Marcoux S, Bérubé S, Brisson C, Mondor M
Laval University Epidemiology Research Group, Québec, Canada.
Epidemiology. 1999 Jul;10(4):376-82. doi: 10.1097/00001648-199907000-00004.
In a case-control study we assessed whether exposure to high job strain during the first 20 weeks of pregnancy increases the risk of preeclampsia and gestational hypertension. Cases (128 with preeclampsia and 201 with gestational hypertension) and controls (N = 401) were primiparous women who had a paid occupation for at least 1 week during the first 20 weeks of their pregnancy and who delivered between 1984 and 1986 in 10 hospitals of Quebec, Canada. Based on their job title, we assigned women scores of psychological demand and decision latitude derived from the National Population Health Survey and classified these women as exposed to high (high demand, low latitude) versus low (low demand, high latitude) job strain. Women exposed to high job strain were more likely to develop preeclampsia [adjusted odds ratio (aOR) = 2.1; 95% confidence interval (CI) = 1.1-4.1] than women exposed to low job strain. The risk was quite similar for women exposed to a full-time, high strain job (> or =35 hours per week) (aOR = 2.0) than in a part-time, high strain job (aOR = 1.8). High job strain increased the risk of gestational hypertension slightly (aOR = 1.3; 95% CI = 0.8-2.2). These results indicate that women exposed to high job strain are at higher risk of developing preeclampsia and, to a lesser extent, gestational hypertension.
在一项病例对照研究中,我们评估了孕期前20周暴露于高工作压力是否会增加先兆子痫和妊娠期高血压的风险。病例组(128例先兆子痫患者和201例妊娠期高血压患者)和对照组(N = 401)均为初产妇,她们在孕期前20周至少有1周从事有薪工作,且于1984年至1986年在加拿大魁北克省的10家医院分娩。根据她们的职位,我们根据全国人口健康调查为女性分配心理需求和决策自由度得分,并将这些女性分为高工作压力暴露组(高需求、低自由度)和低工作压力暴露组(低需求、高自由度)。与低工作压力暴露的女性相比,高工作压力暴露的女性更易患先兆子痫[调整优势比(aOR)= 2.1;95%置信区间(CI)= 1.1 - 4.1]。对于从事全职高压力工作(每周≥35小时)的女性(aOR = 2.0)和从事兼职高压力工作的女性(aOR = 1.8),风险相当。高工作压力会轻微增加妊娠期高血压的风险(aOR = 1.3;95% CI = 0.8 - 2.2)。这些结果表明,暴露于高工作压力的女性患先兆子痫的风险更高,患妊娠期高血压的风险相对较低。