Meyer John D, Muntaner Carles, O'Campo Patricia, Warren Nicolas
Selikoff Centers for Occupational Medicine and the Pediatric Environmental Health Specialty Unit, Department of Preventive Medicine, Icahn-Mount Sinai School of Medicine, 1 Gustave L Levy Place, Box 1057, New York, NY, 10029, USA.
Bloomberg Faculty of Nursing, Institute for Global Health Equity and Innovation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Matern Child Health J. 2016 Jul;20(7):1366-74. doi: 10.1007/s10995-016-1933-0.
To assess longitudinal changes in occupational effort-reward imbalance (ERI) and demand-control (DC) scores across pregnancy and examine associations with blood pressure (BP) during pregnancy.
A pilot repeated-measures survey was administered four times to a sample of working women across pregnancy using the ERI and DC instruments. Demographic data and blood pressure measurements were collected at each interval. Growth mixture modeling was used to examine trajectories of change in occupational characteristics. Associations with BP were examined using repeated-measures linear regression models.
ERI model components (effort, reward, and overcommitment) all declined across pregnancy while job control remained stable. Increasing ERI trajectory was associated with higher systolic BP (b = 8.8; p < 0.001) as was high overcommitment; declining ERI also showed a lesser association with higher BP. Associations between DC trajectories and BP were much smaller, and non-significant once controlled for overcommitment.
Self-assessed efforts, rewards, and overcommitment at work decline across pregnancy in our participants, while job control remains stable. Replication in a more diverse pregnant working population is warranted to confirm these results. These preliminary data suggest that further investigation into the factors that may be linked with improved work psychosocial climate during pregnancy may be useful in order to improve pregnancy outcomes.
评估孕期职业付出-回报失衡（ERI）和工作要求-控制（DC）得分的纵向变化，并研究其与孕期血压（BP）的关联。
使用ERI和DC工具，对在职女性样本在孕期进行了四次重复测量的试点调查。每次测量时收集人口统计学数据和血压测量值。采用生长混合模型来研究职业特征的变化轨迹。使用重复测量线性回归模型来研究与血压的关联。
在整个孕期，ERI模型的各个组成部分（付出、回报和过度投入）均下降，而工作控制保持稳定。ERI轨迹增加与收缩压升高相关（b = 8.8；p < 0.001），过度投入程度高时也是如此；ERI下降与血压升高的关联也较小。DC轨迹与血压之间的关联要小得多，在控制过度投入后无统计学意义。
在我们的研究对象中，孕期自我评估的工作付出、回报和过度投入均下降，而工作控制保持稳定。有必要在更多样化的孕期在职人群中进行重复研究以证实这些结果。这些初步数据表明，进一步调查可能与孕期工作心理社会环境改善相关的因素，可能有助于改善妊娠结局。
