Maternity leave in the ninth month of pregnancy and birth outcomes among working women.
OBJECTIVE
The health effects of antenatal maternity leave have been scarcely evaluated. In California, women are eligible for paid benefits up to 4 weeks before delivery. We explored whether leave at > or =36 weeks gestation increases gestation and birthweight, and reduces primary cesarean deliveries among full-time working women.


METHODS
Drawing from a 2002--2003 nested case-control study of preterm birth and low birthweight among working women in Southern California, we compared a cohort of women who took leave (n = 62) or worked until delivery (n = 385). Models weighted for probability of sampling were used to calculate hazards ratios for gestational age, odds ratios (OR) for primary cesarean delivery, and multilinear regression coefficients for birthweight.


RESULTS
Leave-takers were similar to non-leave-takers on demographic and health characteristics, except that more clerical workers took leave (p = .02). Compared with non-leave-takers, leave-takers had almost 4 times lower odds of cesarean delivery after adjusting for covariates (OR, 0.27; 95% confidence interval [CI], 0.08-0.94). Overall, there were no marked differences in length of gestation or mean birthweight. However, in a subgroup of women whose efforts outstripped their occupational rewards, gestation was prolonged (hazard ratio for delivery each day between 36 and 41 weeks, 0.56; 95% CI, 0.34-0.93).


CONCLUSIONS
Maternity leave in late pregnancy shows promise for reducing cesarean deliveries and prolonging gestation in occupationally strained women.
Guendelman
Sylvia
S
School of Public Health, University of California, Berkeley, Berkeley, CA 94720-7360, USA. sylviag@berkeley.edu
Pearl
Michelle
M
Graham
Steve
S
Hubbard
Alan
A
Hosang
Nap
N
Kharrazi
Martin
M
D000328:Adult; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016001:Confidence Intervals; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008429:Maternal Welfare / Q000706:statistics & numerical data; D016017:Odds Ratio; D016524:Parental Leave / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011295:Prenatal Care / Q000379:methods; D016387:Women's Health; D014931:Women, Working / Q000706:statistics & numerical data*; D055815:Young Adult