Work and pregnancy: The role of fatigue and the "second shift" on antenatal morbidity

OBJECTIVE: This study was undertaken to evaluate factors at home and work a ssociated with antenatal morbidity (emergency department visits and hospita lizations) among employed pregnant women. STUDY DESIGN: This prospective study of 213 women included 3 antenatal inte rviews at about 16, 24, and 30 weeks' gestation with questions on health hi story, lifestyle, housework, working conditions, and emergency department v isits and hospitalizations. Work scores and home scores were formulated fro m each interview. Fatigue was defined as being very tired or extremely tire d at the end of a typical workday. The risk of antenatal morbidity was mode led by means of logistic regression; results are presented as adjusted odds ratios with 95% confidence intervals. RESULTS: The risk of antenatal morbidity, which was greatest during the sec ond trimester, was increased by stress (adjusted odds ratio, 2.45: 95% conf idence interval, 1.32-4.57), fatigue (adjusted odds ratio, 3.77; 95% confid ence interval, 1.98-7.18), work plus home score (adjusted odds ratio, 1.55; 95% confidence interval, 1.22-1.97), and the interaction of fatigue and wo rk plus home score (adjusted odds ratio, 4.61;95% confidence interval, 2.02 -10.50). CONCLUSIONS: These findings suggest that maternal fatigue contributes signi ficantly to antenatal morbidity.