Maine Health Institute for Research, Maine Medical Center, Scarborough 04074, MN, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Occup Med (Lond). 2023 Oct 20;73(7):419-426. doi: 10.1093/occmed/kqad089.
Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP).
To investigate whether first-trimester night shift work, work hours and work-related activities are associated with HDP.
We conducted a cross-sectional analysis of 6610 women within the Nurses' Health Study II. We used multiple logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of occupational exposures to HDP.
Nine per cent of respondents reported an HDP in the index pregnancy (gestational hypertension: n = 354, 5%, preeclampsia: n = 222, 3%). First-trimester fixed or rotating night shift work was not significantly associated with gestational hypertension or preeclampsia compared to day shift work only. Compared to those working 21-40 h/week, working overtime (≥41 h/week) was not associated with gestational hypertension but was associated with 43% higher odds of preeclampsia (95% CI 1.02, 2.00). For part-time work (≤20 h/week), the OR was 0.76 (95% CI 0.56, 1.02) for gestational hypertension and 0.64 (95% CI 0.43, 0.97) for preeclampsia. The odds of preeclampsia were 3% higher per additional hour worked per week (95% CI 1.01-1.04). Compared to 0-4 h spent standing or walking per day, standing or walking ≥9 h daily was associated with 32% lower odds of gestational hypertension (95% CI 0.47, 0.99) but was not significantly associated with preeclampsia. Frequency of heavy lifting was not associated with either hypertensive disorder or pregnancy.
Among nurses, working overtime was associated with higher odds of preeclampsia.
关于妊娠高血压疾病（HDP）与妊娠早期护理职业暴露之间的影响，目前的数据有限且存在争议。
调查妊娠早期夜班工作、工作时间和与工作相关的活动是否与 HDP 有关。
我们对护士健康研究 II 中的 6610 名女性进行了横断面分析。我们使用多因素逻辑回归来估计职业暴露与 HDP 之间的比值比（OR）和 95%置信区间（CI）。
9%的受访者报告在指数妊娠中患有 HDP（妊娠期高血压：n=354，5%，子痫前期：n=222，3%）。与仅白天工作相比，妊娠早期固定或轮班夜班工作与妊娠期高血压或子痫前期并无显著相关性。与每周工作 21-40 小时相比，加班（≥41 小时/周）与妊娠期高血压无关，但与子痫前期的发生风险增加 43%相关（95%CI 1.02，2.00）。对于兼职工作（≤20 小时/周），妊娠期高血压的 OR 为 0.76（95%CI 0.56，1.02），子痫前期的 OR 为 0.64（95%CI 0.43，0.97）。每周每增加 1 小时工作，子痫前期的发生风险增加 3%（95%CI 1.01-1.04）。与每天站立或行走 0-4 小时相比，每天站立或行走≥9 小时与妊娠期高血压的发生风险降低 32%相关（95%CI 0.47，0.99），但与子痫前期无显著相关性。重度举重的频率与任何一种高血压疾病或妊娠均无相关性。
在护士中，加班与子痫前期的发生风险增加相关。
