Bell Janice F, Zimmerman Frederick J, Diehr Paula K
Health Services, University of Washington, Box 357668, Seattle, WA, 98195, USA.
Matern Child Health J. 2008 Jul;12(4):415-26. doi: 10.1007/s10995-007-0264-6. Epub 2007 Aug 15.
We tested relations between aspects of maternal work and birth outcomes in a national sample and in subgroups known to experience disparities.
Three indices of work attributes (Status and Recognition, Physical Demands, and Exposure to Conflict) were derived by factor analysis of variables extracted from the Department of Labor's O*Net database. The indices were linked to the National Longitudinal Survey of Youth using occupation codes for the primary jobs held by women who gave birth between 1979 and 2000 and worked during the quarter prior to birth (n = 3,386 births to n = 2,508 mothers). Multiple regression was used to model birth outcomes as functions of the work attribute indices, controlling for several measures of socioeconomic status and risk factors for adverse birth outcomes.
In the full sample, work-related Physical Demands were associated with lower average birthweight and increased odds of preterm birth while Status and Recognition was associated with higher average birthweight and lower odds of fetal growth restriction. In stratified models, Status and Recognition was associated with higher birth weight among women with low (versus high) income and with lower odds of preterm birth among women with low (versus high) education. Physical Demands were associated with higher rates of preterm birth among women with low (versus high) income and education and among African-American mothers (compared to Whites).
The work environment is an important predictor of healthy births. Relations between maternal work attributes and birth outcomes differ by race/ethnicity and socioeconomic status and according to the outcome under investigation. Further research with measures of work attributes specific to maternal work experiences is recommended to confirm our findings.
我们在一个全国性样本以及已知存在差异的亚组中，测试了母亲工作的各个方面与分娩结局之间的关系。
通过对从美国劳工部的O*Net数据库中提取的变量进行因子分析，得出了三个工作属性指标（地位与认可、体力要求、接触冲突情况）。这些指标通过职业代码与全国青年纵向调查相联系，该调查涉及1979年至2000年间分娩且在分娩前一个季度仍在工作的女性的主要工作（n = 3386例分娩，涉及n = 2508位母亲）。使用多元回归将分娩结局建模为工作属性指标的函数，并控制社会经济地位的若干衡量指标以及不良分娩结局的风险因素。
在全样本中，与工作相关的体力要求与较低的平均出生体重以及早产几率增加有关，而地位与认可则与较高的平均出生体重以及胎儿生长受限几率降低有关。在分层模型中，地位与认可在低收入（相对于高收入）女性中与较高的出生体重有关，在低教育程度（相对于高教育程度）女性中与较低的早产几率有关。体力要求在低收入（相对于高收入）和低教育程度女性以及非裔美国母亲（与白人相比）中与较高的早产率有关。
工作环境是健康分娩的重要预测因素。母亲工作属性与分娩结局之间的关系因种族/民族、社会经济地位以及所调查的结局而异。建议进一步开展针对母亲工作经历特定的工作属性测量的研究，以证实我们的发现。
