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Agarwal I, MacVane CZ. Shift Scheduling and Overnight Work Among Pregnant Emergency Medicine Residents. Ann Emerg Med 2024; 83:598-602. [PMID: 38402481 DOI: 10.1016/j.annemergmed.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Isha Agarwal
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine.
| | - Casey Z MacVane
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine
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Corbisiero MF, Acker SN, Bothwell S, Christian N. Transforming Perceptions: The Impact of a Formal Parental Leave Policy on Surgical Trainees. JOURNAL OF SURGICAL EDUCATION 2024; 81:816-822. [PMID: 38677898 PMCID: PMC11088490 DOI: 10.1016/j.jsurg.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/13/2024] [Accepted: 03/03/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE Surgical trainees who welcome a new child during residency often face challenges related to appropriate parental leave. To address this, we instituted a comprehensive family medical leave policy within our training program and assessed resident perceptions before and after the policy's introduction. We hypothesized that this new formal policy would enhance feelings of support amongst all (not just childbearing) trainees. DESIGN A web-based survey to gauge resident perceptions on parental leave was distributed to all residents at a single academic general surgery residency at 2 intervals: prior to policy implementation and 1 year after policy implementation. SETTING The study was conducted at a single institution, academic general surgery residency program. PARTICIPANTS All general surgery residents at the institution were included (n = 95). RESULTS About 40 out of 95 (42%) residents participated in the initial survey and 25 of 95 (26%) completed the subsequent survey. There was a significant improvement in resident reported satisfaction with the policy from pre to post: 15% pre to 68% post, p < 0.001, report the policy frequently supported trainees' needs, 20% pre to 88% post, p < 0.001, perceived the policy as fair. Most residents (90.0% pre and 80.0% post) perceived pregnancy as a risk during surgical training. There were no differences in perception of the new policy between residents who were parents and residents who were not parents. CONCLUSIONS The introduction of a comprehensive family medical leave policy improved all surgical trainees' (including nonparents) perception of policy effectiveness and policy fairness. This is counter to the published perception that parental leave creates a burden on fellow trainees. However, pregnancy remains a stressor for the individual new parent. Surgical programs can develop supportive formal family medical leave policies; it is important to address the inherent systemic and cultural barriers surrounding childrearing during surgical training.
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Affiliation(s)
| | - Shannon N Acker
- Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Samantha Bothwell
- Center for Children's Surgery, Research Outcomes in Children's Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Nicole Christian
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
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Martiana T, Rahman FS, Martini S, Paskarini I, Melaniani S, Kusumawardani A, Jalaludin J, Abd Mumin KH. Prediction of pregnancy disorders in female workers in the industrial sector. Heliyon 2024; 10:e30987. [PMID: 38803879 PMCID: PMC11128464 DOI: 10.1016/j.heliyon.2024.e30987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Context As female workers face a higher risk of exposure to workplace hazards than women in general, it is imperative that measures be put in place in the workplace to ensure safe and healthy pregnancies. Objectives This study aimed to analyze the effects of occupational hazards in the workplace environment on the potential for pregnancy disorders experienced by female workers. Methods This was an analytical, observational study with a case-control design. The participants were female workers who worked in industrial environments in both formal and nonformal industries. The inclusion criteria used in this study were female workers who had been or were pregnant at the time of the study, had worked in the industrial sector for at least one year, and did not smoke or consume alcohol. The samples were collected from 144 female workers. Midwives assisted in collecting data and conducting examinations of female workers. This study was conducted in Surabaya and Sidoarjo between June and December 2020. Data were analyzed descriptively, and a multivariable logistic regression test was performed. The study was conducted in accordance with the health protocols and prevention of COVID-19. Results The results showed that occupational hazards in the workplace environment that affect pregnancy disorders include workload (p = 0.004, OR = 28.676 (2.979-276.076); hot working environment (p = 0.014, OR = 3.077 (1.254-7.552); strong odors (p = 0.017, OR = 7.640 (1.436-40.656); shift work (p = 0.023, OR = 8.063 (1.337-48.623); irregular shift work (p = 0.018, OR = 7.371 (1.409-38.557); and night shift work (p = 0.015, OR = 11.780 (1.605-86.450). Conclusions Companies are expected to pay special attention to female workers regarding various workplace controls to prevent potential pregnancy-related disorders.
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Affiliation(s)
- Tri Martiana
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Airlangga, Indonesia
| | - Firman Suryadi Rahman
- Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Indonesia
| | - Santi Martini
- Epidemiology Division, Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion, Faculty of Public Health, Universitas Airlangga, Indonesia
| | - Indriati Paskarini
- Occupational Health and Safety Department, Faculty of Public Health, Universitas Airlangga, Indonesia
| | - Soenarnatalina Melaniani
- Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion Faculty of Public Health, Universitas Airlangga, Indonesia
| | - Ajeng Kusumawardani
- Doctorale Program of Social Sciences, Faculty of Social and Political Sciences, Indonesia
| | - Juliana Jalaludin
- Faculty of Medicine and Health Science, Universitas Putra Malaysia, Indonesia
| | - Khadizah H. Abd Mumin
- Institute of Health Sciences (PAPRSB, IHS), Universiti Brunei Darussalam (UBD), Indonesia
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Omari A, Siegel MR, Rocheleau CM, Fujishiro K, Van Buren K, Shi D, Agopian A, Gilboa SM, Romitti PA. Multiple Job Holding, Job Changes, and Associations with Gestational Diabetes and Pregnancy-Related Hypertension in the National Birth Defects Prevention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:619. [PMID: 38791833 PMCID: PMC11121455 DOI: 10.3390/ijerph21050619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/03/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
We used National Birth Defects Prevention Study data to investigate associations between working patterns shortly before and during pregnancy and gestational diabetes and pregnancy-related hypertension. We analyzed working patterns (multiple-job holders, job changers, single-job holders) during the three months before and during pregnancy for 8140 participants who delivered a live-born child without a birth defect. "Multiple-job holders" worked more than one job simultaneously, "job changers" worked more than one job with no overlap, and "single-job holders" (referent) worked one job. We used multivariable logistic regression to estimate associations between working pattern and each outcome, adjusting for maternal age and educational attainment at delivery. We explored effect measure modification by household income, peak weekly working hours, and maternal race/ethnicity. Multiple-job holders had higher odds of gestational diabetes (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.1-2.1) and pregnancy-related hypertension (aOR: 1.5; 95% CI: 1.0-2.2) compared with single-job holders. Multiple-job holders with a household income of more than 30,000 USD per year, 32-44 peak weekly working hours, and from racial/ethnic minority groups had higher odds of gestational diabetes compared with single-job holders in respective categories. Detailed occupational information is important for studies of occupation and maternal health.
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Affiliation(s)
- Amel Omari
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 45213, USA (K.V.B.)
- Epidemic Intelligence Service Officer, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Miriam R. Siegel
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 45213, USA (K.V.B.)
| | - Carissa M. Rocheleau
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 45213, USA (K.V.B.)
| | - Kaori Fujishiro
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 45213, USA (K.V.B.)
| | - Kristen Van Buren
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 45213, USA (K.V.B.)
| | - Dallas Shi
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 45213, USA (K.V.B.)
- Epidemic Intelligence Service Officer, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - A.J. Agopian
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX 77030, USA
| | - Suzanne M. Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Paul A. Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA;
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Cui Z, Xu H, Wu F, Chen J, Zhu L, Shen Z, Yi X, Yang J, Jia C, Zhang L, Zhou P, Li MJ, Zhu L, Duan S, Yao Z, Yu Y, Liu Q, Zhou J. Maternal circadian rhythm disruption affects neonatal inflammation via metabolic reprograming of myeloid cells. Nat Metab 2024; 6:899-913. [PMID: 38561509 DOI: 10.1038/s42255-024-01021-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
Disruption of circadian rhythm during pregnancy produces adverse health outcomes in offspring; however, the role of maternal circadian rhythms in the immune system of infants and their susceptibility to inflammation remains poorly understood. Here we show that disruption of circadian rhythms in pregnant mice profoundly aggravates the severity of neonatal inflammatory disorders in both male and female offspring, such as necrotizing enterocolitis and sepsis. The diminished maternal production of docosahexaenoic acid (DHA) and the impaired immunosuppressive function of neonatal myeloid-derived suppressor cells (MDSCs) contribute to this phenomenon. Mechanistically, DHA enhances the immunosuppressive function of MDSCs via PPARγ-mediated mitochondrial oxidative phosphorylation. Transfer of MDSCs or perinatal supplementation of DHA relieves neonatal inflammation induced by maternal rhythm disruption. These observations collectively demonstrate a previously unrecognized role of maternal circadian rhythms in the control of neonatal inflammation via metabolic reprograming of myeloid cells.
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Affiliation(s)
- Zhaohai Cui
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Institute of Pediatric Health and Disease, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China
| | - Haixu Xu
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Fan Wu
- Institute of Pediatric Health and Disease, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China
- Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiale Chen
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Lin Zhu
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zhuxia Shen
- Department of Cardiology, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xianfu Yi
- Department of Bioinformatics, Tianjin, China
| | - Jinhao Yang
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Chunhong Jia
- Institute of Pediatric Health and Disease, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China
- Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijuan Zhang
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Pan Zhou
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | | | - Lu Zhu
- Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Shengzhong Duan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, China
| | - Zhi Yao
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Ying Yu
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
- Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
| | - Qiang Liu
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
| | - Jie Zhou
- Tianjin Institute of Immunology, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, International Joint Laboratory of Ocular Diseases, Ministry of Education, State Key Laboratory of Experimental Hematology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
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Goodman JM, Crawford AM, Cottrell EK, Guise JM. "How Do I Prepare for This?" Patient Perspectives on Providers' Employment-related Support During Pregnancy. Womens Health Issues 2024; 34:291-302. [PMID: 38383227 PMCID: PMC11116059 DOI: 10.1016/j.whi.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Health care providers can offer employment-related support to pregnant patients by providing information about occupational risks and benefits, discussing adjustments, and/or completing paperwork to help patients obtain accommodations or benefits, but little research has examined whether and how this support is provided. METHODS We conducted interviews with 20 adults who had been employed while pregnant within the 5 years preceding data collection. Eligible participants had low incomes, were hourly wage earners, or were employed in service or retail occupations. Applied thematic analysis was used to identify emergent themes. RESULTS People who had been employed while pregnant described a range of experiences during that time, including physical and psychological demands from work, lack of access to appropriate accommodations, difficulties combining breastfeeding with work, and work-related challenges accessing health care. Participants described four primary roles that health care providers played: 1) completing paperwork needed to apply for benefits or receive work modification; 2) providing information about how to mitigate employment-related risks; 3) providing referrals to social or medical services; and 4) advocating for patients to ensure receipt of accommodations, resources, and information. Strategies identified by patients that could be enacted within health care to help them better navigate the work-pregnancy interface include increasing appointment flexibility, providing information about work-related risks and benefits programs and referrals to legal support, and helping providers to understand and support their patients' individual work-related concerns. CONCLUSIONS Health care providers have a critical role to play in supporting employed pregnant people to achieve flexibility in managing their work and to be active participants in discussions about recommended workplace accommodations.
