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早产与产前孕妇职业:以加利福尼亚州洛杉矶的一个基于人群的样本为例分析西班牙裔和出生地点的作用

Preterm birth and prenatal maternal occupation: the role of Hispanic ethnicity and nativity in a population-based sample in Los Angeles, California.

机构信息

Ondine S. von Ehrenstein is with the Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA). Michelle Wilhem, Anthony Wang, and Beate Ritz are with the Department of Epidemiology, Fielding School of Public Health, UCLA.

出版信息

Am J Public Health. 2014 Feb;104 Suppl 1(Suppl 1):S65-72. doi: 10.2105/AJPH.2013.301457. Epub 2013 Dec 19.

Abstract

OBJECTIVES

We investigated preterm birth (PTB) in relation to maternal occupational exposure and whether effect measures were modified by Hispanic ethnicity and nativity in a population-based sample with high proportion of Hispanics.

METHODS

We used a case-control study (n = 2543) nested within a cohort of 58,316 births in Los Angeles County, California, in 2003. We categorized prenatal occupations using the US Census Occupation Codes and Classification System and developed a job exposure matrix. Odds ratios for PTB were estimated using logistic regression.

RESULTS

Odds ratios for PTB were increased for all women in health care practitioner and technical occupations, but the 95% confidence intervals included the null value; effects were more pronounced among Hispanics. We estimated elevated odds ratios for foreign-born Hispanic women in building and grounds cleaning and maintenance occupations. Shift work and physically demanding work affected births among US-born but not foreign-born Hispanics.

CONCLUSIONS

Hispanic women are at particular risk for PTB related to adverse prenatal occupational exposure. Nativity may moderate these effects on PTB. Maternal occupational exposures likely contribute to ethnic disparities in PTB.

摘要

目的

我们调查了与母亲职业暴露相关的早产(PTB),并研究了在一个西班牙裔人口比例较高的基于人群的样本中,西班牙裔种族和出生地是否会改变效应度量。

方法

我们使用了一项病例对照研究(n=2543),该研究嵌套在加利福尼亚州洛杉矶县 2003 年进行的一项 58316 例出生队列中。我们使用美国人口普查职业代码和分类系统对产前职业进行分类,并开发了工作暴露矩阵。使用逻辑回归估计 PTB 的比值比。

结果

所有从事医疗保健从业者和技术职业的女性发生 PTB 的比值比均增加,但 95%置信区间包含零值;在西班牙裔中,影响更为明显。我们估计在建筑和场地清洁和维护职业中,外国出生的西班牙裔女性发生早产的比值比升高。轮班工作和体力劳动会影响在美国出生的西班牙裔的分娩,但不会影响外国出生的西班牙裔。

结论

西班牙裔女性因产前职业暴露不良而面临特定的早产风险。出生地可能会调节这些对 PTB 的影响。产妇职业暴露可能导致 PTB 的种族差异。

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