Yang Hui-Ju, Kao Feng-Yu, Chou Yiing-Jeng, Huang Nicole, Chang Kuang-Yi, Chien Li-Yin
Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University, Taipei, Taiwan.
Birth. 2014 Sep;41(3):262-7. doi: 10.1111/birt.12118. Epub 2014 Jun 17.
Nurses encounter multiple occupational exposures at work which may harm their reproductive health. The purpose of the study was to compare pregnancy complications and outcomes including cesarean deliveries, tocolysis, miscarriage, and preterm labor between female nurses and comparable women who were not nurses in Taiwan.
This nationwide population-based study was performed using the National Health Insurance Research Database from 1997 to 2008. We identified 3,656 pregnancies among 2,326 nurses and 111,889 pregnancies among 74,919 non-nurses. A generalized estimating equation was used to compare risks between the two groups.
The rates of tocolysis (28.6 vs 22.3%), miscarriage (6.0 vs 5.3%), and preterm labor (8.1 vs 4.4%) were significantly higher among nurses than non-nurses. After adjustment for background differences, nurses had significantly higher risks for cesarean section (adjusted OR 1.12 [95% confidence interval (CI) 1.03-1.22]), tocolysis (OR 1.18 [95% CI 1.09-1.29]), and preterm labor (OR 1.46 [95% CI 1.28-1.67]) than non-nurses.
Nurses are at higher risk for cesarean section, tocolysis, and preterm labor than non-nurses. Occupational exposure related to these adverse pregnancy outcomes should be examined. Strategies to decrease the risks should be developed to improve reproductive health among nurses.
护士在工作中会面临多种职业暴露,这可能会损害她们的生殖健康。本研究的目的是比较台湾女性护士与非护士的可比女性之间的妊娠并发症及结局,包括剖宫产、安胎治疗、流产和早产。
本全国性基于人群的研究使用了1997年至2008年的国民健康保险研究数据库。我们在2326名护士中识别出3656次妊娠,在74919名非护士中识别出111889次妊娠。使用广义估计方程比较两组之间的风险。
护士中安胎治疗(28.6%对22.3%)、流产(6.0%对5.3%)和早产(8.1%对4.4%)的发生率显著高于非护士。在调整背景差异后,护士剖宫产(调整后比值比1.12[95%置信区间(CI)1.03 - 1.22])、安胎治疗(比值比1.18[95%CI 1.09 - 1.29])和早产(比值比1.46[95%CI 1.28 - 1.67])的风险显著高于非护士。
护士剖宫产、安胎治疗和早产的风险高于非护士。应检查与这些不良妊娠结局相关的职业暴露。应制定降低风险的策略,以改善护士的生殖健康。