Abstract
Spontaneous preterm birth (sPTB) is a major pregnancy complication involving biological, social, behavioural and environmental mechanisms. Workload, shift and intensity may play a role in the occurrence of sPTB. This analysis is aimed addressing the effect of occupational activities on the risk for sPTB and the related outcomes. We conducted a secondary analysis of the EMIP study, a Brazilian multicentre cross-sectional study. For this analysis, we included 1,280 singleton sPTB and 1,136 singleton term birth cases. Independent variables included sociodemographic characteristics, clinical complications, work characteristics, and physical effort devoted to household chores. A backward multiple logistic regression analysis was applied for a model using work characteristics, controlled by cluster sampling design. On bivariate analysis, discontinuing work during pregnancy and working until the 7th month of pregnancy were risks for premature birth while working during the 8th - 9th month of pregnancy, prolonged standing during work and doing household chores appeared to be protective against sPTB during pregnancy. Previous preterm birth, polyhydramnios, vaginal bleeding, stopping work during pregnancy, or working until the 7th month of pregnancy were risk factors in the multivariate analysis. The protective effect of variables compatible with exertion during paid work may represent a reverse causality. Nevertheless, a reduced risk associated with household duties, and working until the 8th-9th month of pregnancy support the hypothesis that some sort of physical exertion may provide actual protection against sPTB.
Highlights
Preterm birth (PTB) remains a co mplex health problem
We believe that a study of the potential risk factors for preterm birth associated with paid work seems opportune
After excluding PROM and provider-initiated preterm births and multiple pregnancies, our analysis considered 1,280 women with spontaneous preterm births (sPTB) and 1,136 with term births
Summary
Preterm birth (PTB) remains a co mplex health problem. Risks for PTB vary according to ethnicity, geography and factors related to lifestyle[1]. In 75% of cases, preterm birth is spontaneous and has a multifactorial origin It appears that risk factors vary according to gestational age, as well as social and environmental aspects[5]. Data from the Brazilian Demographic Health Survey (DHS) showed that white women, women from urban areas, history of hypertension or heart disease, twin gestations, non-elective Caesarean sections, health insurance for delivery, low number of antenatal visits, and severe morbidity were all maternal factors associated with preterm birth[7]. There was the risk of sPTB in pregnant women working long hours maintaining the same body position (more than six hours, either sitting or standing)[12], a job that required sitting and standing multiple times, shift work[10], or working 40 hours or more per week[13] This association may vary according to the occupational activity. We believe that a study of the potential risk factors for preterm birth associated with paid work seems opportune
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