Longitudinal measurement of work stressors in pregnancy

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DESCRIPTION (provided by applicant): Evidence suggests that some groups of pregnant workers may be at risk for premature delivery or small-for-gestational age (SGA) births as a consequence of workplace psychosocial stressors. Clear associations between occupational stressors and adverse pregnancy outcomes have been difficult to draw. Factors including study design, retrospective assessment of exposure, and choice of exposure measurement may be partially obscuring any association between work-related stress and pregnancy outcomes. The overall goals of this proposed developmental and planning grant are to obtain preliminary data assessing two models of occupational stress during pregnancy, in particular measuring repeatedly and longitudinally across the course of pregnancy to evaluate the possibility that these may change across pregnancy. This proposal aims also to evaluate the use of the effort-reward imbalance (ERI) model, which has not been tested in pregnant workers or used in studies of pregnancy outcomes. Using a sample of 200 pregnant working women, this study proposes repeated, longitudinal measures of occupational stress across the course of pregnancy. Principal aims of the study are: 1) To explore the use of newer instruments measuring occupational psychosocial stressors in pregnant women; specifically using the Effort-Reward Imbalance (ERI) model, with comparison to, and possible combination of features with, the Demand-Control (DC) model. 2) To evaluate the psychometric properties of the ERI in pregnancy, including reliability, and content validity. 3) To evaluate the construct validity of the stress scales, to enable their use in measuring occupational psychosocial strain in pregnancy. 4) To evaluate the possibility that occupational psychosocial stressor levels in working women change across the unique time period represented by pregnancy, assessing the direction and magnitude of this change. Statistical methods for repeated-measures and hierarchical data will be used to examine trajectories of occupational stressors as well as their possible modification by other individual-level factors. The work proposed here represents a necessary first step in the ability to test these hypothesized effects, and will assist in determining whether newer models of the psychosocial parameters of stress in the workplace might be useful in measuring an association with adverse pregnancy outcomes. As well, this work will represent an initial assessment of whether changes in measured parameters of stress, or distinct trajectories over time, occur during the course of pregnancy. Once these aims are accomplished, the resultant exposure measurements can be used in ongoing studies to recognize and target particular types of work that may be associated with adverse birth outcomes. The exploratory work proposed here addresses NORA priorities, principally in the area of pregnancy and fertility abnormalities, as well as in piloting newer tools for describing the organization of work, and, through its focus on a particular subgroup, may enhance understanding of special populations at risk.