article Open Access (hybrid) EN 1995-09-01

The association between occupational factors and preterm birth: A United States nurses' study

Barbara Luke, N. Mamelle, Louis Keth, F. Munoz, John Minogue, E Papiernik, Timothy R.B. Johnson

American Journal of Obstetrics and Gynecology, Vol. 173, Issue 3, pp. 849–862 (1995)

Johns Hopkins University, Johns Hopkins Medicine, Northwestern University, Northwestern Memorial Hospital, Inserm, Maternité Port Royal

DOI: 10.1016/0002-9378(95)90354-2 PMID: 7573257

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Abstract

OBJECTIVE: Our purpose was to evaluate factors associated with preterm birth among a national sample of U.S. nurses. STUDY DESIGN: We conducted a case-control study of 210 nurses whose infants were delivered prematurely (< 37 weeks) (cases) and 1260 nurses whose infants were delivered at term (> or = 37 weeks) (controls). An occupational fatigue score was constructed from four sources and varied from 0 to 4. The relation between occupational activity (including hours working and fatigue score) and preterm birth was analyzed with the use of Pearson chi 2 tests, estimates of odds ratios with 95% confidence intervals, and multivariate logistic regression; we controlled for confounding factors. RESULTS: Factors significantly associated with preterm birth included hours worked per week (p < 0.002), per shift (p < 0.001), and while standing (p < 0.001); noise (p = 0.005); physical exertion (p = 0.01); and occupational fatigue score (p < 0.002). The adjusted odds ratios were 1.6 (p = 0.006) for hours worked per week (< or = 36 vs > 36) and 1.4 (p = 0.02) for fatigue score < 3 vs > or = 3. CONCLUSIONS: Preterm birth among working women may be related to hours worked per day or week and to adverse working conditions.