title: Reproductive health and burn-out among female physicians: nationwide, representative study from Hungary.
abstract: BACKGROUND
  There is a worldwide rising tendency of women deciding to become physicians; hence, one of the most remarkable fields of investigation is the wellbeing of female doctors. The aim of this study was to describe female physicians' reproductive health in Hungary and to explore the potential correlation between their reproductive disorders and burnout symptoms. Up to our present knowledge, there have not been any studies investigating the correlation between reproductive disorders and burnout of female physicians; therefore, our study represents a unique approach.
  
  
  METHODS
  Data in this representative cross-sectional epidemiological study were obtained from online questionnaires completed by 3039 female physicians. Participants in a representative nationwide survey (Hungarostudy, 2013) served as controls (n = 1069). Differences between physicians and the control group were disclosed by chi-square test. Correlations between certain factors of reproductive health and the three dimensions of burnout were detected by Pearson correlations and X2 test. Binary logistic regression analysis was used to determine the association between burnout and reproductive health.
  
  
  RESULTS
  Female physicians were more often characterised by time-to-pregnancy interval longer than one year (18.4% vs. 9.8%), were bearing more high-risk pregnancies (26.3% vs.16.3%), and were more likely to be undergoing infertility therapy (8.5% vs. 3.4%) and experiencing miscarriage (20.8% vs. 14.6%) during their reproductive years, compared with the general female population. With the exception of miscarriages, the difference remained significant in all comparisons with the professional control group. Both high-risk pregnancies and miscarriages of doctors were associated with depersonalisation (p = 0.028 and p = 0.012 respectively) and personal accomplishment (p = 0.016 and p = 0.008 respectively) dimensions of burnout. Results of the multivariate analysis showed that, beside traditional risk factors, depersonalisation acted as an important explanatory factor in case of high-risk pregnancies (OR = 1.086).
  
  
  CONCLUSIONS
  There is a circulatory causality between burnout and the development of reproductive disorders. Burnout is an important risk factor for high-risk pregnancies and miscarriages, and it has a negative effect on the outcome of pregnancies. At the same time, women suffering from reproductive disorders are more likely to develop burnout syndrome. Improvement of working conditions and prevention of burnout in female doctors are equally important tasks.
authors.affiliation: Institute of Behavioural Sciences, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary. gyorffy@chello.hu.
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Győrffy
authors.forename: Diána
authors.initials: D
authors.lastname: Dweik
authors.forename: Edmond
authors.initials: E
authors.lastname: Girasek
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003861:Depersonalization / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D006814:Hungary; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D010822:Physicians, Women / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D060728:Reproductive Health / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D061685:Time-to-Pregnancy; D055815:Young Adult