Escribá-Agüir V, Perez-Hoyos S, Saurel-Cubizolles M J
Valencia School for Health Studies, Regional Ministry of Health, Spain.
Int Arch Occup Environ Health. 2001 Oct;74(8):583-8. doi: 10.1007/s004200100259.
To evaluate the effect of physical workload and psychological demand on all preterm births, and to determine whether these risk factors have the same effect on different types of preterm birth (moderate versus very preterm birth) and different modes of delivery onset (spontaneous versus indicated preterm birth).
A case-control study was carried out in two public general hospitals in the Valencia Region, Spain. All preterm births (228) which occurred between 22 and 36 completed weeks of amenorrhea and 348 controls of 37 or more completed weeks of amenorrhea were included. The information was collected by interviewing women within 2 days of their giving birth. Physical workload, psychological demand, weekly working hours and daily time spent commuting between home and work were used as explanatory variables. A polytomous logistic regression was carried out.
Exposure to medium or high level physical workload increases the risk of preterm birth, with an adjusted odds ratio (OR) of 1.59 and 2.31, respectively. The risk of moderate preterm birth was greater in women with a medium or high level of physical workload, OR: 1.73 and 2.35, respectively. The same trend was observed for very preterm birth. Physical workload showed a different effect on spontaneous and indicated preterm birth. The exposure to medium and high level physical workload increases the risk of indicated preterm birth, with an OR of 2.74 and 3.88, respectively. The same trend was seen in the case of spontaneous preterm birth. Psychological demands were not associated with preterm birth.
High physical exertion increases the risk of preterm birth in Spain. The magnitude of the effect of physical workload on moderate and very preterm birth is similar, but is higher on indicated preterm birth than on spontaneous preterm birth. Psychological demands show no effect on the risk of preterm birth.
评估体力工作负荷和心理需求对所有早产的影响，并确定这些风险因素对不同类型的早产（中度早产与极早产）以及不同分娩发动方式（自然早产与医源性早产）是否具有相同影响。
在西班牙巴伦西亚地区的两家公立综合医院开展了一项病例对照研究。纳入了所有在闭经22至36足周发生的早产（228例）以及348例闭经37足周及以上的对照。在女性分娩后2天内通过访谈收集信息。将体力工作负荷、心理需求、每周工作时长以及每天上下班通勤时间用作解释变量。进行了多分类逻辑回归分析。
暴露于中度或高度体力工作负荷会增加早产风险，调整后的优势比（OR）分别为1.59和2.31。体力工作负荷处于中度或高度水平的女性发生中度早产的风险更高，OR分别为1.73和2.35。极早产也观察到相同趋势。体力工作负荷对自然早产和医源性早产有不同影响。暴露于中度和高度体力工作负荷会增加医源性早产风险，OR分别为2.74和3.88。自然早产情况也呈现相同趋势。心理需求与早产无关。
在西班牙，高强度体力活动会增加早产风险。体力工作负荷对中度和极早产的影响程度相似，但对医源性早产的影响高于自然早产。心理需求对早产风险无影响。
