Role of maternal occupational physical activity and psychosocial stressors on adverse birth outcomes
Role of maternal occupational physical activity and psychosocial stressors on adverse birth outcomes
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DOI：
10.1136/oemed-2016-103715
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发表时间：
2017-03-01
影响因子：
4.9
通讯作者：
Canfield, Mark A.
中科院分区：
文献类型：
--
作者：
Lee, Laura J.;Symanski, Elaine;Canfield, Mark A.
目的研究孕期一系列估计的母亲职业体力活动和心理社会应激源与早产(PTB)和小于胎龄(SGA)的关系。方法从全国出生缺陷预防研究获得1997-2009年出生的无重大出生缺陷婴儿的数据，这些婴儿的母亲在孕期至少工作1个月。我们将职业代码链接到美国劳工部的职业信息网，该信息网按职业类别提供了多个领域的体力活动和心理社会应激源的暴露估计。对17项职业活动进行主成分提取，进行因子分析，计算因子分。用Logistic回归方法计算各孕期PTB和SGA各因子分位数的ORS。结果因子分析根据因子负荷将职业领域分为4组。这四个群体分别是“职业体力活动”、“人际关系压力”、“自动化工作”和“工作责任感”。高水平的职业体力活动与SGA显著相关(最高四分位数与因子分最低四分位的调整后OR分别为1.36；95%CIS1.02~1.82；趋势P=0.001)，与肺结核也呈正相关(AOR：1.24；95%CI 0.93~1.64；P趋势=0.01)。在心理社会压力的各个领域没有观察到明确的结果。结论我们的发现扩大了对职业体力活动和心理社会应激源与PTB和SGA之间关系的理解，并建议需要进一步的研究来进一步检验这些关系。
Objectives We examined the association of an array of estimated maternal occupational physical activities and psychosocial stressors during pregnancy with odds for preterm birth (PTB) and small-for-gestational age (SGA).Methods Data for infants born without major birth defects delivered from 1997 to 2009 whose mothers reported working at least 1 month during pregnancy were obtained from the National Birth Defects Prevention Study. We linked occupational codes to the US Department of Labor's Occupational Information Network, which provides estimates of exposure for multiple domains of physical activity and psychosocial stressors by occupational categories. We conducted factor analysis using principal components extraction with 17 occupational activities and calculated factor scores. ORs for PTB and SGA across quartiles of factor scores in each trimester were computed using logistic regression.Results Factor analysis grouped occupational domains into 4 groups based on factor loadings. These groups were 'occupational physical activity', 'interpersonal stressor', 'automated work' and 'job responsibility'. High levels of occupational physical activity' were significantly associated with SGA (adjusted OR (AOR) for highest quartile compared with lowest quartile of factor score: 1.36; 95% CIs 1.02 to 1.82; p for trend=0.001) and were also positively associated with PTB (AOR: 1.24; 95% CI 0.93 to 1.64; p for trend=0.01). No clear results were observed across domains of psychosocial stressors.Conclusions Our findings expand understanding of associations between occupational physical activity and psychosocial stressors and PTB and SGA and suggest that additional research is needed to further examine these relationships.