Jou Judy, Kozhimannil Katy B, Abraham Jean M, Blewett Lynn A, McGovern Patricia M
Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St. SE, MMC 729, Minneapolis, MN, 55455, USA.
Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Matern Child Health J. 2018 Feb;22(2):216-225. doi: 10.1007/s10995-017-2393-x.
Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18-45 who gave birth in 2011-2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospitalizing their infants (95% CI 0.3, 1.0) and a 51% decrease in the odds of being re-hospitalized themselves (95% CI 0.3, 0.9) at 21 months postpartum, compared to women taking unpaid or no leave. They also had 1.8 times the odds of doing well with exercise (95% CI 1.1, 3.0) and stress management (95% CI 1.1, 2.8), compared to women taking only unpaid leave. Conclusions for Practice Paid maternity leave significantly predicts lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management. Policies aimed at expanding access to paid maternity and family leave may contribute toward reducing socio-demographic disparities in paid leave use and its associated health benefits.
目标 美国是全球仅有的三个没有国家政策保障在职生育女性带薪休假的国家之一。虽然在国际背景下，产假与改善母婴结局相关，但在美国背景下，需要最新的研究证据为当前关于带薪家庭假的政策辩论提供信息。方法 利用“倾听母亲III”的数据，这是一项对2011 - 2012年生育的18 - 45岁女性进行的全国性调查，我们进行了多变量逻辑回归，以预测带薪产假的使用情况和时长与婴儿健康、母亲身心健康及母亲健康行为相关结局的可能性。结果 带薪和无薪休假的使用情况因种族/族裔和家庭收入而有显著差异。与休无薪假或未休假的女性相比，休带薪产假的女性在产后21个月时，其婴儿再次住院的几率降低了47%（95%置信区间0.3，1.0），自身再次住院的几率降低了51%（95%置信区间0.3，0.9）。与仅休无薪假的女性相比，她们进行锻炼（95%置信区间1.1，3.0）和压力管理（95%置信区间1.1，2.8）表现良好的几率是其1.8倍。实践结论 带薪产假显著预示着母婴再次住院几率较低，以及锻炼和压力管理表现良好的几率较高。旨在扩大带薪产假和家庭假获取途径的政策可能有助于减少带薪休假使用及其相关健康益处方面的社会人口差异。
