title: Maternity leave in the ninth month of pregnancy and birth outcomes among working women.
abstract: 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.
authors.affiliation: School of Public Health, University of California, Berkeley, Berkeley, CA 94720-7360, USA. sylviag@berkeley.edu
authors.forename: Sylvia
authors.initials: S
authors.lastname: Guendelman
authors.forename: Michelle
authors.initials: M
authors.lastname: Pearl
authors.forename: Steve
authors.initials: S
authors.lastname: Graham
authors.forename: Alan
authors.initials: A
authors.lastname: Hubbard
authors.forename: Nap
authors.initials: N
authors.lastname: Hosang
authors.forename: Martin
authors.initials: M
authors.lastname: Kharrazi
mesh_terms: 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