Maternal work and birth outcome disparities.
OBJECTIVE
We tested relations between aspects of maternal work and birth outcomes in a national sample and in subgroups known to experience disparities.


METHODS
Three indices of work attributes (Status and Recognition, Physical Demands, and Exposure to Conflict) were derived by factor analysis of variables extracted from the Department of Labor's O*Net database. The indices were linked to the National Longitudinal Survey of Youth using occupation codes for the primary jobs held by women who gave birth between 1979 and 2000 and worked during the quarter prior to birth (n = 3,386 births to n = 2,508 mothers). Multiple regression was used to model birth outcomes as functions of the work attribute indices, controlling for several measures of socioeconomic status and risk factors for adverse birth outcomes.


RESULTS
In the full sample, work-related Physical Demands were associated with lower average birthweight and increased odds of preterm birth while Status and Recognition was associated with higher average birthweight and lower odds of fetal growth restriction. In stratified models, Status and Recognition was associated with higher birth weight among women with low (versus high) income and with lower odds of preterm birth among women with low (versus high) education. Physical Demands were associated with higher rates of preterm birth among women with low (versus high) income and education and among African-American mothers (compared to Whites).


CONCLUSIONS
The work environment is an important predictor of healthy births. Relations between maternal work attributes and birth outcomes differ by race/ethnicity and socioeconomic status and according to the outcome under investigation. Further research with measures of work attributes specific to maternal work experiences is recommended to confirm our findings.
Bell
Janice F
JF
Health Services, University of Washington, Box 357668, Seattle, WA, 98195, USA. jfbell@u.washington.edu
Zimmerman
Frederick J
FJ
Diehr
Paula K
PK
D000293:Adolescent; D000328:Adult; D003628:Database Management Systems; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology; D012923:Social Class; D014481:United States / Q000453:epidemiology; D014931:Women, Working; D016526:Workload; D055815:Young Adult
Am J Epidemiol. 1990 Jan;131(1):104-13
2293743
Obstet Gynecol. 1991 Sep;78(3 Pt 1):391-3
1876371
Br J Ind Med. 1988 Jan;45(1):56-62
3342188
Am J Public Health. 1996 Oct;86(10):1370-8
8876504
Am J Public Health. 1997 Feb;87(2):199-204
9103097
Eur J Obstet Gynecol Reprod Biol. 1991 Jun 5;40(1):29-34
1855606
Pediatrics. 2003 Dec;112(6 Pt 1):1215-30
14654589
Am J Obstet Gynecol. 2002 Nov;187(5):1272-6
12439519
Int Arch Occup Environ Health. 2001 Oct;74(8):583-8
11768048
Am J Public Health. 1990 Feb;80(2):173-7
2297061
Am J Ind Med. 1993 Apr;23(4):541-57
8338526
J Epidemiol Community Health. 1987 Dec;41(4):312-20
3455425
J Reprod Med. 1989 Oct;34(10):790-6
2795562
Int J Epidemiol. 2003 Jun;32(3):419-28
12777430
Am J Epidemiol. 1997 Jan 1;145(1):58-67
8982023
Public Health Rep. 1995 Jul-Aug;110(4):410-8
7638328
Occup Environ Med. 2000 Oct;57(10):661-7
10984337
J Epidemiol Community Health. 1985 Jun;39(2):129-34
4040151
Pediatrics. 1982 Jun;69(6):724-7
7079037
Soc Sci Med. 2005 May;60(10):2217-28
15748670
Am J Epidemiol. 1987 Jul;126(1):150-2
3591780
Int J Epidemiol. 1990 Mar;19(1):90-7
2351529
J Epidemiol Community Health. 1991 Mar;45(1):29-34
2045741
Br J Ind Med. 1989 Mar;46(3):196-9
2930730
Int J Epidemiol. 2001 Dec;30(6):1233-41
11821313
Am J Obstet Gynecol. 1987 Jul;157(1):79-83
3605271
Am J Public Health. 2006 Nov;96(11):2032-9
17018818
Am J Public Health. 1991 Aug;81(8):1007-12
1853991
Am J Obstet Gynecol. 1993 Oct;169(4):858-65
8238139
Matern Child Health J. 2001 Jun;5(2):127-34
11573838
Schizophr Res. 2004 Dec 1;71(2-3):417-26
15474913
Am J Obstet Gynecol. 1990 Jan;162(1):213-8
2301495
Epidemiology. 1996 May;7(3):245-9
8728436
Public Health Rep. 1992 Nov-Dec;107(6):701-6
1454982
Br J Ind Med. 1987 Apr;44(4):236-43
3567097
Epidemiology. 1996 Jul;7(4):346-51
8793358
Obstet Gynecol. 1989 Jul;74(1):13-6
2733929
Scand J Work Environ Health. 1992 Apr;18(2):73-83
1604276
Am J Public Health. 1990 Jun;80(6):728-30
2343963
Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):849-62
7573257
J Epidemiol Community Health. 1978 Dec;32(4):244-9
744814
Paediatr Perinat Epidemiol. 2001 Jul;15 Suppl 2:17-29
11520397
Int J Epidemiol. 1985 Mar;14(1):118-23
3988426
Epidemiology. 1999 Nov;10(6):774-7
10535796
Paediatr Perinat Epidemiol. 2000 Jul;14(3):194-210
10949211
J Occup Med. 1985 Nov;27(11):841-7
4067691
Am J Epidemiol. 1990 Mar;131(3):522-31
2301361
Am J Epidemiol. 1992 Feb 1;135(3):302-11
1546706
J Reprod Med. 1983 Sep;28(9):581-8
6631844
Epidemiology. 1999 Jul;10(4):376-82
10401871
Br J Obstet Gynaecol. 1990 Jan;97(1):62-70
2306429
Br J Ind Med. 1987 Aug;44(8):521-6
3651350
Health Serv Res. 2003 Dec;38(6 Pt 2):1819-41
14727799
Obstet Gynecol. 1983 Jun;61(6):705-9
6843928
Semin Perinatol. 1993 Feb;17(1):37-44
8446915
Pediatrics. 1986 Apr;77(4):459-64
3960614
Scand J Work Environ Health. 1998 Jun;24(3):206-12
9710373
Am J Obstet Gynecol. 1991 Feb;164(2):467-71
1992685
Pediatrics. 2005 Mar;115(3):619-34
15741364
Scand J Work Environ Health. 1989 Dec;15(6):404-14
2617257
Obstet Gynecol. 1996 Feb;87(2):163-8
8559516
J Epidemiol Community Health. 1989 Jun;43(2):147-52
2592903
Epidemiology. 2001 Nov;12(6):744-6
11679805
N Engl J Med. 1992 Jun 4;326(23):1522-6
1579135
Ann Intern Med. 2001 May 15;134(10):955-62
11352696
Future Child. 1995 Spring;5(1):19-34
7633862
Am J Epidemiol. 1984 Mar;119(3):309-22
6702809
Epidemiology. 2000 Jan;11(1):95
10615855
Br J Obstet Gynaecol. 1999 Aug;106(8):834-41
10453835
Am J Psychiatry. 1988 Dec;145(12):1507-13
3057922
J Psychosom Res. 1995 Jul;39(5):563-95
7490693
Soc Sci Med. 2004 May;58(10):1889-901
15020006
N Engl J Med. 1990 Oct 11;323(15):1040-5
2215563