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Affiliation(s)
| | | | - Erika K Cottrell
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon; OCHIN, Inc., Portland, Oregon
| | - Jeanne-Marie Guise
- Harvard Medical School, Boston, Massachusetts; Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Freudenberger DC, Riner AN, Herremans KM, Vudatha V, McGuire KP, Anand RJ, Trevino JG. A Gravid Situation: General Surgery Faculty Support for Pregnant Surgical Residents. J Surg Res 2024; 299:9-16. [PMID: 38677003 DOI: 10.1016/j.jss.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/05/2024] [Accepted: 03/11/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION The perceptions of teaching faculty toward pregnant general surgery residents have been overlooked despite the daily interactions amongst these groups. METHODS A 32-question survey designed to measure general surgery teaching faculty perceptions toward pregnant residents was distributed electronically from March 2022 to April 2022 to general surgery teaching faculty in the United States. Descriptive statistics were used to characterize responses and differences in perceptions, and qualitative analysis identified recurring themes from free-text responses. RESULTS Among 163 respondents included in the final analysis, 58.5% were male and 41.5% were female. Despite 99.4% of surgeons feeling comfortable if a resident told them they were pregnant, 22.4% of surgeons disagreed that their institutions have supportive cultures toward pregnancy. Almost half (45.4%) have witnessed negative comments about pregnant residents and half (50.3%) believe that pregnant surgical residents are discriminated against by their coresidents. Nearly two-thirds of surgeons (64.8%) believe that someone should have a child whenever they wish during training. Given recent reports, 80.2% of surgeons recognized that female surgeons have increased risks of infertility and pregnancy complications. Recurring themes of normalizing pregnancy, improving policies, and creating a culture change were expressed. CONCLUSIONS In this national survey, although there appears to be positive perceptions of pregnancy in surgical training amongst those surveyed, there is acknowledged necessity of further normalizing pregnancy and improving policies to better support pregnant residents. These data provide further evidence that though perceptions may be improving, changes are still needed to better support pregnancy during training.
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Affiliation(s)
- Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Vignesh Vudatha
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Rahul J Anand
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Jose G Trevino
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
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Arabzadeh H, Doosti-Irani A, Kamkari S, Farhadian M, Elyasi E, Mohammadi Y. The maternal factors associated with infant low birth weight: an umbrella review. BMC Pregnancy Childbirth 2024; 24:316. [PMID: 38664680 PMCID: PMC11044292 DOI: 10.1186/s12884-024-06487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND In this umbrella review, we systematically evaluated the evidence from meta-analyses and systematic reviews of maternal factors associated with low birth weight. METHODS PubMed, Scopus, and Web of Science were searched to identify all relevant published studies up to August 2023. We included all meta-analysis studies (based on cohort, case-control, cross-sectional studies) that examined the association between maternal factors (15 risk factors) and risk of LBW, regardless of publication date. A random-effects meta-analysis was conducted to estimate the summary effect size along with the 95% confidence interval (CI), 95% prediction interval, and heterogeneity (I2) in all meta-analyses. Hedges' g was used as the effect size metric. The effects of small studies and excess significance biases were assessed using funnel plots and the Egger's test, respectively. The methodological quality of the included studies was assessed using the AMSTAR 2 tool. RESULTS We included 13 systematic Review with 15 meta-analysis studies in our study based on the inclusion criteria. The following 13 maternal factors were identified as risk factors for low birth weight: crack/cocaine (odds ratio [OR] 2.82, 95% confidence interval [CI] 2.26-3.52), infertility (OR 1.34, 95% CI 1.2-1.48), smoking (OR 2.00, 95% CI 1.76-2.28), periodontal disease (OR 2.41, 95% CI 1.67-3.47), depression (OR 1.84, 95% CI 1.34-2.53), anemia (OR 1.32, 95% CI 1.13-1.55), caffeine/coffee (OR 1.34, 95% CI 1.14-1.57), heavy physical workload (OR 1.87, 95% CI 1.00-3.47), lifting ≥ 11 kg (OR 1.59, 95% CI 1.02-2.48), underweight (OR 1.79, 95% CI 1.20-2.67), alcohol (OR 1.23, 95% CI 1.04-1.46), hypertension (OR 3.90, 95% CI 2.73-5.58), and hypothyroidism (OR 1.40, 95% CI 1.01-1.94). A significant negative association was also reported between antenatal care and low birth weight. CONCLUSIONS This umbrella review identified drug use (such as crack/cocaine), infertility, smoking, periodontal disease, depression, caffeine and anemia as risk factors for low birth weight in pregnant women. These findings suggest that pregnant women can reduce the risk of low birth weight by maintaining good oral health, eating a healthy diet, managing stress and mental health, and avoiding smoking and drug use.
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Affiliation(s)
- Hoda Arabzadeh
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sima Kamkari
- Department of Obstetrics and Gynecology, Fatemiyeh Hospital Research Center, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran
| | - Elahe Elyasi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Hino M, Takashima R, Yano R. Health Management of Working Pregnant Nurses: A grounded theory study. Nurs Open 2024; 11:e2158. [PMID: 38641902 PMCID: PMC11031647 DOI: 10.1002/nop2.2158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 04/21/2024] Open
Abstract
AIM To explore the recognition of pregnant nurses on how they managed their health conditions to examine safe working strategies. DESIGN A qualitative study with a grounded theory approach. METHODS Twenty-one nurses engaged in work during their pregnancy were recruited and interviewed using a semi-structured questionnaire from January to June 2021. The data were analysed using a constant comparative method. RESULTS The core category 'duelling roles' and the four other categories emerged. Pregnant nurses understand the 'weight of one' of being a professional in the workplace. Therefore, despite their health concerns, they struggle to complete their work as one team member to avoid inconveniencing others. However, through experiencing various nursing situations, they 'perceive one's limits' of working as they had done before pregnancy and protect their health and patients. Nevertheless, interactions with patients and their colleagues bring 'delight in nursing', which encourages them to continue working. Pregnant nurses thus develop a 'prioritizing the foetus' working style to continue being nurses while protecting their health. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE These results provide meaningful guidance in considering safe job retention strategies for pregnant nurses. Sharing and developing the 'prioritizing the foetus' mindset and management skills gained by the participants may be beneficial for the appropriate health management of pregnant nurses. The study may also facilitate nursing managers' understanding of the experiences of pregnant nurses and encourage them to consider reviewing nursing practices. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Studies checklist was used to ensure the quality of research reporting. PATIENT OR PUBLIC CONTRIBUTION Members of the nursing team were involved in the design, conduct and interpretation of the data in this study.
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Affiliation(s)
- Marie Hino
- Graduate School of Health SciencesHokkaido UniversityHokkaidoJapan
| | - Risa Takashima
- Faculty of Health SciencesHokkaido UniversityHokkaidoJapan
| | - Rika Yano
- Faculty of Health SciencesHokkaido UniversityHokkaidoJapan
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Bernal IC, Moon SL, Hotta M, Newman MI. Residents' Perspectives of Pregnancy and Growing a Family During Surgical Training: A Review of the Literature. Cureus 2024; 16:e58335. [PMID: 38752085 PMCID: PMC11095911 DOI: 10.7759/cureus.58335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/29/2024] [Indexed: 05/18/2024] Open
Abstract
As more female surgical residents choose to start families during training, concerns regarding program support and peer perceptions emerge. Delayed parenthood, stress, and even attrition can result from inadequate support systems. Database search (MEDLINE, PubMed, EMBASE) in June 2022 identified 17 relevant studies published between 2012-2022, including systematic reviews and qualitative surveys, focused on surgical residents/fellows and program directors. The thematic analysis explored themes related to supporting residents navigating parenthood. Thematic analysis of 17 studies (systematic reviews and qualitative surveys with residents/fellows and program directors) identified key recurring themes related to challenges experienced by surgical residents navigating parenthood. The themes included modified work schedules, mentorship programs, cross-coverage plans, lactation support, childcare options, and clear leave policies. By understanding these challenges and implementing tailored support strategies, surgical residency programs can foster a more inclusive and supportive environment for residents starting families. This can improve resident well-being, reduce attrition, and create a significantly more enjoyable training experience for all involved. This review aims to provide insight into residents' difficulties while pregnant or considering pregnancy and identify changes programs could implement to promote a more supportive culture for pregnant residents.
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Affiliation(s)
- Isabel C Bernal
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Savannah L Moon
- Plastic and Reconstructive Surgery, Nicklaus Children's Hospital, Miami, USA
| | - Mayo Hotta
- Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, FL, USA
| | - Martin I Newman
- Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, USA
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Hobgood CD, Jarman AF. Resilience Building Practices for Women Physicians. J Womens Health (Larchmt) 2024; 33:532-541. [PMID: 37843899 DOI: 10.1089/jwh.2022.0502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Women now make up more than half of the physician workforce, but they are disproportionately plagued by burnout. Medicine is a fast-paced stressful field, the practice of which is associated with significant chronic stress due to systems issues, crowding, electronic medical records, and patient case mix. Hospitals and health care systems are responsible for mitigating system-based burnout-prone conditions, but often their best efforts fail. Physicians, particularly women, must confront their stressors and the daily burden of significant system strain when this occurs. Those who routinely exceed their cumulative stress threshold may experience burnout, career dissatisfaction, and second victim syndrome and, ultimately, may prematurely leave medicine. These conditions affect women in medicine more often than men and may also produce a higher incidence of health issues, including depression, substance use disorder, and suicide. The individual self-care required to maintain health and raise stress thresholds is not widely ingrained in provider practice patterns or behavior. However, the successful long-term practice of high-stress occupations, such as medicine, requires that physicians, especially women physicians, attend to their wellness. In this article, we address one aspect of health, resilience, and review six practices that can create additional stores of personal resilience when proactively integrated into a daily routine.
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Affiliation(s)
- Cherri D Hobgood
- Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Angela F Jarman
- Department of Emergency Medicine, University of California, Davis School of Medicine, California, USA
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Clarke GS, Vincent AD, Ladyman SR, Gatford KL, Page AJ. Circadian patterns of behaviour change during pregnancy in mice. J Physiol 2024. [PMID: 38477893 DOI: 10.1113/jp285553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Food intake and activity adapt during pregnancy to meet the increased energy demands. In comparison to non-pregnant females, pregnant mice consume more food, eating larger meals during the light phase, and reduce physical activity. How pregnancy changes the circadian timing of behaviour was less clear. We therefore randomised female C57BL/6J mice to mating for study until early (n = 10), mid- (n = 10) or late pregnancy (n = 11) or as age-matched, non-pregnant controls (n = 12). Mice were housed individually in Promethion cages with a 12 h light-12 h dark cycle [lights on at 07.00 h, Zeitgeber (ZT)0] for behavioural analysis. Food intake between ZT10 and ZT11 was greater in pregnant than non-pregnant mice on days 6.5-12.5 and 12.5-17.5. In mice that exhibited a peak in the last 4 h of the light phase (ZT8-ZT12), peaks were delayed by 1.6 h in the pregnant compared with the non-pregnant group. Food intake immediately after dark-phase onset (ZT13-ZT14) was greater in the pregnant than non-pregnant group during days 12.5-17.5. Water intake patterns corresponded to food intake. From days 0.5-6.5 onwards, the pregnant group moved less during the dark phase, with decreased probability of being awake, in comparison to the non-pregnant group. The onset of dark-phase activity, peaks in activity, and wakefulness were all delayed during pregnancy. In conclusion, increased food intake during pregnancy reflects increased amplitude of eating behaviour, without longer duration. Decreases in activity also contribute to positive energy balance in pregnancy, with delays to all measured behaviours evident from mid-pregnancy onwards. KEY POINTS: Circadian rhythms synchronise daily behaviours including eating, drinking and sleep, but how these change in pregnancy is unclear. Food intake increased, with delays in peaks of food intake behaviour late in the light phase from days 6.5 to 12.5 of pregnancy, in comparison to the non-pregnant group. The onset of activity after lights off (dark phase) was delayed in pregnant compared with non-pregnant mice. Activity decreased by ∼70% in the pregnant group, particularly in the dark (active) phase, with delays in peaks of wakefulness evident from days 0.5-6.5 of pregnancy onwards. These behavioural changes contribute to positive energy balance during pregnancy. Delays in circadian behaviours during mouse pregnancy were time period and pregnancy stage specific, implying different regulatory mechanisms.
