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American Journal of Epidemiology Advance Access originally published online on July 25, 2007
American Journal of Epidemiology 2007 166(8):951-965; doi:10.1093/aje/kwm171
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Work Activity in Pregnancy, Preventive Measures, and the Risk of Preterm Delivery

Agathe Croteau1,2, Sylvie Marcoux3 and Chantal Brisson3

1 National Institute of Public Health of Québec, Québec, QC, Canada
2 CHUQ Research Center, Laval University, Québec, QC, Canada
3 Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Québec, QC, Canada

Correspondence to Dr. Agathe Croteau, National Institute of Public Health of Québec, 945 Wolfe Avenue, Second Floor, Québec, QC, Canada G1V 5B3 (e-mail: agathe.croteau{at}inspq.qc.ca).

Received for publication November 3, 2006. Accepted for publication May 9, 2007.

The objective of this case-control study was to evaluate whether occupational conditions during pregnancy are associated with preterm delivery (PTD). Women whose work conditions changed following the use of a legally justified preventive measure (withdrawal from work or job reassignment) were also compared with those whose work conditions did not change. Cases (n = 1,242) and controls (n = 4,513) were selected from 43,898 women who had single livebirths between January 1997 and March 1999 in Québec, Canada. They were interviewed by telephone after delivery. Results showed association of PTD with demanding posture for at least 3 hours per day, whole-body vibrations, high job strain combined with low or moderate social support, and a cumulative index composed of nine occupational conditions. The adjusted odds ratio increased from 1.0 to 2.0 for PTD (ptrend < 0.0001) and from 1.0 to 2.7 for very PTD (<34 weeks; ptrend = 0.0015) as the number of conditions increased from zero to four or more. The associations for PTD and very PTD with most of the above-mentioned work conditions were weaker when exposures were eliminated following recourse to a legally justified preventive measure. This study provides relevant information on the possible influence of preventive measures on the risk of PTD in pregnant workers.

maternal exposure; occupational exposure; posture; pregnancy outcome; premature birth; stress, psychological; vibration; work schedule tolerance

Abbreviations: PTD, preterm delivery


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