Maternal Work and Birth Outcome Disparities

Health Services, University of Washington, Box 357668, Seattle, WA, 98195, USA.
Maternal and Child Health Journal (Impact Factor: 2.24). 09/2007; 12(4):415-26. DOI: 10.1007/s10995-007-0264-6
Source: PubMed


We tested relations between aspects of maternal work and birth outcomes in a national sample and in subgroups known to experience disparities.
Three indices of work attributes (Status and Recognition, Physical Demands, and Exposure to Conflict) were derived by factor analysis of variables extracted from the Department of Labor's O*Net database. The indices were linked to the National Longitudinal Survey of Youth using occupation codes for the primary jobs held by women who gave birth between 1979 and 2000 and worked during the quarter prior to birth (n = 3,386 births to n = 2,508 mothers). Multiple regression was used to model birth outcomes as functions of the work attribute indices, controlling for several measures of socioeconomic status and risk factors for adverse birth outcomes.
In the full sample, work-related Physical Demands were associated with lower average birthweight and increased odds of preterm birth while Status and Recognition was associated with higher average birthweight and lower odds of fetal growth restriction. In stratified models, Status and Recognition was associated with higher birth weight among women with low (versus high) income and with lower odds of preterm birth among women with low (versus high) education. Physical Demands were associated with higher rates of preterm birth among women with low (versus high) income and education and among African-American mothers (compared to Whites).
The work environment is an important predictor of healthy births. Relations between maternal work attributes and birth outcomes differ by race/ethnicity and socioeconomic status and according to the outcome under investigation. Further research with measures of work attributes specific to maternal work experiences is recommended to confirm our findings.