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Affiliation(s)
- Georgia S Clarke
- School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew D Vincent
- Freemasons Centre for Male Health & Wellbeing, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Sharon R Ladyman
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Anatomy, School of Biomedical Sciences, Dunedin, New Zealand
| | - Kathryn L Gatford
- School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Amanda J Page
- School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Zhu J, Zheng T, Jin H, Wei M, Yu J, Ni J, Sun K, Zhang J. Sleep Disturbances in Early Gestation and the Risks of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study. Am J Epidemiol 2024; 193:479-488. [PMID: 37968336 DOI: 10.1093/aje/kwad223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
Abstract
Maternal poor sleep quality may increase blood pressure during pregnancy, but sound evidence is still limited and inconsistent. To evaluate whether sleep disturbances in early gestation are risk factors for the development of hypertensive disorders of pregnancy, we conducted the Early Life Plan Project from June 2016 to December 2019. Maternal sleep patterns were assessed at 12-16 weeks of gestation by using the Pittsburgh Sleep Quality Index questionnaire. For gestational hypertension and preeclampsia, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using multinomial logistic regression models adjusting for potential confounders. Among 5,532 eligible women, we observed that maternal blood pressure in early gestation was significantly higher in women with low sleep efficiency (≤85%), long sleep duration (≥9 hours/night), and snoring. Compared with nonsnorers, snoring in early gestation was independently associated with preeclampsia (OR = 1.72 (95% CI: 1.09, 2.73) for snoring once or twice per week; OR = 2.06 (95% CI: 1.01, 4.31) for snoring 3 or more times per week), particularly for term preeclampsia (OR = 1.79 (95% CI: 1.08, 2.95) and 2.26 (95% CI: 1.03, 4.95), respectively). Results suggest that snoring in early gestation may be a significant risk factor for preeclampsia, with a dose-response pattern.
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Lancaster AJ, Stevenson KL, Noel PH, Grothaus OF, Blackburn BE, Gililland JM. Motivations and Barriers for Women Orthopaedic Surgeons Considering Arthroplasty Fellowship. J Arthroplasty 2024; 39:527-532. [PMID: 37572723 DOI: 10.1016/j.arth.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Arthroplasty is one of the least gender-diverse orthopaedic subspecialties. While previous studies have looked at factors influencing fellowship choices for women, few studies have attempted to understand the decision for or against arthroplasty specifically. Working to better understand fellowship choice is a critical step in the process of increasing women recruitment. METHODS An anonymous survey was distributed using REDCap to women orthopaedic surgeons and trainees through listservs, social media groups, and residency programs. Surgeons who had decided on a specific subspecialty or already completed fellowship were included. Responses were obtained from 164 surgeons (72 arthroplasty surgeons, 92 other subspecialties). Chi-squared and Fisher's Exact tests were then performed. RESULTS The most important factor for those who chose arthroplasty was enjoyment of the surgeries. The biggest concerns from those in the arthroplasty group about the field were work-life balance, ability to become pregnant and/or have a healthy pregnancy, and sex bias from referring physicians. Of those who ultimately chose another subspecialty, 30.4% considered arthroplasty "a little" and 8.7% considered it "strongly." The most important dissuaders for the group that considered arthroplasty were concerns about "boy's club" culture, concerns about the physicality of the surgeries, and a lack of mentors. CONCLUSION While the decision to choose a career path is multifactorial, our hope is that through the identification of modifiable factors we can increase women representation in arthroplasty. Increasing mentorship, implementing practical solutions to improve work-life balance, supporting healthy pregnancies, and mitigating the physical demands of surgery could help address current disparities.
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Affiliation(s)
- Alex J Lancaster
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | | | - Paighton H Noel
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
| | - Olivia F Grothaus
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah
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Kim JH, Kim O, Cho M, Jeong H, Dan H. Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study. Int J Nurs Pract 2024:e13232. [PMID: 38273459 DOI: 10.1111/ijn.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/15/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024]
Abstract
AIM To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.
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Affiliation(s)
- Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Mijung Cho
- Department of Nursing, Hallym Polytechnic University, Chuncheon, Republic of Korea
| | - Hyunseon Jeong
- College of Nursing, Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Hyunju Dan
- Department of Nursing, Hwasung Medi-Science University, Hwasung-si, Kyunggi-do, Republic of Korea
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Lee SJ, Kim C, Lee EJ, Lim MN, Na S, Kim WJ. Associations of Night Shift Status During Pregnancy With Small for Gestational Age and Preterm Births. J Korean Med Sci 2024; 39:e25. [PMID: 38193332 PMCID: PMC10782040 DOI: 10.3346/jkms.2024.39.e25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/17/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Shift work, including night shift work, during pregnancy has been associated with adverse birth outcomes such as small for gestational age (SGA) infants and preterm births. This study, conducted in South Korea using the Korean CHildren's ENvironmental health Study (Ko-CHENS) cohort, aimed to investigate the association between shift work and night shift status during pregnancy and adverse birth outcomes. METHODS The Korean Ko-CHENS is a nationwide prospective birth cohort study of children's environmental diseases, conducted by the Ministry of Environment and the National Institute of Environmental Research. This study included pregnant women recruited from 2015 to 2020 for Ko-CHENS Core Cohorts, and 4,944 out of a total of 5,213 pregnant women were selected as final subjects. A logistic regression model was used to identify the risk factors affecting SGA births, preterm births, and low-birth-weight infants, and the odds ratio (OR) was adjusted. This was confirmed by calculating ORs. Maternal age, infant sex, maternal educational status, body mass index, smoking status, alcohol consumption status, parity, gestational diabetes mellitus, preeclampsia, and abortion history were used as adjusted variables. RESULTS No statistically significant differences were observed in the birth outcomes or maternal working patterns. There were no significant differences in the adjusted odds ratios (aORs) of SGA and preterm births between the non-worker, day worker, and shift worker. However, there was a significant difference in the aORs of SGA between non-workers and night shift workers. (aORs [95% confidence interval], 2.643 [1.193-5.859]). CONCLUSION Working during pregnancy did not increase the risk of SGA or preterm birth, and night shift work did not increase the risk of preterm birth. However, night-shift work increases the risk of SGA.
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Affiliation(s)
- Se Jin Lee
- Department of Obstetrics and Gynecology, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Chorong Kim
- Department of Obstetrics and Gynecology, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Eun Ju Lee
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Myoung-Nam Lim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Sunghun Na
- Department of Obstetrics and Gynecology, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Korea.
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, Korea.
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Gasior AC, Bergus KC, Beeler WH, Xi AS, Rialon KL. Pregnancy in Medical Training: A Survey of Physician Moms on Their Experiences During Residency and Fellowship. JOURNAL OF SURGICAL EDUCATION 2024; 81:84-92. [PMID: 37919135 DOI: 10.1016/j.jsurg.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Resident physicians undergo physically and emotionally rigorous training; this is particularly difficult for the pregnant resident and affects their unborn child. This study aims to elucidate pregnant residents' perspectives regarding their prenatal and postnatal experiences, across all specialties, with a focus on pregnancy complications, postpartum health, and policy execution. DESIGN This is a nationwide cross-sectional survey study developed to characterize resident and fellow perceptions about work schedules while pregnant, perceived discrimination, complications during pregnancy, lactation and lactation support, marital distress, parental leave policy, and overall satisfaction with the parental leave period. Descriptive statistics were used to characterize survey responses. SETTING/PARTICIPANTS The experiences of physician mothers in online Facebook support groups: Physician Mom Group, Surgeon Mom Group, and Dr Mothers Interested in Lactation Knowledge, were queried by an electronic survey distributed using Qualtrics XM. Physicians who had children during their U.S. residency training were eligible to participate and 1,690 physician mothers from all specialties completed the survey. RESULTS One thousand six hundred and ninety responses from members of the Facebook support groups were analyzed. Most surveyed physicians (1353/1519, 89.1%) were required to work until delivery and 63.6% (993/1561) of women took in-house calls during the last month of pregnancy. Half (820/1560, 52.6%) thought that the physical demands of their jobs compromised their own health and safety, or that of their child, and 1259 complications were reported among 1690 respondents, an average of three complications for every four respondents. Twenty-nine percent (442/1519, 29.1%) of physician mothers suffered from postpartum depression. Ninety-two percent (1479/1602, 92.3%) of respondents breastfed, but only one-third (483/1456, 33.2%) breastfed for more than 12 months and 52.7% (769/1458) would have liked to breastfeed longer. Marital distress was reported by nearly half (756/1650, 45.8%) of respondents during pregnancy and/or the first year of their child's life due to parental leave policies. The majority (957/1688, 56.7%) did not have a parental leave policy at their institution. Nearly two-thirds (946/1518, 62.3%) of respondents took 6 or fewer weeks off, and 79.7% (1211/1520) felt their duration of time off was inadequate. Nearly 30% (457/1593, 28.7%) stated they would recommend against a female medical student going into their field of medicine based upon their own experiences during pregnancy. CONCLUSIONS Many mothers experienced discrimination from colleagues and worked until delivery despite concerns about the health and safety of themselves or their unborn children, and many reported experiencing a pregnancy-related complication. Most did not have a parental leave policy, which likely contributed to the disproportionately higher rates of postpartum depression among physician mothers compared to the general public. Residency training parental leave policies should be more accommodating to improve mental health, career satisfaction, and retention of the next generation of physician mothers.
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Affiliation(s)
- Alessandra C Gasior
- Division of Colon and Rectal Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Katherine C Bergus
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Whitney H Beeler
- Department of Radiation Oncology, Spectrum Healthcare Partners, Portland, Maine
| | - Amanda S Xi
- Department of Anesthesia, Massachusetts General Hospital, Boston, Massachusetts
| | - Kristy L Rialon
- Department of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
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Persson Waye K, Löve J, Lercher P, Dzhambov AM, Klatte M, Schreckenberg D, Belke C, Leist L, Ristovska G, Jeram S, Kanninen KM, Selander J, Arat A, Lachmann T, Clark C, Botteldooren D, White K, Julvez J, Foraster M, Kaprio J, Bolte G, Psyllidis A, Gulliver J, Boshuizen H, Bozzon A, Fels J, Hornikx M, van den Hazel P, Weber M, Brambilla M, Braat-Eggen E, Van Kamp I, Vincens N. Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities. ENVIRONMENTAL RESEARCH 2023; 239:117279. [PMID: 37778607 DOI: 10.1016/j.envres.2023.117279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/03/2023]
Abstract
Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.
