title: [Preventive withdrawal from work, psychosocial work demands and major depressive symptoms].
abstract: OBJECTIVE
  Our study objectives were as follows: assess exposure to psychosocial work demands among working pregnant women and women on preventive withdrawal from work; and measure the association between psychosocial work demands and major depressive symptoms, according to time of withdrawal from work.
  
  
  METHODS
  Karasek's abbreviated scale was used to measure psychosocial work demands (Job strain and "Iso-strain") and CES-D scale (Center for Epidemiological Studies Depression Scale) was used to measure major depressive symptoms (CES-D score≥23), at 24-26 weeks of pregnancy, among 3043 pregnant women in Montreal (Quebec) who worked at paid jobs at least 15 h/week and at least four consecutive weeks since the beginning of their pregnancy. Multivariate logistic regression models were built.
  
  
  RESULTS
  At 24-26 weeks of pregnancy, 31.4% (956/3043) of pregnant women were on preventive withdrawal from work. They were more in "high-strain" (31.1% vs. 21.1%) and "Iso-strain" groups (21.0% vs. 14.2%) than those who continued to work (P<0.0001). The prevalence of major depressive symptoms was higher in women on preventive withdrawal from work (10.8%; CI 95%: 8.9 to 12.9) compared to working women (7.1%; CI 95%: 6.1-8.3). After adjustment for personal and professional risk factors, "Iso-strain" remained significantly associated with major depressive symptoms in working women (adjusted OR=1.75; CI 95%: [1.05 to 2.92]) and women on preventive withdrawal from work, regardless of duration of activity before withdrawal: 4 to 12 weeks (adjusted OR=2.72; CI 95%: [1.19-6.12]), 13 to 20 weeks (adjusted OR=3.51; CI 95%: [1.54-7.97]), and ≥21 weeks (adjusted OR=2.39; CI 95%: [1.10-5.20]).
  
  
  CONCLUSIONS
  Psychosocial work demands are an important risk factor for the mental health of pregnant workers and require that preventive actions be put forward.
authors.affiliation: École de santé publique, université de Montréal, Québec, Canada. Electronic address: a.fall@umontreal.ca.
authors.forename: A
authors.initials: A
authors.lastname: Fall
authors.affiliation: École de santé publique, université de Montréal, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Goulet
authors.affiliation: Institut national de santé publique du Québec, Québec, Canada; Département de médecine sociale et préventive, université Laval, Québec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Vézina
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology / Q000517:prevention & control*; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology; D016272:Occupational Health / Q000706:statistics & numerical data; D011247:Pregnancy; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014937:Work / Q000523:psychology* / Q000706:statistics & numerical data; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Contraintes psychosociales du travail (Job strain, Iso-strain); Femmes enceintes; Job strain; Major depressive symptoms; Pregnant women; Preventive withdrawal from work (occupational safety); Retrait préventif du travail; Symptômes dépressifs majeurs; “Iso-strain”