National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark.
BJOG. 2014 Jun;121(7):830-8; discussion 839. doi: 10.1111/1471-0528.12612. Epub 2014 Mar 5.
To investigate if maternal exposure to psychosocial job strain at work (high demands and low control) measured by questionnaire early in pregnancy (median week 15) is associated with malformations in the offspring.
Population-based cohort study.
The Danish National Birth Cohort.
A cohort of 60,386 singleton children with full information on mother's occupational status, exposure to psychosocial job strain and all covariates during pregnancy.
Logistic regression analysis was used to calculate the odds of congenital malformations as a function of job strain with adjustment for maternal age, body mass index, parity, smoking, alcohol use, manual versus nonmanual work, maternal serious disease and gestational age at interview.
Circulatory malformation, musculoskeletal malformation or any malformation.
Logistic regression analyses, both crude and adjusted, indicated no associations between working under high strain and giving birth to a child with circulatory malformation (adjusted odds ratio [OR] 1.04, 95% confidence interval [95% CI] 0.75-1.44), musculoskeletal malformation (aOR 0.88, 95% CI 0.71-1.10) or any malformation (aOR 0.99, 95% CI 0.85-1.15). Supplementary analyses including restriction to first-borns and a stratified analysis with respect to manual and nonmanual work did not change the results.
Association between exposure to high job strain during pregnancy and elevated risk of circulatory, muscle and any malformations is not supported by this study.
探讨孕妇在妊娠早期(中位数第 15 周)通过问卷调查所暴露的工作场所心理社会紧张(高需求低控制)是否与后代畸形有关。
基于人群的队列研究。
丹麦全国出生队列。
共有 60386 名单胎妊娠且有完整母亲职业状况、妊娠期间心理社会工作紧张暴露及其所有协变量信息的儿童。
使用逻辑回归分析计算畸形儿的出现概率作为职业紧张的函数,同时调整了母亲的年龄、体重指数、产次、吸烟、饮酒、体力劳动与非体力劳动、母亲严重疾病和访谈时的孕龄。
循环系统畸形、肌肉骨骼系统畸形或任何畸形。
无论是在未调整还是调整后模型中,高压力工作与循环系统畸形(调整后的比值比[aOR]为 1.04,95%置信区间[95%CI]为 0.75-1.44)、肌肉骨骼系统畸形(aOR 为 0.88,95%CI 为 0.71-1.10)或任何畸形(aOR 为 0.99,95%CI 为 0.85-1.15)的出生无相关性。包括仅纳入初产妇和针对体力劳动与非体力劳动分层分析的补充分析并未改变结果。
本研究不支持妊娠期间暴露于高工作压力与循环系统、肌肉和任何畸形风险升高之间的关联。