EFFECT OF EMPLOYMENT AND ITS CORRELATES ON SPONTANEOUS-ABORTION RISK

While several studies have examined the role of employment during pregnancy on reproductive risk, few have taken into account the potential selection pressures which may cause a woman to choose employment or non-employment during pregnancy. This study was designed to test the hypothesis that employment, or certain types or preconditions of employment, places a woman at increased risk for spontaneous abortion. A case-control study design, utilizing two control groups matched to the 334 cases for age and parity (total N = 981) allowed detailed comparisons of exposures and correlates during the index pregnancy. Control groups consisted of pregnant women (less than 25 wk gestation) and postnatal women. Detailed histories of employment in the 3 months preceding and 4 months following the last menstrual period (LMP), were taken, as well as data on such potential confounding variables as past obstetrical history and socioeconomic status. No significant differences were found between groups in terms of overall employment status. In addition, particular characteristics of jobs, such as hours worked per week, physical activity level, shift work of flexibility of hours were found to be non-significant when analyzed several ways. However, a marked difference in risk (OR for prenatal comparison 1.79, P < 0.01; OR for postnatal comparison 2.13, P < 0.001) was found for job motivation amongst full-time workers for risk, with those women stating they worked primarily out of financial need being at highest risk for abortion. This remained after using multiple logistic regression to control for family income and other socioeconomic variables, job characteristics and subjective measures of job satisfaction. Thus, while employment itself would seem not to be a risk factor for spontaneous abortion, preconditions which lead to such employment may in fact affect this relationship. © 1991.