2008-3-19 13:04:51

Soc Sci Med：孕妇工作条件影响妊娠结果

出于对胎儿健康的考虑，没有哪个怀孕妇女愿意从事繁重的劳动。但绝大部分妇女在怀孕后还必须工作相当长时间。那么，怀孕妇女的工作条件对妊娠的影响如何呢？

2008年3月的爱思唯尔期刊《社会科学与医学》（Social Science & Medicine）报道了一项相关的研究成果。瑞典科学家通过分析1980年至1985年间28万名孕妇的工作情况和妊娠的数据，研究了孕妇工作条件对妊娠结果的影响。其中妊娠结果的评价指标包括婴儿出生体重不足、早产等6个方面。

研究人员通过统计分析发现，3个方面的原因会引起所有6个妊娠结果评价指标的恶化，即：孕妇没有能力改变工作环境，工作具有高危险性，工作需要高体能消耗。制造行业中从事体力劳动的孕妇出现不良妊娠结果的比例很高。工作控制能够解释不同工作阶层的妊娠结果指标迥异的原因，非体力劳动孕妇的工作控制程度是最高的，制造业中体力劳动孕妇的工作控制程度是最低的。同时，研究人员也发现，排除工作条件的影响后，不同工作类型孕妇的妊娠结果差异依然存在。

文章作者得出结论认为，工作条件无疑是导致妊娠结果差异的因素之一。（科学网荔涛/编译）

生物谷推荐原始出处：

Social Science & Medicine，doi:10.1016/j.socscimed.2007.11.036 ，Marit Dahlén Gisselmann and Örjan HemstrÖm

The contribution of maternal working conditions to socio-economic inequalities in birth outcome

Marit Dahlén Gisselmann^,^a^, and Örjan Hemström¹^,^a^,
^aCentre for Health Equity Studies, CHESS, Stockholm, Sweden

Available online 16 January 2008.

Abstract

The aims of this study were to examine the association between maternal working conditions and birth outcomes, and to determine the extent to which these contributed to class inequalities in six birth outcomes. We used an existing job exposure matrix developed from survey data collected in 1977 and 1979 to apply occupational-level information on working conditions to the national Swedish Registry, including approximately 280,000 mothers and 360,000 births during the period 1980–1985. Data were analysed using multivariate logistic regressions. Low levels of job control, high levels of physical demands and job hazards were more common in manual compared to non-manual classes. The self-employed had intermediate levels of such exposures. Job exposures, particularly low levels of job control, were generally and significantly associated with higher risks for low birthweight, very low birthweight, small for gestational age, all preterm, very preterm and extremely preterm births, but not with mortality. Compared to middle non-manuals (the reference group), lower non-manual and manual classes had higher risks for all birth outcomes, and these risks were nearly all significant. The highest odds ratios were found for skilled and unskilled manual workers in the manufacturing sector, with ratios between 1.35 and 2.66 (all significant). Job control explained a considerable proportion of inequalities in all birth outcomes. Job hazards contributed particularly to very low birthweight and extremely preterm birth, and physical demands to low birthweight and all preterm births. In conclusion, class differences in maternal working conditions clearly contributed to class differences in low birthweight (explained fraction 14–38%), all preterm births (20–46%), very (14–46%) and extremely (12–100%) preterm births. For very low birthweight and small for gestational age, there was a similar contribution in the manufacturing sector only. For all birth outcomes, class differences could still be detected after working conditions were taken into consideration.