title: Do nurses have worse pregnancy outcomes than non-nurses?
abstract: BACKGROUND
  Nurses encounter multiple occupational exposures at work which may harm their reproductive health. The purpose of the study was to compare pregnancy complications and outcomes including cesarean deliveries, tocolysis, miscarriage, and preterm labor between female nurses and comparable women who were not nurses in Taiwan.
  
  
  METHODS
  This nationwide population-based study was performed using the National Health Insurance Research Database from 1997 to 2008. We identified 3,656 pregnancies among 2,326 nurses and 111,889 pregnancies among 74,919 non-nurses. A generalized estimating equation was used to compare risks between the two groups.
  
  
  RESULTS
  The rates of tocolysis (28.6 vs 22.3%), miscarriage (6.0 vs 5.3%), and preterm labor (8.1 vs 4.4%) were significantly higher among nurses than non-nurses. After adjustment for background differences, nurses had significantly higher risks for cesarean section (adjusted OR 1.12 [95% confidence interval (CI) 1.03-1.22]), tocolysis (OR 1.18 [95% CI 1.09-1.29]), and preterm labor (OR 1.46 [95% CI 1.28-1.67]) than non-nurses.
  
  
  CONCLUSIONS
  Nurses are at higher risk for cesarean section, tocolysis, and preterm labor than non-nurses. Occupational exposure related to these adverse pregnancy outcomes should be examined. Strategies to decrease the risks should be developed to improve reproductive health among nurses.
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hui-Ju
authors.initials: HJ
authors.lastname: Yang
authors.forename: Feng-Yu
authors.initials: FY
authors.lastname: Kao
authors.forename: Yiing-Jeng
authors.initials: YJ
authors.lastname: Chou
authors.forename: Nicole
authors.initials: N
authors.lastname: Huang
authors.forename: Kuang-Yi
authors.initials: KY
authors.lastname: Chang
authors.forename: Li-Yin
authors.initials: LY
authors.lastname: Chien
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D009726:Nurses / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth; D012307:Risk Factors; D013624:Taiwan; D015145:Tocolysis / Q000706:statistics & numerical data; D055815:Young Adult
keywords: cesarean section; nurse; occupational health; pregnancy complications; pregnancy outcomes