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Affiliation(s)
- Kerstin Persson Waye
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Lercher
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Angel M Dzhambov
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Bulgaria
| | - Maria Klatte
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Dirk Schreckenberg
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Christin Belke
- Centre for Applied Psychology, Environmental and Social Research (Zeus GmbH), Hagen, Germany
| | - Larisa Leist
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Gordana Ristovska
- Institute of Public Health of the Republic of North Macedonia, Skopje, Macedonia
| | - Sonja Jeram
- National Institute of Public Health, Ljubljana, Slovenia
| | - Katja M Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jenny Selander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arzu Arat
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Lachmann
- Cognitive and Developmental Psychology, University of Kaiserslautern-Landau, Kaiserslautern, Germany; Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, Madrid, Spain
| | - Charlotte Clark
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Dick Botteldooren
- Department of Information Technology, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium
| | - Kim White
- National Institute for Public Health and the Environment, Netherlands
| | - Jordi Julvez
- Institut D'Investigació Sanitària Pere Virgili (IISPV), Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Reus, Spain
| | | | - Jaakko Kaprio
- Institute for Molecular Medicine Finland and Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Achilleas Psyllidis
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - John Gulliver
- Population Health Research Institute, St George's, University of London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Hendriek Boshuizen
- Department for Statistics, Datascience and Mathematical Modelling, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Alessandro Bozzon
- Department of Sustainable Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Janina Fels
- Institute for Hearing Technology and Acoustics, RWTH Aachen University, Aachen, Germany
| | - Maarten Hornikx
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Peter van den Hazel
- International Network on Children's Health, Environment and Safety, Ellecom, the Netherlands
| | | | - Marco Brambilla
- Data Science Laboratory, Politecnico di Milano, Milan, Italy
| | | | - Irene Van Kamp
- National Institute for Public Health and the Environment, Netherlands
| | - Natalia Vincens
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Niedhammer I, Pineau E, Bertrais S. Employment Factors Associated With Long Working Hours in France. Saf Health Work 2023; 14:483-487. [PMID: 38187204 PMCID: PMC10770083 DOI: 10.1016/j.shaw.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 01/09/2024] Open
Abstract
The objectives of the study were to explore the employment factors associated with long working hours, known as a risk factor for various health outcomes. The study relied on the national representative data of the 2013 French working conditions survey and a study sample of 23,378 full-time employees. Long working hours were defined by the threshold of 48 hours a week following the European Working Time Directive. The prevalence of long working hours was higher among men (13.5%) than among women (8.5%). Employees of the private sector, with permanent work contract, in small companies, and men in the services had a higher prevalence of exposure. This prevalence increased with educational and occupational levels. Our findings may help decision-makers to define preventive strategies. More research is needed to improve our knowledge of the employment factors associated with long working hours, as there may be strong differences between countries.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, Angers, France
| | - Elodie Pineau
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, Angers, France
| | - Sandrine Bertrais
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, Angers, France
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Méndez N, Corvalan F, Halabi D, Ehrenfeld P, Maldonado R, Vergara K, Seron-Ferre M, Torres-Farfan C. From gestational chronodisruption to noncommunicable diseases: Pathophysiological mechanisms of programming of adult diseases, and the potential therapeutic role of melatonin. J Pineal Res 2023; 75:e12908. [PMID: 37650128 DOI: 10.1111/jpi.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/19/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
During gestation, the developing fetus relies on precise maternal circadian signals for optimal growth and preparation for extrauterine life. These signals regulate the daily delivery of oxygen, nutrients, hormones, and other biophysical factors while synchronizing fetal rhythms with the external photoperiod. However, modern lifestyle factors such as light pollution and shift work can induce gestational chronodisruption, leading to the desynchronization of maternal and fetal circadian rhythms. Such disruptions have been associated with adverse effects on cardiovascular, neurodevelopmental, metabolic, and endocrine functions in the fetus, increasing the susceptibility to noncommunicable diseases (NCDs) in adult life. This aligns with the Developmental Origins of Health and Disease theory, suggesting that early-life exposures can significantly influence health outcomes later in life. The consequences of gestational chronodisruption also extend into adulthood. Environmental factors like diet and stress can exacerbate the adverse effects of these disruptions, underscoring the importance of maintaining a healthy circadian rhythm across the lifespan to prevent NCDs and mitigate the impact of gestational chronodisruption on aging. Research efforts are currently aimed at identifying potential interventions to prevent or mitigate the effects of gestational chronodisruption. Melatonin supplementation during pregnancy emerges as a promising intervention, although further investigation is required to fully understand the precise mechanisms involved and to develop effective strategies for promoting health and preventing NCDs in individuals affected by gestational chronodisruption.
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Affiliation(s)
- Natalia Méndez
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Fernando Corvalan
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Diego Halabi
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- School of Dentistry, Facultad de Medicina, Universidad Austral de Chile, Santiago, Chile
| | - Pamela Ehrenfeld
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- School of Dentistry, Facultad de Medicina, Universidad Austral de Chile, Santiago, Chile
- Centro Interdisciplinario de Estudios del Sistema Nervioso (CISNe), Universidad Austral de Chile, Valdivia, Chile
| | - Rodrigo Maldonado
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- School of Dentistry, Facultad de Medicina, Universidad Austral de Chile, Santiago, Chile
- Centro Interdisciplinario de Estudios del Sistema Nervioso (CISNe), Universidad Austral de Chile, Valdivia, Chile
| | - Karina Vergara
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Maria Seron-Ferre
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
- School of Dentistry, Facultad de Medicina, Universidad Austral de Chile, Santiago, Chile
- Centro Interdisciplinario de Estudios del Sistema Nervioso (CISNe), Universidad Austral de Chile, Valdivia, Chile
- Programa de Fisiopatología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago de Chile
| | - Claudia Torres-Farfan
- Laboratorio de Cronobiología del Desarrollo, Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
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Whitburn J, Miah S, Howles SA. Pregnancy and parenthood in surgical training: a cross-sectional survey in the UK. Br J Surg 2023; 110:1628-1631. [PMID: 37463398 PMCID: PMC10638525 DOI: 10.1093/bjs/znad204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Jessica Whitburn
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Saiful Miah
- Department of Urology, Addenbrookes Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Sarah A Howles
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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22
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Begtrup LM, Sejbaek CS, Flachs EM, Garde AH, Specht IO, Hansen J, Kolstad HA, Bonde JPE, Hammer PEC. Night work during pregnancy and small for gestational age: a Danish nationwide register-based cohort study. Occup Environ Med 2023; 80:610-616. [PMID: 37813484 DOI: 10.1136/oemed-2023-108981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/02/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The aim was to investigate the association between night work during pregnancy and risk of having a small for gestational age (SGA) child. METHODS This cohort study had payroll data with detailed information on working hours for employees in all Danish administrative regions (primarily hospital employees) between 2007 and 2015, retrieved from the Danish Working Hour Database. Pregnancies, covariates and outcome were identified from the national birth registry. We used logistic regression to investigate the association between intensity and duration of night work during the first 32 pregnancy weeks and SGA. The adjusted model included age, body mass index, socioeconomic status and smoking. Using quantitative bias analysis and G-estimation, we explored potential healthy worker survivor bias (HWSB). RESULTS The final cohort comprised 24 548 singleton pregnancies in 19 107 women, primarily nurses and medical doctors. None of the dimensions of night work were associated with an increased risk of SGA. We found a tendency towards higher risk of SGA in pregnancies where the women stopped having night shifts during pregnancy. Using G-estimation we found an OR<1 for the association between night work and SGA if all workers continued having night work during pregnancy compared with daywork only. CONCLUSION We found no increased risk of SGA in association with night work during pregnancy among healthcare workers. G-estimation was not precise enough to estimate the observed indication of HWSB. We need better data on pregnancy discomforts and complications to be able to safely rule out HWSB.
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Affiliation(s)
- Luise Moelenberg Begtrup
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Department of Public Health, Copenhagen University, Copenhagen, Denmark
| | - Camilla Sandal Sejbaek
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Anne Helene Garde
- Department of Public Health, Copenhagen University, Copenhagen, Denmark
- National Research Centre for the Working Environment, Kobenhavn, Denmark
| | - Ina Olmer Specht
- The Parker Institute, Frederiksberg Hospital, Frederiksberg, Denmark
- Section for General Practice, Department of Public Health, Copenhagen University, Copenhagen, Denmark
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Insitute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Department of Public Health, Copenhagen University, Copenhagen, Denmark
| | - Paula Edeusa Cristina Hammer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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23
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Adane HA, Iles R, Boyle JA, Gelaw A, Collie A. Maternal Occupational Risk Factors and Preterm Birth: A Systematic Review and Meta-Analysis. Public Health Rev 2023; 44:1606085. [PMID: 37937117 PMCID: PMC10625911 DOI: 10.3389/phrs.2023.1606085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/01/2023] [Indexed: 11/09/2023] Open
Abstract
Objective: This systematic review and meta-analysis aimed to summarize the evidence on the relationship between physical occupational risks (high physical workload, long working hours, shift work, whole-body vibrations, prolonged standing, and heavy lifting) and preterm birth. Methods: A systematic review and meta-analysis was conducted across six databases to investigate the relationship between physical occupational risks and preterm birth. Result: A comprehensive analysis of 37 studies with varying sample sizes found moderate evidence of positive associations between high physical workload, long working hours, shift work, whole-body vibration, and preterm birth. Meta-analysis showed a 44% higher risk (OR 1.44, 95% CI 1.25-1.66) for preterm birth with long working hours and a 63% higher risk (OR 1.63, 95% CI 1.03-2.58) with shift work. Conclusion: Pregnant women in physically demanding jobs, those working long hours or on shifts, and those exposed to whole-body vibration have an increased risk of preterm birth. Employers should establish supportive workplaces, policymakers implement protective measures, healthcare providers conduct screenings, and pregnant women must stay informed and mitigate these job-related risks. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], Identifier [CRD42022357045].
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Affiliation(s)
- Haimanot Abebe Adane
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Ross Iles
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jacqueline A. Boyle
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Asmare Gelaw
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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24
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Agarwal I, Wang S, Stuart J, Strohmaier S, Schernhammer E, Rich-Edwards J, Kang JH. First-trimester occupational exposures and hypertensive disorders of pregnancy among US nurses. Occup Med (Lond) 2023; 73:419-426. [PMID: 37587907 PMCID: PMC11009503 DOI: 10.1093/occmed/kqad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP). AIMS To investigate whether first-trimester night shift work, work hours and work-related activities are associated with HDP. METHODS We conducted a cross-sectional analysis of 6610 women within the Nurses' Health Study II. We used multiple logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of occupational exposures to HDP. RESULTS Nine per cent of respondents reported an HDP in the index pregnancy (gestational hypertension: n = 354, 5%, preeclampsia: n = 222, 3%). First-trimester fixed or rotating night shift work was not significantly associated with gestational hypertension or preeclampsia compared to day shift work only. Compared to those working 21-40 h/week, working overtime (≥41 h/week) was not associated with gestational hypertension but was associated with 43% higher odds of preeclampsia (95% CI 1.02, 2.00). For part-time work (≤20 h/week), the OR was 0.76 (95% CI 0.56, 1.02) for gestational hypertension and 0.64 (95% CI 0.43, 0.97) for preeclampsia. The odds of preeclampsia were 3% higher per additional hour worked per week (95% CI 1.01-1.04). Compared to 0-4 h spent standing or walking per day, standing or walking ≥9 h daily was associated with 32% lower odds of gestational hypertension (95% CI 0.47, 0.99) but was not significantly associated with preeclampsia. Frequency of heavy lifting was not associated with either hypertensive disorder or pregnancy. CONCLUSIONS Among nurses, working overtime was associated with higher odds of preeclampsia.
