[Occupation-related psychosocial factors in pregnancy and risk of preterm delivery].

BACKGROUND

Despite scientific developments and an increasing standard of medical care, preterm delivery does not cease to be the problem even in the developed countries. Among preterm delivery risk factors, attention is also paid to stress perceived by a pregnant woman, however, job-related stress is often disregarded as a problem. The purpose of this work was to define the extent to which psychosocial characteristics of the work environment are perceived to generate stress as well as to find out their relationship with preterm delivery.

MATERIAL AND METHODS

The study group comprised 1433 pregnant women working during pregnancy (terminated after the 22nd week with delivery of a living baby) in the period from January 1, 1999 to June 30, 2000. They delivered babies in obstetric wards of 23 hospitals of the Lódź region on randomly chosen days (94 days altogether). A standard questionnaire which sought information about the pregnancy as well as about time and kind of work performed was used after the delivery. Psychosocial factors were categorized by 19 characteristics, which were evaluated by women on the 1-5 point scale in view of the stress related with a given factor.

RESULTS

Although preterm delivery was not more frequent in women who evaluated particular work features as stressogenic, it did occur more frequently in the group of women whose overall evaluation score exceeded 50. After adjusting for age and health conditions during pregnancy the odds ratio of preterm delivery related to highly stressful work was 1.98 (95% CI: 1.12-3.48). It was also observed that the proportion of women who evaluated their work as highly stressogenic was smaller in the subpopulation that continued job performance after the 5th month of pregnancy than in the women working shorter. However, the relative risk of preterm delivery was significantly higher in the latter subpopulation and it accounted for 2.36 (95% CI: 1.05-5.30). It was found that fast work pace, high workload, insufficient equipment for the work performed, conflict situations in daily activities, lack of support in difficult situations, and negative influence of other people on work and conditions of work performance were the most common sources of stress.

CONCLUSIONS

The obtained data indicate the need to evaluate stress at work in groups of occupationally active pregnant women as well as to select more thoroughly work posts for this group of employees.