EMPLOYMENT DURING PREGNANCY IN RELATION TO RISK-FACTORS AND PREGNANCYOUTCOME

Objective To describe the relation of employment status during pregnan cy to potential demographic, behavioural and obstetrical risk factors for adverse late pregnancy outcome, as well as the risks of having a p reterm delivery and a small for gestational age infant. Design Cohort study. Setting A university hospital. Subjects Of 8711 women with sing leton pregnancies (1989-91), 5875 returned questionnaires about risk f actors and employment status at 16 and 30 weeks gestation. Of the resp ondents 5552 were analysed in five groups: (1) women working throughou t pregnancy, (2) women working in the first, but unemployed during the second trimester, (3) women on sick leave in the first and second tri mester, (4) women unemployed throughout pregnancy, and (5) students. T he association between employment status and having a small for gestat ional age infant and preterm delivery was evaluated, accounting for ot her risk factors. Results Working women and students had the most and unemployed women the least favourable demographic risk factors. Women on sick leave had the least favourable obstetrical and medical history , followed by unemployed women. No clear pattern of the behavioural ri sk factors was found. Differences in risk of having a small for gestat ional age infant were a function of parity, smoking and maternal heigh t. Adjustment for these factors plus education yielded a lower risk of preterm delivery in partially unemployed women and higher risk among women on sick leave compared to working women, accounted for by differ ent risks of bleeding in the second and third trimester. Conclusions C omparison of pregnancy outcome among women with different work status should consider the differences in risk factor profile. Adjusting for such risk factors, we found no evidence that work per se had any detri mental or beneficial effects on the risk of having a small for gestati onal age infant or preterm delivery.