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Affiliation(s)
- I Agarwal
- Maine Health Institute for Research, Maine Medical Center, Scarborough 04074, MN, USA
| | - S Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - J Stuart
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - S Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna 1090, Austria
| | - E Schernhammer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna 1090, Austria
| | - J Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - J H Kang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
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25
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Xu Q, Guan Q, Lu Y, Xu J, Deng S, Dong C, Zhang X, Li W, Xia Y. Effect of short-term ambient air pollution exposure on early miscarriage and pregnancy hormones with critical window identification. JOURNAL OF HAZARDOUS MATERIALS 2023; 460:132328. [PMID: 37666168 DOI: 10.1016/j.jhazmat.2023.132328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Pregnancy hormones are particularly important in early miscarriage, and some evidence suggests that exposure to air pollution is associated with pregnancy hormones and miscarriage. However, the effects of air pollution on pregnancy hormone-mediated miscarriages have not yet been investigated. METHODS We collected air pollution exposure measurements and pregnancy hormone tests from the participants. Logistic regression models were used to investigate the association between air pollution and early miscarriages. A distributed lag nonlinear model (DLNM) was used to investigate non-linear and delayed associations and identify the crucial window. We performed mediation analysis to estimate the potential association that may exist between pregnancy hormone levels and early miscarriage. RESULTS Short-term exposure to CO and SO2 was associated with early miscarriage. Lag 22-28 days of exposure to both CO and SO2 and lag 15-21 days of exposure to CO were significantly positively associated with early miscarriage, with an obvious exposure dose response. Serum progesterone concentration explained 36.79 % of the association between lag 15-28 days of CO exposure and early miscarriage. CONCLUSION This study provides evidence for the association between short-term exposure to air pollution and early miscarriage, and provides clues for further exploration of biological mechanisms.
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Affiliation(s)
- Qing Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China; State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Quanquan Guan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yingying Lu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jie Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Siting Deng
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chao Dong
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaochen Zhang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wen Li
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
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26
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Berical KA, Vogel TS, Robinson JM, Ward AM, Wiener-Kronish J. Championing the Mom: The Role of a Mother's Support Group in Academic Anesthesia Practice. Anesth Analg 2023; 137:777-781. [PMID: 37712469 DOI: 10.1213/ane.0000000000006575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- Kinza A Berical
- From the Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Talia S Vogel
- From the Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jill M Robinson
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Anna M Ward
- Mayo Clinic College of Medicine and Science, Phoenix, Arizona
- Department of Anesthesiology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Jeanine Wiener-Kronish
- From the Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
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27
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Ropponen A, Ervasti J, Härmä M. Concurrent trajectories of part-time work and sickness absence: a longitudinal cohort study over 11 years among shift working hospital employees. BMJ Open 2023; 13:e072987. [PMID: 37748850 PMCID: PMC10533668 DOI: 10.1136/bmjopen-2023-072987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES To investigate the concurrent changes in part-time work and sickness absence (SA) in healthcare. Another aim was to investigate the role of age and sex on different concurrent trajectory groups. DESIGN Prospective cohort study. SETTING Public hospital districts (n=10) and cities (n=11) in Finland. PARTICIPANTS Payroll-based objective working hour data of the healthcare sector in Finland for 28 969 employees in 2008-2019 were used. The final sample included those working shifts with 3 consecutive years of data and without baseline (≥14 days) SA. PRIMARY OUTCOMES Part-time work (yes or no) and months of SA. MEASURES Group-based trajectory modelling to identify concurrent changes in part-time work, and months of SA while controlling the time-variant amount of night work and multinomial regression models for relative risk (RR) with 95% CIs were used. RESULTS Four-group trajectory model was the best solution: group 1 (61.2%) with full-time work and no SA, group 2 (16.9%) with slowly increasing probability of part-time work and low but mildly increasing SA, group 3 (17.6%) with increasing part-time work and no SA, and group 4 (4.3%) with fluctuating, increasing part-time work and highest and increasing levels of SA. Men had a lower (RR 0.49-0.75) and older age groups had a higher likelihood (RRs 1.32-3.79) of belonging to trajectory groups 2-4. CONCLUSIONS Most of the sample were in the trajectory group with full-time work and no SA. The probability of part-time work increased over time, linked with concurrent low increase or no SA. A minor group of employees had both an increased probability of part-time work and SA. Part-time work and other solutions might merit attention to promote sustainable working life among healthcare employees.
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Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
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28
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Ooshige N, Matsunaka E, Ueki S, Takuma S. Pregnant nurses' experiences of working shifts: a qualitative systematic review. JBI Evid Synth 2023:02174543-990000000-00211. [PMID: 37747425 DOI: 10.11124/jbies-23-00184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The objective of this systematic review was to synthesize the experiences of nurses who work shifts during pregnancy. INCLUSION CRITERIA This review included studies that focused on the experiences of pregnant registered nurses, regardless of their level of qualification, working shifts in any workplace, including hospitals, nursing home facilities, or clinics, in any country. Nurses not involved in direct care (eg, advanced practice nurses, administrators, educators) were excluded. METHODS The review followed the JBI methodology for qualitative systematic reviews. Published and gray literature were searched for via CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycINFO (EBSCOhost), Igaku Chuo Zasshi (Japan Medical Abstracts Society), and JBI Evidence Synthesis. No language restrictions were imposed, and the date limit was set for 2013 to 2021. Two independent reviewers performed data collection, extraction, critical appraisal, and analysis. Unequivocal and credible findings were used to develop categories, which were then synthesized to provide a set of comprehensive findings, which were graded according to ConQual. RESULTS Five qualitative studies were included (2 from the USA, 2 from Japan, and 1 from Korea), from which 23 findings with narrative illustrations were extracted. Of these findings, 22 were assessed as unequivocal, 1 as credible, and 3 not supported. The studies were low-to-moderate quality based on the JBI critical appraisal checklist for qualitative research. All studies used qualitative methodologies, including phenomenology, qualitative description, and the grounded theory approach. Results were integrated into 7 categories and 3 synthesized findings. The first synthesized finding was that nurses struggle with the physical burden of pregnancy and work environments that threaten continued pregnancy. The second was that nurses achieve work-pregnancy compatibility by disclosing their pregnancy and obtaining support. The third was that development as a nurse results from continuing to work during pregnancy. CONCLUSIONS Pregnant nurses face a harsh work environment; the support they receive after disclosing their pregnancy allows them to balance work and pregnancy; and they feel that they grow as professionals by continuing to work even if they are pregnant. More research is needed to inform support systems for them. REVIEW REGISTRATION PROSPERO CRD42022309674. SUPPLEMENTAL DIGITAL CONTENT A Japanese-language version of the abstract of this review is available [http://links.lww.com/SRX/A31].
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Affiliation(s)
- Narumi Ooshige
- Department of Nursing, Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan
| | - Eriko Matsunaka
- Japanese Red Cross, Kyushu International College of Nursing, Fukuoka, Japan
- The Japan Centre for Evidence Based Practice: A JBI Centre of Excellence, Osaka University, Osaka, Japan
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shingo Ueki
- The Japan Centre for Evidence Based Practice: A JBI Centre of Excellence, Osaka University, Osaka, Japan
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sayuka Takuma
- Reference Service Section, Medical Library, Kyushu University, Fukuoka, Japan
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Mészáros B, Kukor Z, Valent S. Recent Advances in the Prevention and Screening of Preeclampsia. J Clin Med 2023; 12:6020. [PMID: 37762960 PMCID: PMC10532380 DOI: 10.3390/jcm12186020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Throughout the history of medicine, preeclampsia has remained an enigmatic field of obstetrics. In 2023, despite its prevalence and impact, preeclampsia's exact cause and effective treatment remain elusive; the current options are limited to delivery. The purpose of this review is to summarize the knowledge of the possible novel prophylactic therapies and screening methods for preeclampsia, thereby providing valuable insights for healthcare professionals and researchers. Aspirin and LMWH have already been widely used; meanwhile, calcium, vitamin D, and pravastatin show promise, and endothelin receptor antagonists are being explored. Stress reduction, dietary changes, and lifestyle modifications are also being investigated. Another interesting and fast-growing area is AI- and software-based screening methods. It is also key to find novel biomarkers, which, in some cases, are not only able to predict the development of the disease, but some of them hold promise to be a potential therapeutic target. We conclude that, while a definitive cure for preeclampsia may not be eligible in the near future, it is likely that the assessment and enhancement of preventive methods will lead to the prevention of many cases. However, it is also important to highlight that more additional research is needed in the future to clarify the exact pathophysiology of preeclampsia and to thus identify potential therapeutic targets for more improved treatment methods.
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Affiliation(s)
- Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, 1082 Budapest, Hungary
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
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30
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Stefanou AJ. Fertility and Pregnancy: How Do These Affect Family Planning and Surgeon Health? Clin Colon Rectal Surg 2023; 36:327-332. [PMID: 37564346 PMCID: PMC10411105 DOI: 10.1055/s-0043-1764240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
There are unique considerations to fertility and pregnancy for women surgeons. Women surgeons often decide to delay pregnancy and childbearing due to concerns of conflict with work and training. This is particularly true for surgical trainees who face many obstacles, including bias from peers and program directors, and work-life conflict. As such, rates of infertility are higher compared with the general population. Women surgeons require assisted reproductive technologies more often than the general population. During pregnancy, there are also additional occupational hazards that are unique to a surgical career. Overall, we must be aware of these issues to support surgeons who decide to become parents during a surgical career.
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31
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Kanters AE, Shubeck SP. The Importance of Parental Leave and Lactation Support for Surgeons. Clin Colon Rectal Surg 2023; 36:333-337. [PMID: 37564351 PMCID: PMC10411055 DOI: 10.1055/s-0043-1764288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Despite the growing population of surgeons who will spend the bulk of their potential childbearing years in medical school, training, or early in practice, the stigma associated with pregnancy remains. The challenges of childbearing for surgeons also extend to the pregnancy experience from a health perspective including increased rates of infertility, miscarriage, and preterm labor. Given the unique demands of a surgical practice, surgeons may experience pressure to minimize the disruption of their work during and after pregnancy. This may include attempts at carrying a full workload until the day of delivery, reducing the length of planned parental leave, and not requesting accommodations for time to express milk. Concern for discrimination, clinical productivity expectations, and promotion timelines can limit a surgeon's ability to receive pregnancy-related support and adequate parental leave. Though not all surgeons will choose to pursue pregnancy, we must still acknowledge the need to support these individuals. Furthermore, this support should not be limited to the pregnancy alone but include postpartum support including that related to family leave and lactation. Here, we provide an overview of just some of the challenges faced by surgeons in the pursuit of parenthood and present the arguments for accommodations related to pregnancy, parental leave, and lactation.
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Affiliation(s)
- Arielle E. Kanters
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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32
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Oh JW, Kim S, Yoon JW, Kim T, Kim MH, Ryu J, Choe SA. Women's Employment in Industries and Risk of Preeclampsia and Gestational Diabetes: A National Population Study of Republic of Korea. Saf Health Work 2023; 14:272-278. [PMID: 37818217 PMCID: PMC10562116 DOI: 10.1016/j.shaw.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 10/12/2023] Open
Abstract
Background Some working conditions may pose a higher physical or psychological demand to pregnant women leading to increased risks of pregnancy complications. Objectives We assessed the association of woman's employment status and the industrial classification with obstetric complications. Methods We conducted a national population study using the National Health Information Service database of Republic of Korea. Our analysis encompassed 1,316,310 women who experienced first-order live births in 2010-2019. We collected data on the employment status and the industrial classification of women, as well as their diagnoses of preeclampsia (PE) and gestational diabetes mellitus (GDM) classified as A1 (well controlled by diet) or A2 (requiring medication). We calculated odds ratios (aORs) of complications per employment, and each industrial classification was adjusted for individual risk factors. Results Most (64.7%) were in employment during pregnancy. Manufacturing (16.4%) and the health and social (16.2%) work represented the most prevalent industries. The health and social work exhibited a higher risk of PE (aOR = 1.11, 95% confidence interval [CI]: 1.03-1.21), while the manufacturing industry demonstrated a higher risk of class A2 GDM (1.20, 95% CI: 1.03-1.41) than financial intermediation. When analyzing both classes of GDM, women who worked in public administration and defense/social security showed higher risk of class A1 GDM (1.04, 95% CI: 1.01, 1.07). When comparing high-risk industries with nonemployment, the health and social work showed a comparable risk of PE (1.02, 95% CI: 0.97, 1.07). Conclusion Employment was associated with overall lower risks of obstetric complications. Health and social service work can counteract the healthy worker effect in relation to PE. This highlights the importance of further elucidating specific occupational risk factors within the high-risk industries.
