title: Pregnancy outcomes among daycare employees in Finland.
abstract: OBJECTIVE
  The aim of this study was to investigate whether working as a daycare employee increases the risk of perinatal death, pre-term birth, low birth weight, smallness for gestational age, or congenital malformations.
  
  
  METHODS
  We conducted a register-based cohort study among daycare employees and women from various occupations of healthcare (reference group). Study subjects were identified from the files of Finnish trade unions and the National Authority for Medicolegal Affairs. Pregnancy outcomes, antenatal occupation, and working status were obtained by linkage to national registers. The final data consisted of 13 299 and 12 182 singleton births in the study and reference groups, respectively. We analyzed pregnancy outcome data using generalized estimating equations and linear regression.
  
  
  RESULTS
  The occurrences of pre-term birth [odds ratio (OR) 0.91, 95% confidence interval (95% CI) 0.79-1.06], perinatal death (OR 0.91, 95% CI 0.62-1.34), smallness for gestational age (OR 1.01, 95% CI 0.91-1.12), and congenital malformation (OR 1.10, 95% CI 0.92-1.32) were similar among the children of the daycare employees and the reference group. The adjusted mean birth weight of the children of the daycare employees was slightly higher (14 g, 95% CI -1-29) than that of the reference group, but the difference was attenuated to 6 g in the subset of the first births.
  
  
  CONCLUSIONS
  Daycare employees were not, in general, at an increased risk of an adverse pregnancy outcome. However, efforts should nevertheless be made to prevent their exposure to harmful viruses and heavy physical load during pregnancy.
authors.affiliation: Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland. anita.riipinen@ttl.fi
authors.forename: Anita
authors.initials: A
authors.lastname: Riipinen
authors.forename: Markku
authors.initials: M
authors.lastname: Sallmén
authors.forename: Helena
authors.initials: H
authors.lastname: Taskinen
authors.forename: Aki
authors.initials: A
authors.lastname: Koskinen
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Lindbohm
mesh_terms: D000328:Adult; D002656:Child Day Care Centers; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016014:Linear Models; D008423:Maternal Age; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D012042:Registries; D018570:Risk Assessment; D000078329:Workforce; D055815:Young Adult