1. The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis
- Author
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Ben Vandermeer, Margie H. Davenport, Robin Featherstone, Chenxi Cai, Kara Nerenberg, Meghan Sebastianski, and Rshmi Khurana
- Subjects
Gestational hypertension ,medicine.medical_specialty ,Time Factors ,Birth weight ,Population ,Personnel Staffing and Scheduling ,Miscarriage ,Shift work ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,Risk Factors ,Work Schedule Tolerance ,Odds Ratio ,Humans ,Medicine ,030212 general & internal medicine ,education ,education.field_of_study ,Fetal Growth Retardation ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Infant, Newborn ,Pregnancy Outcome ,Shift Work Schedule ,Obstetrics and Gynecology ,Hypertension, Pregnancy-Induced ,Infant, Low Birth Weight ,Stillbirth ,medicine.disease ,Abortion, Spontaneous ,Pregnancy Complications ,Diabetes, Gestational ,Low birth weight ,Infant, Small for Gestational Age ,Premature Birth ,Small for gestational age ,Female ,medicine.symptom ,business - Abstract
Backgroud An increasing number of original studies suggest that exposure to shift work and long working hours during pregnancy could be associated with the risk of adverse pregnancy outcomes, but the results remain conflicted and inconclusive. Objective To examine the influences of shift work and longer working hours during pregnancy on maternal and fetal health outcomes. Data Sources Five electronic databases and three gray literature sources were searched up to March 15, 2019. Methods of Study Selection: Studies of all designs (except case studies and reviews) were included, which contained information on the relevant population (women who engaged in paid work during pregnancy); exposure (rotating shift work [shifts change according to a set schedule], fixed night shift [typical working period is between 11:00 pm to 11:00 am] or longer working hours [h] [>40 h per week]);comparator (fixed day shift [typical working period between 8:00 am- 6:00 pm] or standard working hours [≤40 h per week]); and outcomes (preterm delivery, low birth weight [birth weight Tabulation, Integration, and Results From 3305 unique citations, 62 observational studies (196,989 women) were included. “Low” to “very low” certainty evidence from these studies revealed that working rotating shifts was associated with an increased odds of preterm delivery (OR=1.13, 95% CI: 1.00 to 1.28, I 2 =31%), having a small for gestational age baby (OR=1.18, 95% CI: 1.01 to 1.38, I 2 =0%), preeclampsia (OR=1.75, 95% CI: 1.01 to 3.01, I 2 =75%) and gestational hypertension (OR=1.19, 95% CI: 1.10 to 1.29, I 2 =0%), compared to those who worked a fixed day shift. Working fixed night shifts was associated with an increased odds of preterm delivery (OR=1.21, 95% CI: 1.03 to 1.42, I 2 =36%) and miscarriage (OR=1.23, 95% CI: 1.03 to 1.47, I 2 =37%). Compared with standard hours, working longer hours was associated with an increased odds of miscarriage (OR=1.38, 95% CI: 1.08 to 1.77, I 2 =73%), preterm delivery (OR=1.21, 95% CI: 1.11 to 1.33, I 2 =30%), an infant of low birth weight (OR=1.43, 95% CI: 1.11 to 1.84, I 2 =0%), or an infant of small for gestational age (OR=1.16, 95% CI: 1.00 to 1.36, I 2 =57%). Dose-response analysis showed women working more than 55.5 hours per week (versus 40) had a 10% increase in the odds of having a preterm delivery. Conclusion Pregnant women who work rotating shifts, fixed night shifts, or longer hours have an increased risk of adverse pregnancy outcomes.
- Published
- 2019