Meyer John D, Warren Nicholas, Reisine Susan
Section of Occupational and Environmental Health, Division of Public Health and Population Sciences, University of Connecticut Health Center, Farmington, Connecticut, USA.
Am J Ind Med. 2007 Sep;50(9):664-75. doi: 10.1002/ajim.20496.
Indices of job strain have demonstrated a variable relationship to low birth weight (LBW) and prematurity, with conflicting study results. This study sought to examine the associations of psychosocial work environment characteristics with adverse pregnancy outcomes using and comparing the demand-control model and job attributes derived from the O*NET.
Job characteristics were imputed to maternal occupation recorded in the 2000 Connecticut state birth registry for 26,408 singleton births, using scores for psychological job demands, control, and physical demands derived from the Job Content Questionnaire, and for substantive complexity of work and physical demands using variables derived from O*NET job attributes. Odds ratios for LBW and preterm delivery were estimated while controlling for relevant covariates.
High psychological demands were not associated with pregnancy outcomes, while high physical demand scores from the O*NET were associated with LBW. Associations of term- and all-LBW with both low control and low substantive complexity were attenuated by adjustment for educational and demographic covariates. A gradient with lower scores was seen for term LBW and substantive complexity, and for prematurity and control. Both constructs were correlated with maternal education.
These results suggest that low maternal job control and substantive complexity may be modestly associated with LBW and, to a lesser extent, prematurity. A greater association with control may explain why a weak link of birth outcomes to high-strain work has been noted in past studies. Observed associations with occupational are reduced after adjustment for relevant confounding variables, in particular educational level and race/ethnicity.
工作压力指标与低出生体重（LBW）和早产之间的关系呈现出多变性，研究结果相互矛盾。本研究旨在使用并比较需求控制模型和源自职业信息网络（O*NET）的工作属性，来检验心理社会工作环境特征与不良妊娠结局之间的关联。
利用工作内容问卷得出的心理工作需求、控制和身体需求得分，以及源自O*NET工作属性的变量得出的工作实质复杂性和身体需求得分，将工作特征归因于2000年康涅狄格州出生登记处记录的26408例单胎分娩的母亲职业。在控制相关协变量的同时，估计低出生体重和早产的比值比。
高心理需求与妊娠结局无关，而O*NET的高身体需求得分与低出生体重有关。通过对教育和人口统计学协变量进行调整，足月低出生体重和所有低出生体重与低控制和低实质复杂性之间的关联减弱。在足月低出生体重与实质复杂性、早产与控制方面，均呈现出得分越低的梯度。这两种结构均与母亲教育程度相关。
这些结果表明，母亲工作控制低和实质复杂性低可能与低出生体重有一定关联，在较小程度上也与早产有关。与控制的关联更大，这或许可以解释为何在过去的研究中发现出生结局与高压力工作之间的联系较弱。在对相关混杂变量，尤其是教育水平和种族/民族进行调整后，观察到的与职业的关联会降低。