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Affiliation(s)
- Jeong-Won Oh
- Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Seyoung Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Republic of Korea
| | - Jung-won Yoon
- Department of Obstetrics and Gynecology, National Medical Center, Republic of Korea
| | - Taemi Kim
- Department of Public Health, Korea University, Seoul, Republic of Korea
| | - Myoung-Hee Kim
- Center for Public Health Data Analytics, National Medical Center, Seoul, Republic of Korea
| | - Jia Ryu
- Department of Occupational Medicine, Catholic Kwandong University, Gangwon, Republic of Korea
| | - Seung-Ah Choe
- Department of Public Health, Korea University, Seoul, Republic of Korea
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Van Gilst D, Puchkina AV, Roelants JA, Kervezee L, Dudink J, Reiss IKM, Van Der Horst GTJ, Vermeulen MJ, Chaves I. Effects of the neonatal intensive care environment on circadian health and development of preterm infants. Front Physiol 2023; 14:1243162. [PMID: 37719464 PMCID: PMC10500197 DOI: 10.3389/fphys.2023.1243162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
The circadian system in mammals ensures adaptation to the light-dark cycle on Earth and imposes 24-h rhythmicity on metabolic, physiological and behavioral processes. The central circadian pacemaker is located in the brain and is entrained by environmental signals called Zeitgebers. From here, neural, humoral and systemic signals drive rhythms in peripheral clocks in nearly every mammalian tissue. During pregnancy, disruption of the complex interplay between the mother's rhythmic signals and the fetal developing circadian system can lead to long-term health consequences in the offspring. When an infant is born very preterm, it loses the temporal signals received from the mother prematurely and becomes totally dependent on 24/7 care in the Neonatal Intensive Care Unit (NICU), where day/night rhythmicity is usually blurred. In this literature review, we provide an overview of the fetal and neonatal development of the circadian system, and short-term consequences of disruption of this process as occurs in the NICU environment. Moreover, we provide a theoretical and molecular framework of how this disruption could lead to later-life disease. Finally, we discuss studies that aim to improve health outcomes after preterm birth by studying the effects of enhancing rhythmicity in light and noise exposure.
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Affiliation(s)
- D. Van Gilst
- Department of Molecular Genetics, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - A. V. Puchkina
- Department of Developmental Biology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - J. A. Roelants
- Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus University Medical Center Rotterdam-Sophia Children’s Hospital, Rotterdam, Netherlands
| | - L. Kervezee
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - J. Dudink
- Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - I. K. M. Reiss
- Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus University Medical Center Rotterdam-Sophia Children’s Hospital, Rotterdam, Netherlands
| | - G. T. J. Van Der Horst
- Department of Molecular Genetics, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - M. J. Vermeulen
- Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus University Medical Center Rotterdam-Sophia Children’s Hospital, Rotterdam, Netherlands
| | - I. Chaves
- Department of Molecular Genetics, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
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Morgan C, Li L, Kasetti PR, Varma R, Liddle AD. Pregnancy, parenthood, and fertility in the orthopaedic surgeon. Bone Joint J 2023; 105-B:857-863. [PMID: 37524342 DOI: 10.1302/0301-620x.105b8.bjj-2023-0253.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Aims As an increasing number of female surgeons are choosing orthopaedics, it is important to recognize the impact of pregnancy within this cohort. The aim of this review was to examine common themes and data surrounding pregnancy, parenthood, and fertility within orthopaedics. Methods A systematic review was conducted by searching Medline, Emcare, Embase, PsycINFO, OrthoSearch, and the Cochrane Library in November 2022. The Preferred Reporting Items for Systematic Reviews and Meta Analysis were adhered to. Original research papers that focused on pregnancy and/or parenthood within orthopaedic surgery were included for review. Results Of 1,205 papers, 19 met the inclusion criteria. Our results found that orthopaedic surgeons have higher reported rates of obstetric complications, congenital abnormalities, and infertility compared to the general population. They were noted to have children at a later age and voluntarily delayed childbearing. Negative perceptions of pregnancy from fellow trainees and programme directors were identified. Conclusion Female orthopaedic surgeons have high rates of obstetric complications and infertility. Negative perceptions surrounding pregnancy can lead to orthopaedic surgeons voluntarily delaying childbearing. There is a need for a pregnancy-positive culture shift combined with formalized guidelines and female mentorship to create a more supportive environment for pregnancy within orthopaedic surgery.
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Affiliation(s)
| | - Lily Li
- Imperial College NHS Foundation Trust, London, UK
| | | | - Ria Varma
- Imperial College NHS Foundation Trust, London, UK
| | - Alexander D Liddle
- Department of Surgery and Cancer, The MSk Lab, Imperial College London, London, UK
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Zhang L, Yin W, Yu W, Wang P, Wang H, Zhang X, Zhu P. Environmental exposure to outdoor artificial light at night during pregnancy and fetal size: A prospective cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 883:163521. [PMID: 37062314 DOI: 10.1016/j.scitotenv.2023.163521] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Previous studies suggested outdoor artificial light at night (ALAN) exposure may contribute to children and adult obesity, but less is known about the associations of outdoor ALAN exposure during pregnancy with fetal size. METHODS From 2015 to 2021, 6210 mother-child pairs were included. Average outdoor ALAN levels during pregnancy were measured using satellite imaging data. Fetal biparietal diameter, head circumference, abdominal circumference (AC), and femur length were measured before delivery with ultrasonography. We also collected anthropometric birth outcomes, including birth length, birth weight, macrosomia, low birth weight, small for gestational age, and large for gestational age at delivery. Multivariable linear regression models and binary logistic regression models were used to examine the potential associations of outdoor ALAN with fetal size adjusting for a broad set of potential confounds. RESULTS An IQR (14.87 nW/cm2/sr) increase in outdoor ALAN during pregnancy was associated with 1.30 (β = 1.30, 95 % CI: 0.31,2.29) higher AC percentiles and 13 % (OR = 1.13, 95 % CI: 1.00,1.27) higher odds of macrosomia after adjusting confounders. In sex stratification analysis, an IQR (14.87 nW/cm2/sr) increase in outdoor ALAN during pregnancy was associated with 1.65 (β = 1.65, 95 % CI: 0.24,3.06) higher fetal AC percentiles and 27 % (OR = 1.27, 95 % CI: 1.06,1.53) higher odds of macrosomia in females. CONCLUSIONS Our findings suggest that higher outdoor ALAN exposure during pregnancy is associated with larger fetal AC and a higher risk of macrosomia, particularly in the female fetus. Future studies are needed to verify these preliminary findings and identify potential mechanisms for the association.
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Affiliation(s)
- Lei Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wanjun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wenjie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Haixia Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
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Kim T. The impact of working hours on pregnancy intention in childbearing-age women in Korea, the country with the world's lowest fertility rate. PLoS One 2023; 18:e0288697. [PMID: 37467184 DOI: 10.1371/journal.pone.0288697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023] Open
Abstract
This study aimed to assess factors affecting pregnancy intention among women of reproductive age in Korea. We analyzed data from the Korean National Health and Nutrition Examination Survey (KNHANES), a population-based survey that included 22,731 women aged 15-49. As age was associated with birth year and was found to be a confounding factor in the analysis of participants' characteristics, we used propensity score matching to assess the characteristics of pregnant women compared with non-pregnant women of the same age and birth year. We also employed the XGBoost machine learning model to identify the most important factors related to pregnancy intentions. Our feature importance analysis showed that weekly working hours were the most significant factor affecting pregnancy intentions. Additionally, we performed cluster analysis and logistic regression models to determine optimal weekly working hours. Cluster analysis identified participants into three distinct groups based on their characteristics, indicating that the group with an average of 34.4±12.9 hours per week had the highest likelihood of becoming pregnant. Logistic regression was used to analyze the odds of pregnancy for every 5-hour increase in weekly working hours. The results of logistic regression indicated that women who worked between 35-45 hours per week had higher odds of pregnancy, with significant odds ratios of 2.009 (95% confidence interval: 1.581-2.547, p < .001) for 40-45 hours per week and 1.450 (95% confidence interval: 1.001-2.040, p < .05) for 35-40 hours per week, compared to women working other hours. In Korea, the standard workweek is typically 40 hours; however, Koreans often work considerably longer hours, with the second-highest number of working hours among OECD countries in 2022. This study suggests that strict monitoring of working hours and expansion of telecommuting for childbearing-age women are important factors in increasing the fertility rate in Korea.
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Affiliation(s)
- Taewook Kim
- Presidential Committee on Aging Society and Population Study, Seoul Government Complex, Seoul, Republic of Korea
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37
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Adane HA, Iles R, Boyle JA, Collie A. Maternal occupational risk factors and preterm birth: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0283752. [PMID: 37432928 DOI: 10.1371/journal.pone.0283752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/15/2023] [Indexed: 07/13/2023] Open
Abstract
INTRODUCTION Preterm birth, which accounts for 33.1% of neonatal death globally, is the main cause of under-five mortality. A growing number of studies indicate that occupational risk factors during pregnancy are linked to an increased likelihood of poor pregnancy outcomes. The effect of physical occupational risks on preterm birth has received very little attention, and previous reviews have produced inconclusive results. This systematic review aims to update the evidence on the relationship between maternal physical occupational risks and preterm birth. METHOD AND ANALYSIS We will search electronic databases including Ovid Medline, Embase, Emcare, CINAHL, Scopus, and Web of science to find peer-reviewed studies examining the relationship between six common maternal physical occupational risks (heavy lifting, prolonged standing, heavy physical exertion, long working hours, shift work, and whole-body vibrations) and preterm birth. Articles published in English after 1 January 2000 will be included without geographic restrictions. Two reviewers will screen titles and abstracts independently, and then select full-text articles that meet inclusion criteria. Methodological quality of the included studies will be evaluated using the Joanna Briggs Institute (JBI) critical appraisal method. The quality of evidence across each exposure and the outcome of interest will be examined by using the GRADE (Grade of Recommendations, Assessment, Development, Evaluation) method. Accordingly, a high level of evidence will lead to "strong recommendations". A moderate level of evidence will lead to "practice considerations". For all evidence levels below moderate, the message will be "not enough evidence from the scientific literature to guide policymakers, clinicians, and patients. If data permits, a meta-analysis will be conducted using Stata Software. In case where meta-analysis is not possible, we will perform a formal narrative synthesis. DISCUSSION AND CONCLUSION Evidence suggests that preterm birth is linked to a number of maternal occupational risk factors. This systematic review will update, compile, and critically review the evidence on the effect of maternal physical occupational risk on preterm birth. This systematic review will provide guidance to support decision-makers including maternal and child health services, other health care providers, and government policy agencies. TRIAL REGISTRATION PROSPERO registration number: CRD42022357045.
