title: Longitudinal Assessment of Effort-Reward Imbalance and Job Strain Across Pregnancy: A Preliminary Study.
abstract: To assess longitudinal changes in occupational effort-reward imbalance (ERI) and demand-control (DC) scores across pregnancy and examine associations with blood pressure (BP) during pregnancy.
  
  
  
  A pilot repeated-measures survey was administered four times to a sample of working women across pregnancy using the ERI and DC instruments. Demographic data and blood pressure measurements were collected at each interval. Growth mixture modeling was used to examine trajectories of change in occupational characteristics. Associations with BP were examined using repeated-measures linear regression models.
  
  
  
  ERI model components (effort, reward, and overcommitment) all declined across pregnancy while job control remained stable. Increasing ERI trajectory was associated with higher systolic BP (b = 8.8; p < 0.001) as was high overcommitment; declining ERI also showed a lesser association with higher BP. Associations between DC trajectories and BP were much smaller, and non-significant once controlled for overcommitment.
  
  
  
  Self-assessed efforts, rewards, and overcommitment at work decline across pregnancy in our participants, while job control remains stable. Replication in a more diverse pregnant working population is warranted to confirm these results. These preliminary data suggest that further investigation into the factors that may be linked with improved work psychosocial climate during pregnancy may be useful in order to improve pregnancy outcomes.
authors.affiliation: Selikoff Centers for Occupational Medicine and the Pediatric Environmental Health Specialty Unit, Department of Preventive Medicine, Icahn-Mount Sinai School of Medicine, 1 Gustave L Levy Place, Box 1057, New York, NY, 10029, USA. john.meyer@mssm.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Meyer
authors.affiliation: Bloomberg Faculty of Nursing, Institute for Global Health Equity and Innovation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Carles
authors.initials: C
authors.lastname: Muntaner
authors.affiliation: Centre for Research on Inner City Health, St. Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Campo
authors.affiliation: Section of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Warren
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D016272:Occupational Health; D011247:Pregnancy; D011256:Pregnancy Outcome; D012201:Reward; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology; D000066477:Work Performance; D016526:Workload / Q000523:psychology*; D017132:Workplace / Q000523:psychology; D055815:Young Adult
keywords: Effort–reward imbalance; Longitudinal assessment in pregnancy; Occupational hazards in pregnancy; Occupational trajectories; Work organization