Work, environment and reproductive health

With the increasing labour force participation among women in Western countries, many women will work during their reproductive years. This will increase the likelihood that women during their reproductive years will be exposed to a variety of risk factors at work that may effect their reproductive abilities and the outcome of their pregnancy, such as spontaneous abortion, hypertensive disorders, intrauterine growth restriction, and adverse birth outcomes. Occupational exposures may also interact with foetal development, resulting in health effects in the offspring, such as congenital malformations and neurobehavioural disorders at young age. For several work-related risk factors the associations with reproductive effects are well established and translated into legislation, such as mandatory provisions for pregnant women preparing antineoplastic drugs or being exposed to lead. However, for many other work-related risk factors, the scientific evidence is less consistent. Work-related risk factors can be divided into chemical agents such as metals, solvents, pesticides, physical agents such as radiation and noise, and ergonomic factors such as heavy workload, shift work, and psychosocial stress

Maternal occupation during pregnancy, birth weight, and length of gestation: Combined analysis of 13 European birth cohorts

Objectives We assessed whether maternal employment during pregnancy – overall and in selected occupational sectors – is associated with birth weight, small for gestational age (SGA), term low birth weight (LBW), length of gestation, and preterm delivery in a population-based birth cohort design. Methods We used data from >200 000 mother-child pairs enrolled in 13 European birth cohorts and compared employed versus non-employed women. Among employees, we defined groups of occupations representing the main sectors of employment for women where potential reproductive hazards are considered to be present. The comparison group comprised all other employed women not included in the occupational sector being assessed. We performed meta-analyses of cohort-specific estimates and explored heterogeneity. Results Employees had a lower risk of preterm delivery than non-employees [adjusted odds ratio (ORadj) 0.86, 95% confidence interval (95% CI) 0.81–0.91]. Working in most of the occupational sectors studied was not associated with adverse birth outcomes. Being employed as a nurse was associated with lower risk SGA infants (ORadj 0.91, 95% CI 0.84–0.99) whereas food industry workers had an increased risk of preterm delivery (ORadj 1.50, 95% CI 1.12–2.02). There was little evidence for heterogeneity between cohorts. Conclusions This study suggests that, overall, employment during pregnancy is associated with a reduction in the risk of preterm birth and that work in certain occupations may affect pregnancy outcomes. This exploratory study provides an important platform on which to base further prospective studies focused on the potential consequences of maternal occupational exposures during pregnancy on child development