First-trimester Occupational Exposures and Hypertensive Disorders of Pregnancy Among US Nurses

Overview

Journal Occup Med (Lond)

Publisher Oxford University Press

Specialty Occupational Medicine

Date 2023 Aug 17

PMID 37587907

Authors

I Agarwal

S Wang

J Stuart

S Strohmaier

E Schernhammer

J Rich-Edwards

J H Kang

Affiliations

Soon will be listed here.

Abstract

Background: Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP).

Aims: To investigate whether first-trimester night shift work, work hours and work-related activities are associated with HDP.

Methods: We conducted a cross-sectional analysis of 6610 women within the Nurses' Health Study II. We used multiple logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of occupational exposures to HDP.

Results: Nine per cent of respondents reported an HDP in the index pregnancy (gestational hypertension: n = 354, 5%, preeclampsia: n = 222, 3%). First-trimester fixed or rotating night shift work was not significantly associated with gestational hypertension or preeclampsia compared to day shift work only. Compared to those working 21-40 h/week, working overtime (≥41 h/week) was not associated with gestational hypertension but was associated with 43% higher odds of preeclampsia (95% CI 1.02, 2.00). For part-time work (≤20 h/week), the OR was 0.76 (95% CI 0.56, 1.02) for gestational hypertension and 0.64 (95% CI 0.43, 0.97) for preeclampsia. The odds of preeclampsia were 3% higher per additional hour worked per week (95% CI 1.01-1.04). Compared to 0-4 h spent standing or walking per day, standing or walking ≥9 h daily was associated with 32% lower odds of gestational hypertension (95% CI 0.47, 0.99) but was not significantly associated with preeclampsia. Frequency of heavy lifting was not associated with either hypertensive disorder or pregnancy.

Conclusions: Among nurses, working overtime was associated with higher odds of preeclampsia.

References

Wang W, Xie X, Yuan T, Wang Y, Zhao F, Zhou Z . Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population-based study. BMC Pregnancy Childbirth. 2021; 21(1):364. PMC: 8106862. DOI: 10.1186/s12884-021-03809-2. View

Cai Q, Yang Y, Wang Y, Cui H, Wu X, Liao K . Home Quarantine: A Double-Edged Sword During COVID-19 Pandemic for Hypertensive Disorders of Pregnancy and the Related Complications. Diabetes Metab Syndr Obes. 2022; 15:2405-2415. PMC: 9375559. DOI: 10.2147/DMSO.S374482. View

Hammer P, Flachs E, Specht I, Pinborg A, Petersen S, Larsen A . Night work and hypertensive disorders of pregnancy: a national register-based cohort study. Scand J Work Environ Health. 2018; 44(4):403-413. DOI: 10.5271/sjweh.3728. View

Larson J, Bazalakova M, Godecker A, Delbeccaro M, Aagaard K, Antony K . Shift work and sleep duration are associated with adverse pregnancy outcomes in a predominantly Latinx population with high rates of obesity. PLoS One. 2022; 17(8):e0272218. PMC: 9352044. DOI: 10.1371/journal.pone.0272218. View

Whelan E, Lawson C, Grajewski B, Hibert E, Spiegelman D, Rich-Edwards J . Work schedule during pregnancy and spontaneous abortion. Epidemiology. 2007; 18(3):350-5. DOI: 10.1097/01.ede.0000259988.77314.a4. View

Villar J, Carroli G, Wojdyla D, Abalos E, Giordano D, Baaqeel H . Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions?. Am J Obstet Gynecol. 2006; 194(4):921-31. DOI: 10.1016/j.ajog.2005.10.813. View

Haelterman E, Marcoux S, Croteau A, Dramaix M . Population-based study on occupational risk factors for preeclampsia and gestational hypertension. Scand J Work Environ Health. 2007; 33(4):304-17. DOI: 10.5271/sjweh.1147. View

Wergeland E, Strand K . Working conditions and prevalence of pre-eclampsia, Norway 1989. Int J Gynaecol Obstet. 1997; 58(2):189-96. DOI: 10.1016/s0020-7292(97)00083-0. View

Gamble K, Resuehr D, Johnson C . Shift work and circadian dysregulation of reproduction. Front Endocrinol (Lausanne). 2013; 4:92. PMC: 3736045. DOI: 10.3389/fendo.2013.00092. View

10.

Nurminen T . Shift work, fetal development and course of pregnancy. Scand J Work Environ Health. 1989; 15(6):395-403. DOI: 10.5271/sjweh.1833. View

11.

Lawson C, Whelan E, Hibert E, Grajewski B, Spiegelman D, Rich-Edwards J . Occupational factors and risk of preterm birth in nurses. Am J Obstet Gynecol. 2008; 200(1):51.e1-8. PMC: 4249587. DOI: 10.1016/j.ajog.2008.08.006. View

12.

Jiang L, Tang K, Magee L, von Dadelszen P, Ekeroma A, Li X . A global view of hypertensive disorders and diabetes mellitus during pregnancy. Nat Rev Endocrinol. 2022; 18(12):760-775. PMC: 9483536. DOI: 10.1038/s41574-022-00734-y. View

13.

Trinkoff A, Geiger-Brown J, Brady B, Lipscomb J, Muntaner C . How long and how much are nurses now working?. Am J Nurs. 2006; 106(4):60-71, quiz 72. DOI: 10.1097/00000446-200604000-00030. View

14.

Nugteren J, Snijder C, Hofman A, Jaddoe V, Steegers E, Burdorf A . Work-related maternal risk factors and the risk of pregnancy induced hypertension and preeclampsia during pregnancy. The Generation R Study. PLoS One. 2012; 7(6):e39263. PMC: 3376127. DOI: 10.1371/journal.pone.0039263. View

15.

Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M . The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019; 221(6):563-576. DOI: 10.1016/j.ajog.2019.06.051. View

16.

Schneider K, Huch A, Huch R . Premature contractions: are they caused by maternal standing?. Acta Genet Med Gemellol (Roma). 1985; 34(3-4):175-8. DOI: 10.1017/s0001566000004694. View

17.

Stuart J, Tanz L, Missmer S, Rimm E, Spiegelman D, James-Todd T . Hypertensive Disorders of Pregnancy and Maternal Cardiovascular Disease Risk Factor Development: An Observational Cohort Study. Ann Intern Med. 2018; 169(4):224-232. PMC: 6601621. DOI: 10.7326/M17-2740. View

18.

Stuart J, Tanz L, Cook N, Spiegelman D, Missmer S, Rimm E . Hypertensive Disorders of Pregnancy and 10-Year Cardiovascular Risk Prediction. J Am Coll Cardiol. 2018; 72(11):1252-1263. PMC: 6136445. DOI: 10.1016/j.jacc.2018.05.077. View

19.

Caruso C . Possible broad impacts of long work hours. Ind Health. 2006; 44(4):531-6. DOI: 10.2486/indhealth.44.531. View

20.

Chang P, Chu L, Hsieh W, Chuang Y, Lin S, Chen P . Working hours and risk of gestational hypertension and pre-eclampsia. Occup Med (Lond). 2009; 60(1):66-71. DOI: 10.1093/occmed/kqp119. View