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Affiliation(s)
- Haimanot Abebe Adane
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ross Iles
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline A Boyle
- Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alex Collie
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Jeong H, Chae CH, Lee JH, Chong HW. The relationship between shift work pattern and thyroid stimulating hormone in female workers. Ann Occup Environ Med 2023; 35:e14. [PMID: 37614333 PMCID: PMC10442579 DOI: 10.35371/aoem.2023.35.e14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/21/2023] [Accepted: 05/24/2023] [Indexed: 08/25/2023] Open
Abstract
Background Shift work is known to cause changes in the circadian rhythm of the human body and adversely affect not only physical health but also mental health. Some studies have demonstrated the correlation between shift work and thyroid stimulating hormone (TSH), a hormone that changes according to the diurnal rhythm, but few studies have reported the different TSH levels according to the shift work type. This study aimed to investigate changes in TSH according to the shift work type. Methods This study included 1,318 female workers who had a medical checkup at a university hospital in Changwon from 2015 to 2019. Shift work types were classified as non-shift work, regular 2 shifts, and irregular three shifts, and a TSH ≥ 4.2 mIU/L was defined as abnormal. A general linear model (GLM) was used to compare the TSH levels and the risk of subclinical hypothyroidism in each year, and a binary logistic analysis was performed using a generalized estimation equation (GEE) to compare the risk of subclinical hypothyroidism over the 5-year period. Results Of the 1,318 participants included in this study, 363, 711, and 244 were non-shift, two-shift, and irregular three-shift workers, respectively. In the GEE analysis, after adjusting for age, body mass index, smoking, and alcohol consumption, the odds ratios (ORs) were 1.81 (95% confidence interval [CI]: 1.15-2.86; p = 0.011) in 2 shifts and 2.02 (95% CI: 1.23-3.32; p = 0.006) in irregular three shifts, compared to non-shift. Conclusions Our results showed that shift work had a higher risk of subclinical hypothyroidism than non-shift work and that there was a significant difference in the risk of subclinical hypothyroidism according to the shift work type. These findings suggest that the shift work type can be considered in future thyroid function tests and evaluations.
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Affiliation(s)
- Hun Jeong
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Chang Ho Chae
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Jun Ho Lee
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hyo Won Chong
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Zeman M, Okuliarova M, Rumanova VS. Disturbances of Hormonal Circadian Rhythms by Light Pollution. Int J Mol Sci 2023; 24:ijms24087255. [PMID: 37108420 PMCID: PMC10138516 DOI: 10.3390/ijms24087255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
The circadian rhythms evolved to anticipate and cope with cyclic changes in environmental conditions. This adaptive function is currently compromised by increasing levels of artificial light at night (ALAN), which can represent a risk for the development of diseases of civilisation. The causal links are not completely understood, and this featured review focuses on the chronodisruption of the neuroendocrine control of physiology and behaviour by dim ALAN. The published data indicate that low levels of ALAN (2-5 lux) can attenuate the molecular mechanisms generating circadian rhythms in the central oscillator, eliminate the rhythmic changes in dominant hormonal signals, such as melatonin, testosterone and vasopressin, and interfere with the circadian rhythm of the dominant glucocorticoid corticosterone in rodents. These changes are associated with a disturbed daily pattern of metabolic changes and behavioural rhythms in activity and food and water intake. The increasing levels of ALAN require the identification of the pathways mediating possible negative consequences on health to design effective mitigation strategies to eliminate or minimise the effects of light pollution.
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Affiliation(s)
- Michal Zeman
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University, 842 15 Bratislava, Slovakia
| | - Monika Okuliarova
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University, 842 15 Bratislava, Slovakia
| | - Valentina Sophia Rumanova
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University, 842 15 Bratislava, Slovakia
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Knell J, Kim ES, Rangel EL. The Challenges of Parenthood for Female Surgeons: The Current Landscape and Future Directions. J Surg Res 2023; 288:A1-A8. [PMID: 37055286 DOI: 10.1016/j.jss.2023.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 04/15/2023]
Abstract
Although surgical training programs have nearly reached gender parity, pregnancy and parenthood remain challenging for female surgeons, with obstetric risks related to occupational demands, stigma, inconsistent and brief parental leaves, a paucity of postpartum support for lactation and childcare, and little mentorship on work-family integration. This work environment causes many to postpone starting a family, which leads to higher risks of infertility among female surgeons compared to their male peers. Perception of work-family incompatibility jeopardizes recruitment and retention of our surgical workforce, as it deters medical students from the profession, increases risk of resident attrition, and leads to burnout and career dissatisfaction. The challenges of parenthood for female surgeons was the focus of a Hot Topics session during the 2022 Academic Surgical Congress, the discussion of which is presented herein with recommendations for policy change to better support maternal-fetal health and the needs of surgeons with young children.
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Affiliation(s)
- Jamie Knell
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Eugene S Kim
- Division of Pediatric Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Erika L Rangel
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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Guan Y, Xu M, Zhang Z, Liu C, Zhou J, Lin F, Fang J, Zhang Y, Yue Q, Zhen X, Yan G, Sun H, Liu W. Maternal circadian disruption before pregnancy impairs the ovarian function of female offspring in mice. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:161161. [PMID: 36572306 DOI: 10.1016/j.scitotenv.2022.161161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/02/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Circadian disturbance brought on by shift employment, nighttime light pollution, and other factors is quite prevalent in contemporary culture. However, the effect of maternal circadian disruption before pregnancy on the reproduction of offspring in mice requires further research. Herein, we exposed female ICR mice to constant light to establish a model of preconceptional circadian disruption and then checked the ovarian function of female offspring (named the CLE group below). Our results revealed obesity, abnormal lipid metabolism and earlier puberty onset in the CLE group. Additionally, impaired ovarian follicle development, oocyte quality and preimplantation embryo development were shown in the CLE group. Moreover, the expression levels of Gnrh1 in the hypothalamus and Cyp17a1, Bmper, Bdnf and Lyve1 in ovaries, as well as circadian clock genes, including Clock, Cry1, Nr1d2 and Per2, were significantly downregulated in the CLE group. Mechanistically, immune responses, including the interleukin-17 (IL-17) signalling pathway, cytokine-cytokine receptor interaction and the chemokine signalling pathway, were altered in the CLE group, which may be responsible for the damaged ovarian function.
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Affiliation(s)
- Yajie Guan
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Manlin Xu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Zhe Zhang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Chuanming Liu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Jidong Zhou
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Fei Lin
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Junshun Fang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Yang Zhang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Qiuling Yue
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Xin Zhen
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Guijun Yan
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China.
| | - Haixiang Sun
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Wenwen Liu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China; Center for Molecular Reproductive Medicine, Nanjing University, Nanjing, Jiangsu, China.
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Li Y, Zhang H, Wang Y, Li D, Chen H. Advances in circadian clock regulation of reproduction. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2023; 137:83-133. [PMID: 37709382 DOI: 10.1016/bs.apcsb.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
The mammalian circadian clock is an endogenously regulated oscillator that is synchronized with solar time and cycle within a 24-h period. The circadian clock exists not only in the suprachiasmatic nucleus (SCN) of the hypothalamus, a central pacemaker of the circadian clock system, but also in numerous peripheral tissues known as peripheral circadian oscillators. The SCN and peripheral circadian oscillators mutually orchestrate the diurnal rhythms of various physiological and behavioral processes in a hierarchical manner. In the past two decades, peripheral circadian oscillators have been identified and their function has been determined in the mammalian reproductive system and its related endocrine glands, including the hypothalamus, pituitary gland, ovaries, testes, uterus, mammary glands, and prostate gland. Increasing evidence indicates that both the SCN and peripheral circadian oscillators play discrete roles in coordinating reproductive processes and optimizing fertility in mammals. The present study reviews recent evidence on circadian clock regulation of reproductive function in the hypothalamic-pituitary-gonadal axis and reproductive system. Additionally, we elucidate the effects of chronodisruption (as a result of, for example, shift work, jet lag, disrupted eating patterns, and sleep disorders) on mammalian reproductive performance from multiple aspects. Finally, we propose potential behavioral changes or pharmaceutical strategies for the prevention and treatment of reproductive disorders from the perspective of chronomedicine. Conclusively, this review will outline recent evidence on circadian clock regulation of reproduction, providing novel perspectives on the role of the circadian clock in maintaining normal reproductive functions and in diseases that negatively affect fertility.
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Affiliation(s)
- Yating Li
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, P.R. China; Key Laboratory of Animal Biotechnology of the Ministry of Agriculture and Rural Affairs, Northwest A&F University, Yangling, Shaanxi, P.R. China
| | - Haisen Zhang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, P.R. China; Key Laboratory of Animal Biotechnology of the Ministry of Agriculture and Rural Affairs, Northwest A&F University, Yangling, Shaanxi, P.R. China
| | - Yiqun Wang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, P.R. China; Key Laboratory of Animal Biotechnology of the Ministry of Agriculture and Rural Affairs, Northwest A&F University, Yangling, Shaanxi, P.R. China
| | - Dan Li
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, P.R. China; Key Laboratory of Animal Biotechnology of the Ministry of Agriculture and Rural Affairs, Northwest A&F University, Yangling, Shaanxi, P.R. China
| | - Huatao Chen
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, P.R. China; Key Laboratory of Animal Biotechnology of the Ministry of Agriculture and Rural Affairs, Northwest A&F University, Yangling, Shaanxi, P.R. China.
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Goodman JM, Colon M, Cottrell EK, Guise JM. Work as a social risk factor in pregnancy: A systematic review of screening practices related to working conditions and family leave among pregnant adults. Birth 2023; 50:32-43. [PMID: 36455239 PMCID: PMC9992310 DOI: 10.1111/birt.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/04/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Paid family leave and working conditions are components of employment quality-a key social determinant of health across the life course, particularly during pregnancy. Increased research on prenatal social risk screening has not extended to employment quality. The objective of this systematic review was to identify prenatal screening practices and interventions in health care settings that address employment and working conditions as social risk factors among pregnant adults and to describe their properties and key findings. METHOD We searched MEDLINE, PsychINFO, SocINDEX, EMBASE, and the SIREN Evidence and Resource Library for studies published through February 14, 2022. We selected multiple search terms related to four domains: (1) employment or working conditions; (2) screening; (3) health care settings; and (4) pregnancy or maternal health. RESULTS Of the 2317 unique titles and abstracts that were potentially relevant, eight articles met all inclusion criteria and focused on pregnant populations. The content of identified screening practices varied substantially, highlighting the multiple ways employment is conceptualized as a potential risk factor. Few studies included multidimensional measures of employment to assess working conditions, which may be particularly relevant during pregnancy. CONCLUSIONS Our review suggests that screening for employment as a social risk factor does not regularly occur in prenatal care. Although pragmatic properties of the screening tools we assessed are promising, tools seldom examine the multidimensional nature of work. Understanding the principal intent of screening for employment prenatally could provide greater opportunity to collect and interpret contextual factors that influence how both providers and patients respond to social risk.
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Affiliation(s)
| | - Mina Colon
- OHSU-PSU School of Public Health, Portland, OR
| | - Erika K. Cottrell
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland OR
| | - Jeanne-Marie Guise
- Departments of Obstetrics and Gynecology, Medical Informatics and Clinical Epidemiology, Public Health & Preventive Medicine, and Emergency Medicine; Oregon Health & Science University, Portland OR
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Contributors to Preterm Birth: Data from a Single Polish Perinatal Center. CHILDREN 2023; 10:children10030447. [PMID: 36980005 PMCID: PMC10047259 DOI: 10.3390/children10030447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/09/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023]
Abstract
Preterm birth may result from overlapping causes including maternal age, health, previous obstetric history and a variety of social factors. We aimed to identify factors contributing to preterm birth in respect to new social and environmental changes in the reproductive patterns. Our cross-sectional study included 495 mother–infant pairs and was based on maternal self-reporting in an originally developed questionnaire. Neonates were divided into two groups: 72 premature babies (study group) and 423 full-term babies (control group). We analyzed maternal, sociodemographic and economic characteristics, habits, chronic diseases, previous obstetric history and pregnancy complications. For statistical analysis, Pearson’s Chi-squared independence test was used with a statistical significance level of 0.05. Preterm births were more common among mothers living in villages (p < 0.001) and with lower education level (p = 0.01). Premature births were also positively associated with mothers who were running their own businesses (p = 0.031). Mothers with a history of previous miscarriages gave birth at a significantly older age (p < 0.001). The most frequent pregnancy complications were hypothyroidism (41.4%), pregestational and gestational diabetes mellitus (DM; 17.8%) and hypertension (8.1%). Pregestational DM significantly influenced the occurrence of prematurity (p < 0.05). Pregestational DM, being professionally active, a lower education level and living outside cities are important risk factors of prematurity.
