Institute of Occupational and Environmental Medicine, University of Birmingham, United Kingdom.
J Womens Health (Larchmt). 2009 Dec;18(12):2071-6. doi: 10.1089/jwh.2008.1062.
To assess whether work as a nurse and a midwife during pregnancy increases the risk of adverse pregnancy outcomes.
We identified from the 1990-2006 Finnish Medical Birth Registry all singleton births to nurses (n=109,542), midwives (n=3,009), and teachers (n=23,454) (referents). The main outcomes were sexual differentiation, low and high birth weight, preterm and postterm delivery, small and large for gestational age, and perinatal death.
The prevalence of low birth weight (2.9% vs. 2.5%), preterm delivery (4.4% vs. 4.1%), postterm delivery (4.7% vs. 4.1%), small for gestational age (1.8% vs. 1.4%), perinatal death (0.45% vs. 0.41%) and stillbirth (0.30% vs. 0.25%) was higher among the newborns of nurses than those of teachers. The adjusted odds ratio (OR) from generalized estimating equations was 1.17 (95% confidence interval [CI] 1.07-1.26) for low birth weight, 1.09 (95% CI 1.02-1.16) for preterm delivery, 1.11 (95% CI 1.03-1.18) for postterm delivery, 1.17 (95% CI 1.05-1.30) for small for gestational age, 1.12 (95% CI 0.90-1.35) for perinatal death, and 1.27 (95% CI 0.98-1.56) for stillbirth. For midwives, the risk of small for gestational age (OR=1.25, 95% CI 0.95-1.55) was elevated, but the 95% CI included unity. There was no substantial difference in the sex distribution.
This study provides evidence that work as a nurse may reduce fetal growth and duration of pregnancy. The inference is based on the newborns of teachers as the reference group. However, the prevalence of most of the outcomes was higher among the newborns of all other working women combined than in the newborns of both nurses and teachers.
评估孕期护士和助产士工作是否会增加不良妊娠结局的风险。
我们从 1990 年至 2006 年芬兰医疗出生登记处确定了所有护士（n=109542）、助产士（n=3009）和教师（n=23454）的单胎妊娠（对照）。主要结局是性别分化、低体重和高体重、早产和过期产、小于胎龄和大于胎龄、围产儿死亡。
与教师所生新生儿相比，护士所生新生儿的低体重（2.9%比 2.5%）、早产（4.4%比 4.1%）、过期产（4.7%比 4.1%）、小于胎龄（1.8%比 1.4%）、围产儿死亡（0.45%比 0.41%）和死产（0.30%比 0.25%）的发生率更高。广义估计方程的调整比值比（OR）为低体重 1.17（95%置信区间[CI]1.07-1.26）、早产 1.09（95%CI1.02-1.16）、过期产 1.11（95%CI1.03-1.18）、小于胎龄 1.17（95%CI1.05-1.30）、围产儿死亡 1.12（95%CI0.90-1.35）和死产 1.27（95%CI0.98-1.56）。对于助产士，小于胎龄的风险（OR=1.25，95%CI0.95-1.55）增加，但 95%CI 包括 1。性别分布没有实质性差异。
本研究提供的证据表明，护士工作可能会降低胎儿生长和妊娠持续时间。这一推论是基于教师所生新生儿作为参考组。然而，与护士和教师所生新生儿相比，所有其他职业女性所生新生儿的大多数结局发生率更高。
