Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Occup Environ Med. 2020 Oct;77(10):691-698. doi: 10.1136/oemed-2020-106519. Epub 2020 Jun 3.
Pregnancy complications are common contributors to perinatal mortality and morbidity. Still, the cause(s) of gestational hypertensive disorders and diabetes are largely unknown. Some occupational exposures have been inconsistently associated with pregnancy complications, but exposure to whole-body vibrations (WBV) has been largely overlooked even though it has been associated with adverse birth outcomes. Therefore, the aim was to assess whether occupational WBV exposure during pregnancy is associated with pregnancy complications in a nationwide, prospective cohort study.
The Fetal Air Pollution Exposure cohort was formed by merging multiple Swedish, national registers containing information on occupation during pregnancy and diagnosis codes, and includes all working women who gave birth between 1994 and 2014 (n=1 091 044). WBV exposure was derived from a job-exposure matrix and was divided into categories (0, 0.1-0.2, 0.3-0.4 and ≥0.5 m/s). ORs with 95% CIs were calculated using logistic regression adjusted for potential confounders.
Among women working full time (n=646 490), we found increased risks of all pregnancy complications in the highest exposure group (≥0.5 m/s), compared with the lowest. The adjusted ORs were 1.76 (95% CI 1.41 to 2.20), 1.55 (95% CI 1.26 to 1.91) and 1.62 (95% CI 1.07 to 2.46) for preeclampsia, gestational hypertension and gestational diabetes, respectively, and were similar in all sensitivity analyses. There were no clear associations for part-time workers.
The results suggest that women should not be exposed to WBV at/above the action limit value of 0.5 m/s (European directive) continuously through pregnancy. However, these results need further confirmation.
妊娠并发症是围产期死亡和发病的常见原因。然而，妊娠高血压疾病和糖尿病的病因仍不清楚。一些职业暴露与妊娠并发症之间存在不一致的关联，但全身振动（WBV）的暴露一直被忽视，尽管它与不良的出生结局有关。因此，本研究旨在评估妊娠期间职业性 WBV 暴露与全国性前瞻性队列研究中妊娠并发症的关系。
胎儿空气污染暴露队列是通过合并包含妊娠期间职业信息和诊断代码的多个瑞典国家登记处而形成的，包括 1994 年至 2014 年间分娩的所有工作女性（n=1 091 044）。WBV 暴露是从职业暴露矩阵中得出的，并分为 0、0.1-0.2、0.3-0.4 和≥0.5m/s 四个类别。使用逻辑回归调整潜在混杂因素后，计算比值比（OR）及其 95%置信区间（CI）。
在全职工作的女性中（n=646 490），与最低暴露组相比，最高暴露组（≥0.5m/s）的所有妊娠并发症的风险均增加。调整后的 OR 分别为 1.76（95%CI 1.41-2.20）、1.55（95%CI 1.26-1.91）和 1.62（95%CI 1.07-2.46），分别为子痫前期、妊娠期高血压和妊娠期糖尿病，且在所有敏感性分析中结果相似。兼职工作的女性没有明显的关联。
这些结果表明，女性在妊娠期间不应持续暴露于 0.5m/s（欧洲指令）的动作限值及以上的 WBV 中。然而，这些结果需要进一步证实。
