Aitken Zoe, Garrett Cameryn C, Hewitt Belinda, Keogh Louise, Hocking Jane S, Kavanagh Anne M
Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, VIC 3010, Australia.
Institute for Social Science Research and School of Social Science, The University of Queensland, Brisbane, QLD 4072, Australia.
Soc Sci Med. 2015 Apr;130:32-41. doi: 10.1016/j.socscimed.2015.02.001. Epub 2015 Feb 4.
Paid maternity leave has become a standard benefit in many countries throughout the world. Although maternal health has been central to the rationale for paid maternity leave, no review has specifically examined the effect of paid maternity leave on maternal health. The aim of this paper is to provide a systematic review of studies that examine the association between paid maternity leave and maternal health. We conducted a comprehensive search of electronic databases (Medline, Embase, CINAHL, PsycINFO, Web of Science, Sociological Abstracts) and Google Scholar. We searched websites of relevant organisations, reference lists of key papers and journals, and citation indices for additional studies including those not in refereed journals. There were no language restrictions. Studies were included if they compared paid maternity leave versus no paid maternity leave, or different lengths of paid leave. Data were extracted and an assessment of bias was performed independently by authors. Seven studies were identified, with participants from Australia, Sweden, Norway, USA, Canada, and Lebanon. All studies used quantitative methodologies, including cohort, cross-sectional, and repeated cross-sectional designs. Outcomes included mental health and wellbeing, general health, physical wellbeing, and intimate partner violence. The four studies that examined leave at an individual level showed evidence of maternal health benefits, whereas the three studies conducting policy-level comparisons reported either no association or evidence of a negative association. The synthesis of the results suggested that paid maternity leave provided maternal health benefits, although this varied depending on the length of leave. This has important implications for public health and social policy. However, all studies were subject to confounding bias and many to reverse causation. Given the small number of studies and the methodological limitations of the evidence, longitudinal studies are needed to further clarify the effects of paid maternity leave on the health of mothers in paid employment.
带薪产假已成为世界上许多国家的一项标准福利。尽管孕产妇健康一直是带薪产假政策出台的核心依据，但尚无综述专门研究带薪产假对孕产妇健康的影响。本文旨在对研究带薪产假与孕产妇健康之间关联的文献进行系统综述。我们全面检索了电子数据库（Medline、Embase、CINAHL、PsycINFO、科学引文索引、社会学文摘）以及谷歌学术。我们还搜索了相关组织的网站、关键论文和期刊的参考文献列表，以及包括未发表在学术期刊上的研究在内的其他研究的引文索引。没有语言限制。纳入的研究需比较带薪产假与无薪产假，或不同时长的带薪产假。由作者独立提取数据并进行偏倚评估。共识别出7项研究，参与者来自澳大利亚、瑞典、挪威、美国、加拿大和黎巴嫩。所有研究均采用定量方法，包括队列研究、横断面研究和重复横断面设计。研究结果包括心理健康与幸福感、总体健康、身体健康以及亲密伴侣暴力。4项在个体层面研究产假的结果显示出孕产妇健康受益的证据，而3项进行政策层面比较的研究要么报告无关联，要么显示出负关联的证据。结果综合表明，带薪产假对孕产妇健康有益，尽管这种益处因产假时长而异。这对公共卫生和社会政策具有重要意义。然而，所有研究均存在混杂偏倚，许多研究还存在反向因果关系。鉴于研究数量较少且证据存在方法学局限性，需要开展纵向研究以进一步阐明带薪产假对在职母亲健康的影响。
