Hickey C A, Cliver S P, Mulvihill F X, McNeal S F, Hoffman H J, Goldenberg R L
University of Alabama at Birmingham 35294-2010, USA.
Public Health Rep. 1995 Jul-Aug;110(4):410-8.
Studies of employment-related stress as a risk factor for preterm delivery suggest that contextual factors unrelated to occupation, as well as work-related characteristics, must be examined in assessing this relationship. In this study, the relationship of work and contextual characteristics--assessed at midpregnancy and including scores on an occupational fatigue index--to preterm delivery was examined among 943 black and 425 white low-income multiparous women who were at risk for a poor pregnancy outcome. At 24 to 26 weeks gestational age, a 77-item questionnaire was self-administered to obtain detailed information on sociodemographic and contextual characteristics, home physical activities, and occupational characteristics. Questions in the occupational section of the questionnaire included most of those previously used by Mamelle and coworkers in 1984 and 1987 to construct an occupational fatigue index. The overall preterm delivery rate for black women was 14.0 percent and for white women, 9.6 percent. No relationships were observed between age, education, or marital status and preterm delivery, or between work status, hours per week, transportation, travel time, reliability of child care, or home physical activity and preterm delivery for either black women or white women. Black (but not white) women who continued to work at midpregnancy and who reported being able to take rest breaks when they felt tired had a lower preterm delivery rate (10.4 percent versus 21.9 percent; P = 0.031) compared with those who could or did not. Generally, scores for individual sources and levels of occupational fatigue, as well as total occupational fatigue index scores, were unrelated to preterm delivery in this relatively homogeneous group of low income high-risk women.
将与就业相关的压力作为早产风险因素的研究表明，在评估这种关系时，必须考察与职业无关的背景因素以及与工作相关的特征。在本研究中，对943名黑人及425名白人低收入经产妇进行了研究，这些妇女均有不良妊娠结局的风险，考察了妊娠中期评估的工作和背景特征（包括职业疲劳指数得分）与早产之间的关系。在孕24至26周时，由受试者自行填写一份77项的问卷，以获取有关社会人口学和背景特征、家庭体力活动及职业特征的详细信息。问卷职业部分的问题包括了Mamelle及其同事在1984年和1987年构建职业疲劳指数时所使用的大部分问题。黑人妇女的总体早产率为14.0%，白人妇女为9.6%。未观察到年龄、教育程度或婚姻状况与早产之间存在关联，也未观察到工作状态、每周工作时长、交通方式、通勤时间、儿童照料的可靠性或家庭体力活动与黑人或白人妇女的早产之间存在关联。与那些不能或没有在妊娠中期继续工作且感到疲倦时无法休息的黑人妇女相比，那些在妊娠中期继续工作且报告感到疲倦时能够休息的黑人妇女早产率较低（分别为10.4%和21.9%；P = 0.031）。一般而言，在这群相对同质的低收入高危妇女中，个体职业疲劳来源和水平的得分以及职业疲劳指数总分与早产均无关联。
