title: Work and pregnancy: the role of fatigue and the "second shift" on antenatal morbidity.
abstract: OBJECTIVE
  This study was undertaken to evaluate factors at home and work associated with antenatal morbidity (emergency department visits and hospitalizations) among employed pregnant women.
  
  
  METHODS
  This prospective study of 213 women included 3 antenatal interviews at about 16, 24, and 30 weeks' gestation with questions on health history, lifestyle, housework, working conditions, and emergency department visits and hospitalizations. Work scores and home scores were formulated from each interview. Fatigue was defined as being very tired or extremely tired at the end of a typical workday. The risk of antenatal morbidity was modeled by means of logistic regression; results are presented as adjusted odds ratios with 95% confidence intervals.
  
  
  RESULTS
  The risk of antenatal morbidity, which was greatest during the second trimester, was increased by stress (adjusted odds ratio, 2.45; 95% confidence interval, 1.32-4.57), fatigue (adjusted odds ratio, 3.77; 95% confidence interval, 1.98-7.18), work plus home score (adjusted odds ratio, 1.55; 95% confidence interval, 1.22-1.97), and the interaction of fatigue and work plus home score (adjusted odds ratio, 4.61; 95% confidence interval, 2.02-10.50).
  
  
  CONCLUSIONS
  These findings suggest that maternal fatigue contributes significantly to antenatal morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor 48109-0264, USA.
authors.forename: B
authors.initials: B
authors.lastname: Luke
authors.forename: M
authors.initials: M
authors.lastname: Avni
authors.forename: L
authors.initials: L
authors.lastname: Min
authors.forename: R
authors.initials: R
authors.lastname: Misiunas
mesh_terms: D000328:Adult; D004632:Emergency Medical Services; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006796:Household Work; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D013312:Stress, Physiological / Q000503:physiopathology; D014937:Work