A narrative review on factors associated with job interruption during pregnancy

Sick Leave and Its Associated Factors Among Pregnant Working Women in Egypt

BACKGROUND

As more women enter the workforce, particularly during their childbearing years, high sick leave rates during pregnancy are observed. The current study aimed to measure the prevalence and predictors of sick leave among pregnant workers and to compare it with pre-pregnancy levels.

METHODS

A self-controlled, cross-sectional survey was conducted on 384 pregnant working women using an interviewer-administered questionnaire. Data included sociodemographic, medical, obstetric, and occupational histories, and details of sick leave during pregnancy and the preceding 9 months. Logistic regression analysis was used to identify significant independent predictors of sick leave during pregnancy.

RESULTS

Prevalence of sick leave was significantly higher during pregnancy compared to the prior 9 months and in the third trimester compared to the other trimesters. Significant predictors were sociodemographic factors [adverse health (adjusted odd ration (AOR) 5.5; 95% CI 2.25-13.54), obstetric history (AOR 2.9; 95% CI 1.48-5.50) and multiparity (AOR 2.2; 95% CI 1.15-4.06)], and work-related factors [strenuous (AOR 16.9; 95% CI 5.91-48.35), or medium-skill occupations (AOR 14.1; 95% CI 3.85-50.32), and low job control (AOR 21.1; 95% CI 8.79-50.32)]. Pregnancy-related significant predictors were infertility treatment (AOR 11.4; 95% CI 2.4-54.2), nausea and vomiting (AOR 6.6; 95% CI 3.1-14.4), neck/back pain (AOR 6.1; 95% CI 3.1-11.9), and respiratory infections (AOR 3.1; 95% CI 1.6-6.2).

CONCLUSION

In Egypt, sick leave is common during pregnancy, particularly in the third trimester, due to factors related to work, health, and pregnancy. Workplace adjustments, such as flexible schedules and reduced physical demands, could help minimize sick leave and support pregnant employees.

Use of benefits during pregnancy: a cohort study in four organisations in Spain

Objectives

To analyse the use of either sick leave (SL) benefit and/or pregnancy-related occupational risk (POR) benefit by workers taking work absence during pregnancy.

Methods

Retrospective cohorts of working women from the beginning to the end of pregnancy in three public hospitals and one pharmaceutical company, between 2015 and 2019. We measured the frequency and duration of absences, by age and occupational variables, and cumulative absence days, classifying work status as at work, on SL and on POR absence. Differences between groups for each variable were analysed through the Kruskal-Wallis rank test followed by Dunn's Pairwise Comparisons. Sequence analysis was used to identify pregnancy trajectories.

Results

Among 1116 pregnant workers, absence days due to SL ranged from 9.9% to 28.6% of total possible working days, from 9.2% to 38.4% due to POR, while only 3.9% did not take any absence. Nurse aides and nurses used benefits most often and for the longest duration with respect to other occupational categories (p value<0.001). Age had no statistically significant difference (p value=0.245). Three pregnancy trajectories were identified, characterised by mostly active work, active work combined with POR and active work with SL, with differences by workplace, occupation and work area (p value<0.001). The total time in days during which pregnant women were actively working ranged between 56% and 64% depending on the organisation.

Conclusions

This study in four organisations shows a very similar pattern regarding total time absent from work during pregnancy. Women were actively working for two-thirds of their pregnancy. Of the remaining time, while in two organisations, absences were mainly due to SL, in other two were due to POR. Organisational variations in the management of pregnant women could be an explanation. We need further investigation on this topic.

Predictors of the return to work for pregnant employees on preventive leave: Patients from an occupational medicine consultation in Switzerland

According to the Swiss legislation on maternity protection in the workplace (OProMa), if pregnant workers are exposed to occupational hazards and no protective measures are taken, a gynecologist will prescribe a certificate of preventive leave and the women must stop working. Returning to work is only possible if job adjustments are made. This study aims to evaluate the burden of absences on companies and to examine the predictors of the return to work for pregnant workers on preventive leave, by examining both the probability of return to work and the time required to return to work. The study sample includes data on 258 workplaces of pregnant workers on preventive leave, collected during an occupational medicine consultation aimed at supporting the implementation of the OProMa. Information is available on the worker (age, date of consultation), the hazards to which she is exposed, the company's knowledge of the OProMa and whether a risk analysis exists. Descriptive statistics and multivariate regression analysis are carried out. In 58% of the workplaces, it was not possible to return to work before the end of the pregnancy. This corresponds to an average absence of 4.5 months. In 42% of the workplaces, a return to work was possible thanks to workplace adaptations. A conforming risk analysis and a full knowledge of the OProMa for companies, and an early visit to the occupational medicine consultation for workers are good predictors of the likelihood of returning to work. Younger age and exposure to certain types of risks are factors that influence the duration of preventive leave. The implementation of OProMa in Switzerland poses serious challenges, but early identification of occupational hazards and practices that anticipate compliance with the law in the company increase the return to work in safety for pregnant workers.