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    • "Considering the items that loaded highly on each factor, the three factors resulting from the exploratory analysis were named physical demand, job autonomy , and social engagement (see Table 1 for items with loadings of 0.7 or higher, full table in Appendix 1). Items that loaded highly on our physical demand and job autonomy factors were similar to factors identified in prior research using O*Net data (Alterman et al., 2008; Bell et al., 2008; Meyer et al., 2007). However, the social engagement factor has not been identified in the previous literature. "
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    ABSTRACT: Numerous work-related drinking mechanisms have been posited and, oftentimes, examined in isolation. We combined data from over 100 occupational attributes into several factors and tested the association of these factors with measures of alcohol use. We used the NLSY79 2006 wave, a U.S. representative sample of 6426 workers ages 41 to 49 and the 2006 Occupational Information Network database (O*NET), a nationally representative sample of nearly 1000 occupations. We conducted exploratory factor analysis on 119 occupational attributes and found three independent workplace characteristics - physical demands, job autonomy, and social engagement - explained the majority of the variation. We then tested the association of these composite attributes with three drinking measures, before and after adjusting for gender, race/ethnicity, and a measure of human capital using count data models. We then stratified by gender and repeated our analyses. Men working in occupations with a one standard deviation higher level of physical demand (e.g. construction) reported a higher number of heavy drinking occasions (+20%, p < 0.05). Job autonomy was not significantly associated with measures of alcohol use and when the combined association of higher levels of physical demand and lower levels of job autonomy was examined, modest support for job strain as a mechanism for work-related alcohol consumption was found. In our pooled sample, working in occupations with one standard deviation higher levels of social engagement was associated with lower numbers of drinking days (-9%, p < 0.05) after adjustment. Physical demand and social engagement were associated with alcohol consumption measures but these relationships varied by workers' gender. Future areas of research should include confirmatory analyses using other waves of O*Net data and replicating the current analysis in other samples of workers. If our results are validated, they suggest male workers in high physical demand occupations could be targets for intervention.
    Social Science [?] Medicine 09/2013; 92C:35-42. DOI:10.1016/j.socscimed.2013.05.023 · 2.89 Impact Factor
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    • "The regression models were specified using the following covariates: age, age squared, race-ethnicity, and income category. Although race-ethnicity and age were also included in the propensity score matching model, we included them after matching because they are known to be strong predictors of the study outcomes (Bell et al., 2008; P. J. Johnson, Oakes, & Anderton, 2008). In addition, 110 respondents did not provide information on their family income. "
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    ABSTRACT: Background: Prior research shows an association between prenatal employment characteristics and adverse birth outcomes, but suffers methodological challenges in disentangling women's employment choices from birth outcomes, and little U.S.-based prior research compares outcomes for employed women with those not employed. This study assessed the effect of prenatal employment status on birth outcomes. Methods: With data from the Listening to Mothers II survey, conducted among a nationally representative sample of women who delivered a singleton baby in a U.S. hospital in 2005 (n = 1,573), we used propensity score matching to reduce potential selection bias. Primary outcomes were low birth weight (<2,500 g) and preterm birth (gestational age <37 weeks). Exposure was prenatal employment status (full time, part time, not employed). We conducted separate outcomes analyses for each matched cohort using multivariable regression models. Findings: Comparing full-time employees with women who were not employed, full-time employment was not causally associated with preterm birth (adjusted odds ratio [AOR], 1.37; p = .47) or low birth weight (AOR, 0.73; p = .41). Results were similar comparing full- and part-time workers. Consistent with prior research, Black women, regardless of employment status, had increased odds of low birth weight compared with White women (AOR, 5.07; p = .002). Conclusions: Prenatal employment does not independently contribute to preterm births or low birth weight after accounting for characteristics of women with different employment statuses. Efforts to improve birth outcomes should focus on the characteristics of pregnant women (employed or not) that render them vulnerable.
    Women s Health Issues 12/2012; 23(2). DOI:10.1016/j.whi.2012.11.004 · 1.61 Impact Factor
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    • "Our results are in agreement with the results of earlier studies from Sweden and the USA (Parker et al., 1994; World Health Organization, 1995; Kramer et al., 2000), which found a positive association between lower SES and an increased risk of SGA birth. Low SES may be a risk factor for SGA birth because social and economic deprivation is associated with occupational exposure (Savitz et al., 1996a; Ahmed and Jaakkola, 2007b; Meyer et al., 2008; Simcox and Jaakkola, 2008), low social participation (Dejin-Karlsson and Ostergren, 2003), smoking (Horta et al., 1997; Cnattingius, 2004; Bell et al., 2008) and poor nutrition (Hobel and Culhane, 2003, Mitchell et al., 2004). Previous studies have found that some maternal occupations are associated with an increased risk of SGA birth. "
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    ABSTRACT: Although evidence suggests that some occupations may be a risk factor for small-for-gestational age (SGA) birth, associations between a wide range of maternal and paternal occupations and risk of SGA births remain unclear. Our objective was to analyze the risk of SGA births by parental occupation, including the entire Swedish population of mothers (> or =20 years) and fathers. We linked nationwide data (1990-2004) on singletons born to employed mothers to nationwide data on maternal and paternal occupation and other individual-level variables. Information on parental occupations was obtained from the 1990 census. Approximately 95% of SGA births (calculated using normative data) were defined on the basis of ultrasound. Odds ratios of SGA birth were calculated with 95% confidence intervals. Women and men were analyzed separately. There were 816,310 first singleton live births during the study period, of which 29,603 were SGA events. Families with low incomes had an increased risk of SGA births. After accounting for maternal age at the infant's birth, period of birth, family income, region of residence, marital status and smoking habits, several maternal occupational groups (including 'mechanics and iron and metalware workers' and 'packers, loaders and warehouse workers') had a significantly higher risk of SGA birth than the reference group (all women in the study population). Among paternal occupational groups, only waiters had an increased risk of SGA birth. This large-scale follow-up study shows that maternal occupation affects risk of SGA birth, whereas paternal occupation does not seem to have an impact on SGA birth. Further studies are required to examine the specific agents in those maternal occupations that are associated with an increased risk of SGA birth.
    Human Reproduction 04/2010; 25(4):1044-50. DOI:10.1093/humrep/deq004 · 4.57 Impact Factor
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