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Marsters CM, Stafl L, Bugden S, Gustainis R, Nkunu V, Reimer R, Fletcher S, Smith S, Bruton Joe M, Hyde C, Dance E, Ruzycki SM. Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review. BMJ Open 2023; 13:e064483. [PMID: 36813500 PMCID: PMC9950931 DOI: 10.1136/bmjopen-2022-064483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes. DESIGN Scoping review. DATA SOURCES MEDLINE/PubMed, EMBASE, CINAHL/ EBSCO, SciVerse Scopus and Web of Science/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations. ELIGIBILITY CRITERIA English language citations that studied employed pregnant people and any 'physician-related occupational hazards', meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication. DATA EXTRACTION AND SYNTHESIS Physician-related occupational hazards included physician work, healthcare work, long work hours, 'demanding' work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion. RESULTS Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth. CONCLUSIONS There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.
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Affiliation(s)
- Candace M Marsters
- Department of Neurology, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Lenka Stafl
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Bugden
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | - Victoria Nkunu
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Renee Reimer
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Fletcher
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Smith
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Moss Bruton Joe
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christine Hyde
- Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Erica Dance
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon M Ruzycki
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Marqueze EC, de Sá e Benevides EA, Russo AC, Fürst MSG, Roscani RC, Guimarães PCV, Salim CA. Organizational Risk Factors for Aircrew Health: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3401. [PMID: 36834104 PMCID: PMC9960399 DOI: 10.3390/ijerph20043401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/12/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Addressing the field of health and safety at work, the primary objective of the present systematic review was to analyze the organizational risk factors for aircrew health according to professional category (flight attendants and pilots/co-pilots) and their consequences. The secondary objective was to identify the countries in which studies were carried out, focusing on the quality of content of the publications. The Medline/Pubmed, Cochrane, Web of Science, and Scopus databases were searched for eligible studies according to PRISMA statements. The risk of bias and the methodological quality of the studies were assessed using the Newcastle-Ottawa scale and Loney tools. Of the 3230 abstracts of articles screened, 36 studies met the inclusion criteria. Most of the research conducted on risk factors for the work organization of aircrew was carried out in the United States and the European Union and had moderate or low-quality methodology and evidence. However, the findings are homogeneous and allow the most prevalent organizational risk factors for the health of aircrew to be determined, namely, high work demand, long hours, and night work. Consequently, the most pervasive health problems were sleep disturbances, mental health disorders, musculoskeletal disorders, and fatigue. Thus, the regulation of the aircrew profession must prioritize measures that minimize these risk factors to promote better health and sleep for these professionals and, consequently, to provide excellent safety for workers and passengers.
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Affiliation(s)
- Elaine Cristina Marqueze
- Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho—Fundacentro, São Paulo 30180-100, Brazil
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Yu Y, Groth SW. Risk factors of lower birth weight, small-for-gestational-age infants, and preterm birth in pregnancies following bariatric surgery: a scoping review. Arch Gynecol Obstet 2023; 307:343-378. [PMID: 35332360 DOI: 10.1007/s00404-022-06480-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/17/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Bariatric surgery increases the risk of lower birth weight, small-for-gestational-age (SGA) infants, and preterm birth in a subsequent pregnancy. However, the factors that contribute to these adverse birth outcomes are unclear. This review aimed to collate available information about risk factors of lower birth weight, SGA, and preterm birth following bariatric surgery. METHODS A literature search was conducted using five databases (PubMed, PsycINFO, EMBASE, Web of Science, and Cochrane Library) to obtain relevant studies. RESULTS A total number of 85 studies were included. Studies generally excluded surgery-to-conception interval, pregnancy complications, cigarette use, and maternal age as influencing factors of birth weight, SGA, or preterm birth. In contrast, most studies found that malabsorptive procedures, lower gestational weight gain, lower glucose levels, abdominal pain, and insufficient prenatal care were associated with an elevated risk of adverse birth outcomes. Findings were mixed regarding the effects of surgery-to-conception weight loss, pre-pregnancy body mass index, micronutrient deficiency, and lipid levels on birth outcomes. The examination of maternal microbiome profiles, placental function, alcohol use, and exercise was limited to one study; therefore, no conclusions could be made. CONCLUSION This review identified factors that appear to be associated (e.g., surgery type) or not associated (e.g., surgery-to-conception interval) with birth outcomes following bariatric surgery. The mixed findings and the limited number of studies on several variables (e.g., micronutrients, exercise) highlight the need for further investigation. Additionally, future studies may benefit from exploring interactions among risk factors and expanding to assess additional exposures such as maternal mental health.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Susan W Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA
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Margerison CE, Bruckner TA, MacCallum-Bridges C, Catalano R, Casey JA, Gemmill A. Exposure to the early COVID-19 pandemic and early, moderate and overall preterm births in the United States: A conception cohort approach. Paediatr Perinat Epidemiol 2023; 37:104-112. [PMID: 35830303 PMCID: PMC9350314 DOI: 10.1111/ppe.12894] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/27/2022] [Accepted: 05/01/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND The United States (US) data suggest fewer-than-expected preterm births in 2020, but no study has examined the impact of exposure to the early COVID-19 pandemic at different points in gestation on preterm birth. OBJECTIVE Our objective was to determine-among cohorts exposed to the early COVID-19 pandemic-whether observed counts of overall, early and moderately preterm birth fell outside the expected range. METHODS We used de-identified, cross-sectional, national birth certificate data from 2014 to 2020. We used month and year of birth and gestational age to estimate month of conception for birth. We calculated the count of overall (<37 weeks gestation), early (<33 weeks gestation) and moderately (33 to <37 weeks gestation) preterm birth by month of conception. We employed time series methods to estimate expected counts of preterm birth for exposed conception cohorts and identified cohorts for whom the observed counts of preterm birth fell outside the 95% detection interval of the expected value. RESULTS Among the 23,731,146 births in our study, the mean prevalence of preterm birth among monthly conception cohorts was 9.7 per 100 live births. Gestations conceived in July, August or December of 2019-that is exposed to the early COVID-19 pandemic in the first or third trimester-yielded approximately 3245 fewer moderately preterm and 3627 fewer overall preterm births than the expected values for moderate and overall preterm. Gestations conceived in August and October of 2019-that is exposed to the early COVID-19 pandemic in the late second to third trimester-produced approximately 498 fewer early preterm births than the expected count for early preterm. CONCLUSIONS Exposure to the early COVID-19 pandemic may have promoted longer gestation among close-to-term pregnancies, reduced risk of later preterm delivery among gestations exposed in the first trimester or induced selective loss of gestations.
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Affiliation(s)
| | - Tim A. Bruckner
- Department of Health, Society, and Behavior, and the Center for Population, Inequality, and Policy, University of California, Irvine
| | | | - Ralph Catalano
- School of Public Health, University of California, Berkeley
| | - Joan A. Casey
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health
| | - Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health
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Wang X, He C, Wu N, Tian Y, Wang L, Liao J, Fang D, Liu X, An S, Chen W, Xiong S, Liu Y, Xie Y, Tian K, Huang J, Yuan H, Chen X, Zhang L, Li Q, Shen X, Zhou Y. Maternal urine phthalate metabolite exposure and miscarriage risk: a nested case-control study of the Zunyi Birth Cohort. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:23124-23134. [PMID: 36318415 DOI: 10.1007/s11356-022-23717-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Phthalates (PAEs) are widespread persistent organic pollutants and endocrine disruptors. However, the associations between PAE exposure and the risk of miscarriage in humans are unclear, and an insufficient number of studies have evaluated the possible threshold or dose-dependent effects of first trimester PAE exposure on miscarriage risk. Our research measured the levels of mono-methyl phthalate (MMP), mono-ethyl phthalate, mono-isobutyl phthalate, MiBP mono-butyl phthalate (MBP), mono-octyl phthalate, mono-benzyl phthalate, mono(2-ethylhexyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate, and mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) in maternal urine collected in early gestation between 150 pregnancies ending in miscarriage and 150 pregnancies with live birth. We also estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for miscarriage and each PAE as a continuous variable or quartile. A restrictive cubic splines was used to assess dose-dependent effects after controlling for maternal characteristics (e.g., age, educational level). we identified monotonically increasing dose-dependent effects of MEHHP and MMP on the risk of miscarriage. The largest effect estimates were approximately threefold higher for the highest MBP (OR = 2.57; 95% CI = 1.32-5.01) or MMP quartile (OR = 3.57; 95% CI = 1.82-7.00) and two-fold higher for the highest MEHHP quartile (OR = 2.12; 95% CI = 1.10-4.11). Our research preliminarily obtained possible thresholds of MBP, MEHHP, and MMP which were 18.07, 2.38, and 0.80 µg/g Cr for the risk of miscarriage, respectively. First-trimester exposure to MBP, MEHHP, and MMP exceeding certain thresholds increases the risk of miscarriage.
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Affiliation(s)
- Xia Wang
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Caidie He
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Nian Wu
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Yingkuan Tian
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Linglu Wang
- Department of Obstetrics, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Lu, Zunyi, 563006, People's Republic of China
| | - Juan Liao
- Department of Obstetrics, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Lu, Zunyi, 563006, People's Republic of China
| | - Derong Fang
- Department of Obstetrics, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Lu, Zunyi, 563006, People's Republic of China
| | - Xiang Liu
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Songlin An
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Wei Chen
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Shimin Xiong
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Yijun Liu
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Yan Xie
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Kunming Tian
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Jingyi Huang
- The People's Hospital of Xishui County, Chishui Xilu, Xishui County, Zunyi, Guizhou Province, 564600, People's Republic of China
| | - Hongyu Yuan
- The People's Hospital of Xishui County, Chishui Xilu, Xishui County, Zunyi, Guizhou Province, 564600, People's Republic of China
| | - Xiaoshan Chen
- The People's Hospital of Meitan County, Chacheng Avenue, Meitan County, Zunyi, Guizhou Province, 564100, People's Republic of China
| | - Li Zhang
- The People's Hospital of Meitan County, Chacheng Avenue, Meitan County, Zunyi, Guizhou Province, 564100, People's Republic of China
| | - Quan Li
- Department of Obstetrics, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Lu, Zunyi, 563006, People's Republic of China
| | - Xubo Shen
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, No. 6 Xuefu Xilu, Zunyi, 563006, People's Republic of China.
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Van Drunen R, Eckel-Mahan K. Circadian rhythms as modulators of brain health during development and throughout aging. Front Neural Circuits 2023; 16:1059229. [PMID: 36741032 PMCID: PMC9893507 DOI: 10.3389/fncir.2022.1059229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/08/2022] [Indexed: 01/20/2023] Open
Abstract
The circadian clock plays a prominent role in neurons during development and throughout aging. This review covers topics pertinent to the role of 24-h rhythms in neuronal development and function, and their tendency to decline with aging. Pharmacological or behavioral modification that augment the function of our internal clock may be central to decline of cognitive disease and to future chronotherapy for aging-related diseases of the central nervous system.
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