Whelan-EA; Lawson-CC; Grajewski-B; Hibert-EN; Spiegelman-D; Rich-Edwards-JW
Epidemiology 2007 May; 18(3):350-355
Background: There is inconsistent evidence as to whether work schedule (including rotating shifts and night work) can affect reproductive outcomes. Methods: We investigated the association between work schedule and risk of spontaneous abortion in U.S. nurses. The Nurses' Health Study 11 is a prospective cohort study established in 1989. In 2001, information about occupational activities and exposures during pregnancy was collected from female nurses for the most recent pregnancy since 1993. Of 11,178 eligible respondents, 9547 (85%) indicated willingness to participate in the occupational study, and 8461 of those (89%) returned the questionnaire, for an overall participation rate of 76%. Of these, 7688 women had pregnancies that were eligible for analysis. Results: Participants reported 6902 live births and 786 (10%) spontaneous abortions. Compared with women who reported usually working "days only" during their first trimester, women who reported usually working "nights only" had a 60% increased risk of spontaneous abortion (RR = 1.6; 95% confidence interval [CI] = 1.3-1.9). A rotating schedule, with or without night shifts, was not associated with an increase in risk (RR = 1.2 [CI = 0.9-1.5] and 1.0 [CI = 0.8-1.2], respectively). Women who reported working more than 40 hours per week during the first trimester were also at increased risk of spontaneous abortion (1.5; 1.3-1.7) compared with women working 21-40 hours, even after adjustment for work schedule, Conclusions: Nightwork and long work hours may be associated with an increased risk of spontaneous abortion. Further studies are needed to determine whether hormonal disturbances attributed to night work affect pregnancy outcome.
Prenatal-exposure; Pregnancy; Shift-work; Risk-analysis; Risk-factors; Nurses; Women; Work-environment; Work-performance; Work-analysis; Work-intervals; Workplace-studies; Hormone-activity
Christina C. Lawson, CDC/NIOSH, 4676 Columbia Parkway, R-15, Cincinnati, OH 45226
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