Poor working conditions may increase the chances of pregnant women having underweight or premature babies, according to recent findings by researchers from University College Dublin and the French public health organisation INSERM. In particular, pregnant women who work long hours, shifts, on temporary employment contracts or in positions with high physical work demands may be at increased risk of giving birth to small or premature babies.
Pregnant women who face stress at work and are exposed to difficult working conditions – including long hours, shift work, temporary employment contracts or physically demanding roles – risk giving birth to premature or low weight babies, according to new research published in the British Journal of Obstetrics and Gynaecology (BJOG). The findings were co-authored by researchers from University College Dublin (UCD) and the National Institute of Health and Medical Research (Institut national de la santé et de la recherche médicale, INSERM), a public health organisation in France. The results suggest that more attention should be paid to women’s working conditions during pregnancy, and that efforts should be made to reduce their exposure to physical work demands, shift work and long working hours.
Research methodology
The study involved 676 pregnant women from the Lifeways Cross-Generation Cohort Study who were working at the time of their first prenatal visit and who delivered a single baby. The Lifeways cohort comprises a group of women who agreed to be studied in relation to their lifestyle, working conditions and outcome of pregnancy. The participants were attending two large maternity units in Ireland – University College Hospital Galway and the Coombe Women’s Hospital in Dublin – and were asked to complete a detailed questionnaire. Information collected included the participant’s general health, sociodemographic status, lifestyle behaviour and employment situation. This was followed up with an examination of hospital medical records relating to the mothers’ health during the pregnancy and their pregnancy outcomes.
Occupational risk factors for pregnant women
Significant and strong associations were found between high physical work demands and low birth weight (2,500 grammes), and between temporary work contracts and preterm births. The researchers suggest that women working under temporary employment contracts may have poorer working conditions – experiencing higher stress and anxiety because of job insecurity – which may cause preterm births. Trends were observed in the working of long hours (40 hours or more a week) and shift work with a birth weight of 3,000 grammes. The findings also confirm how unhealthy behaviours during pregnancy, such as smoking and heavy alcohol consumption, lead to poor outcomes – in both cases, an increased incidence of birth weight of 2,500 grammes and 3,000 grammes.
Significantly, the analysis showed that pregnant women who were exposed to at least two of the four occupational risk factors identified as problematic were around five times more likely to face increased risk of preterm delivery (odds ratio of 5.18) and giving birth to a baby with a weight of 2,500 grammes or less (odds ratio of 4.65).
Based on the research findings, the authors conclude that high physical work demands, being on a temporary employment contract, working long hours and working shifts are occupational factors that can lead healthcare professionals to predict a low birth weight and preterm delivery.
Study conclusions
One of the co-authors of the study, Isabelle Niedhammer, from the UCD School of Public Health and Population Science, outlined:
Our prospective research analysed a large number of occupational exposures and linked them with adverse pregnancy outcomes (low birth weight, preterm delivery, and small-for-gestational age).
Dr Niedhammer highlighted that:
Special attention should be given to pregnant women working on temporary contracts which may induce stress and anxiety because of job insecurity.
The Editor-in-Chief of BJOG, Philip Steer, commented that:
It is well known that physical and psychological stress in pregnant women can lead to adverse birth outcomes. This interesting piece of research has given doctors and midwives more information about non-medical reasons for an increased incidence of low birth weight and premature delivery.
Professor Steer added:
It makes it all the more important for women to attend their antenatal appointments so that such risk factors can be identified during the early stages of pregnancy and appropriate arrangements can then be made for the care of the woman and her baby.
Tony Dobbins, NUI Galway