PSYCHOLOGIC STRESS IN THE WORKPLACE AND SPONTANEOUS-ABORTION

The relation of work-related psychologic stress to spontaneous abortio n was examined in a prospective study of 3,953 pregnant, employed memb ers of a prepaid health plan in California, recruited between 1990 and 1991. information on occupation, psychologic stress-related factors a t work, social support at work, physical exertion at work, life events , pregnancy worries, and potential confounders was obtained by a telep hone interview. Psychologic job stress and social support at work were assessed using an abbreviated version of the instrument developed by Karasek and colleagues (Los Angeles: University of Southern California , 1986). Results from the multivariate model indicated that, overall, stressful work was not associated with an increased risk of spontaneou s abortion. However, interactions were observed between stressful work and maternal age over 32 years (p = 0.04), cigarette smoking (p = 0.0 2), and primigravidity (p = 0.06). Relative to the odds ratio for stre ssful work in young, nonsmoking, multigravid women without a history o f two or more spontaneous abortions, the odds ratios for spontaneous a bortion given stressful work were higher by 2.45 (95% confidence inter val (CI) 1.03-5.81) for older women, 2.96 (95% CI 1.16-7.52) for smoke rs, and 2.27 (95% CI 0.97-5.27) for primigravid women.