title: Predictive factors of postpartum fatigue: a prospective cohort study among working women.
abstract: OBJECTIVE
  The aim of this study was to investigate which prepartum determinants contribute to the development of postpartum (PP) fatigue among working women in the Netherlands.
  
  
  METHODS
  A prospective cohort study in 15 Dutch companies was conducted to measure different potential predictors using self-administrated questionnaires at baseline and at 30 weeks of pregnancy. Fatigue was measured at 12 (N=523) and 52 weeks (N=436) PP using the Checklist Individual Strength (CIS). A CIS score>76 was defined as fatigue.
  
  
  RESULTS
  The prevalence of fatigue at 12 and 52 weeks PP was 24.5% and 18.1%, respectively. Fourteen predictive factors were found for fatigue (R(2)=0.37) at 12 weeks PP. Ten predictive factors were found for fatigue at 52 weeks PP (R(2)=0.36). In general, less favourable work relationships and characteristics, poorer mental health, more passive coping styles, more sleeping problems, more fatigue during pregnancy, and beliefs about child care arrangements were related to PP fatigue. At 30 weeks of pregnancy, only more fatigue (OR=3.69, p<0.001; OR=2.68, p=0.02) and poorer mental health (OR=0.50, p=0.02; OR=0.90, p=0.78) predicted fatigue both at 12 and 52 weeks PP.
  
  
  CONCLUSIONS
  A large number of predictive factors for PP fatigue were found. These findings indicate that different aspects can contribute to being fatigued after pregnancy. Further research is needed to investigate the effect of possible interventions by employers and/or occupational physicians.
authors.affiliation: Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
authors.forename: Marloes
authors.initials: M
authors.lastname: Bakker
authors.affiliation: Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Body@Work, Research Centre Physical Activity, Work and Health, TNO-VUmc, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek
authors.affiliation: Body@Work, Research Centre Physical Activity, Work and Health, TNO-VUmc, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; TNO Expertise Centre Life Style, Wassenaarseweg 56, 2333 AL Leiden, The Netherlands.
authors.forename: Ingrid J M
authors.initials: IJ
authors.lastname: Hendriksen
authors.affiliation: The Netherlands Society of Occupational Medicine (NVAB), P.O. Box 2113, 3500 GC Utrecht, The Netherlands.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bruinvels
authors.affiliation: Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Body@Work, Research Centre Physical Activity, Work and Health, TNO-VUmc, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: mnm.vanpoppel@vumc.nl.
authors.forename: Mireille N M
authors.initials: MN
authors.lastname: van Poppel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015331:Cohort Studies; D005221:Fatigue / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D049590:Postpartum Period; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014931:Women, Working / Q000523:psychology*
keywords: Cohort study; Fatigue; Postpartum; Pregnancy; The Netherlands; Working women