title: Employment status and the risk of pregnancy complications: the Generation R Study.
abstract: OBJECTIVE
  This study explored the relationships of employment status, type of unemployment and number of weekly working hours, with a wide range of pregnancy outcomes.
  
  
  METHODS
  Information on employment characteristics and pregnancy outcomes was available for 6111 pregnant women enrolled in a population-based cohort study in the Netherlands.
  
  
  RESULTS
  After adjustment for confounders, there were no statistically significant differences in risks of pregnancy complications between employed and unemployed women. Among unemployed women, women receiving disability benefit had an increased risk of preterm ruptured membranes (OR 3.16, 95% CI 1.49 to 6.70), elective caesarean section (OR 2.98, 95% CI 1.21 to 7.34) and preterm birth (OR 2.64, 95% CI 1.32 to 5.28) compared to housewives. Offspring of students and women receiving disability benefit had a significantly lower mean birth weight than offspring of housewives (difference: -93, 95% CI -174 to -12; and -97, 95% CI -190 to -5, respectively). In employed women, long working hours (>or=40 h/week) were associated with a decrease of 45 g in offspring's mean birth weight (adjusted analysis; 95% CI -89 to -1) compared with 1-24 h/weekly working hours.
  
  
  CONCLUSIONS
  We found no indications that paid employment during pregnancy effects the health of the mother and child. However, among unemployed and employed women, women receiving disability benefit, students and women with long working hours during pregnancy were at risk for some adverse pregnancy outcomes. More research is needed to replicate these results and explain these findings. Meanwhile, prenatal care providers should be made aware of the risks associated with specific types of unemployment and long working hours.
authors: The Generation R Study Group, Erasmus MC-University Medical Centre Rotterdam, PO Box 2040 (Room Ae-029), 3000 CA Rotterdam, the Netherlands. p.w.jansen@erasmusmc.nl
authors: Pauline W
authors: PW
authors: Jansen
authors: Henning
authors: H
authors: Tiemeier
authors: Frank C
authors: FC
authors: Verhulst
authors: Alex
authors: A
authors: Burdorf
authors: Vincent W V
authors: VW
authors: Jaddoe
authors: Albert
authors: A
authors: Hofman
authors: Henriëtte A
authors: HA
authors: Moll
authors: Bero O
authors: BO
authors: Verburg
authors: Eric A P
authors: EA
authors: Steegers
authors: Johan P
authors: JP
authors: Mackenbach
authors: Hein
authors: H
authors: Raat
mesh_terms: D000328:Adult; D006233:Persons with Disabilities; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009426:Netherlands / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors