a literature review of the epidemiological evidence

Scand. J. Work Environ. Health

Pregnancy and exercise — exercise and pregnancy: a short review

Br. J. Obstet. Gynaecol.

Manual support of load by women

Physiology

Working during pregnancy: effects on fetus

Paediatrics

Prematurity and occupational activity during pregnancy

Am. J. Epidemiol.

Pregnancy and its outcome among hospital personnel according to occupation and working conditions

J. Epidemiol. Com. Health

Spontaneous abortion and occupation

Br. J. Indust. Med.