Combined exposure to lifting and psychosocial strain at work and adverse pregnancy outcomes-A study in the Danish National Birth Cohort

• Published in: PloS one Vol. 13; no. 9; p. e0201842
• Main Authors: Sejbaek, Camilla Sandal, Bay, Hans, Larsen, Ann Dyreborg, Kristensen, Petter, Schlünssen, Vivi, Andersen, Anne-Marie Nybo, Bonde, Jens Peter, Juhl, Mette, Hougaard, Karin Sørig
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.09.2018; Public Library of Science (PLoS)
• Subjects: Adult; Age; Analysis; Biology and Life Sciences; Birth Weight; Childbirth & labor; Cohort analysis; Denmark; Epidemiology; Exposure; Female; Fetal development; Gestational Age; Health risk assessment; Hoisting; Humans; Infant, Newborn; Influence; Job stress; Lifting; Logistic Models; Medicine and Health Sciences; Occupational Diseases - physiopathology; Occupational Diseases - psychology; Occupational health; People and Places; Physiological aspects; Pregnancy; Pregnancy Complications - physiopathology; Pregnancy Complications - psychology; Pregnancy Outcome; Pregnant women; Premature birth; Psychological aspects; Public health; Regression analysis; Research and Analysis Methods; Sensitivity analysis; Social aspects; Social Sciences; Statistical analysis; Stress, Psychological - physiopathology; Stress, Psychological - psychology; Studies; Systematic review; Womens health; Denmark; Aarhus Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0201842

Previous studies have investigated physical and psychosocial job exposures separately in relation to foetal growth. We therefore investigated if occupational lifting and psychosocial job strain interact to affect foetal growth and gestational length. We hypothesised that heavy lifting and high job strain would increase the risk of impacted foetal growth (small or large for gestational age) and preterm birth. The cohort included 47,582 pregnancies from the Danish National Birth Cohort (1996-2002), where the woman was pregnant at 22 gestational weeks (GW), expected one child and worked ≥30 hours/week. Information on occupational lifting and psychosocial job strain was derived from an interview (16±3.0 GW). Data to calculate small and large for gestational age (SGA/LGA) and gestational length was retrieved from the Medical Birth Register. Interaction between lifting and job strain (Karasek's model) was analysed by multinomial logistic regression. Overall, the adjusted regression analysis showed statistically significant interaction between lifting and job strain for SGA and LGA. For each additional 250 kg lifted/day, high strain women (high Demand/low Control) had increased odds of giving birth to a LGA-child (OR = 1.15; 95% CI 1.06-1.26), whereas women in the active group (high Demand/high Control) had increased odds of giving birth to a SGA child (OR = 1.12; 95% CI 1.03-1.23). When women lifting ≤1000 kg/day were excluded in the sensitivity analyses the interaction between lifting and job strain became insignificant. No interaction of lifting and job strain was found for gestational length. The main findings may give some support to our hypothesis, as lifting in combination high with job strain increased the risk of giving birth to a LGA child. This finding was, however, not supported in the sensitivity analysis and no association of the interaction was found relative to gestational length.