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Heroual N, Boukfoussa N, Houti L. [Epidemiology and risk factors for preterm births in north-western Algeria]. Pan Afr Med J 2024; 47:183. [PMID: 39092017 PMCID: PMC11293476 DOI: 10.11604/pamj.2024.47.183.40657] [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: 06/03/2023] [Accepted: 02/25/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction preterm births continue to be the main cause of infant and child mortality as well as sensory-motor disabilities and neurodevelopmental difficulties worldwide. The rate of preterm births has been rising, in particular in Algeria. The purpose of this study is to determine the frequency of preterm births in the Oran Wilaya and to identify risk factors. Methods we used data from a multicentre cross-sectional study carried out in all Public Maternity Hospitals in the Oran Wilaya (13). The study included parturient women who had given birth to a live and/or stillborn child (with birthweights ≥500 g), whose gestational age was greater than or equal to 24-36 weeks of amenorrhoea. Mothers´ demographic, medical and socio-behavioural factors were recorded. Logistic regression was used to study predictors of prematurity. Results preterm birth rate was 9.9% (45/452). The average age of patients was 30.4±6 years; multiple pregnancies accounted for 2.2% of births. Factors related to prematurity were the risk of premature labour (aOR=4.68; 95% CI: 2.27-9.64), the lack of clinical monitoring of pregnancy (OR=2.83; CI 95%: 1.83-6.05) and gestational hypertension (aOR = 3.69, 95% CI: 1.83-8.8). Conclusion the rate of preterm births is in line with the rate observed in neighbouring countries. The study identified predictive factors, some of which are already targeted by the national perinatal program. However, it is essential to continue to lead efforts to improve the monitoring and management of pregnancies and premature births at all levels of care.
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Affiliation(s)
- Nabila Heroual
- Centre Hospitalo-universitaire d´Oran, Oran, Algérie
- Labsis, Faculté de médecine Université Oran 1, Labsis, Algérie
| | | | - Leila Houti
- Labsis, Faculté de médecine Université Oran 1, Labsis, Algérie
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Donzelli G, Marcos-Puig B, Peraita-Costa I, Llopis-Morales J, Morales-Suarez-Varela M. Occupational Exposure during Pregnancy and Effects on Newborns: A Nested Case-Control Study. Life (Basel) 2023; 13:1962. [PMID: 37895344 PMCID: PMC10608645 DOI: 10.3390/life13101962] [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: 08/14/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The protection of pregnant workers should be based on evidence regarding the risks to reproductive health from exposure to specific work environments and conditions. The objective of this study was to identify the effects on mothers and newborns resulting from environmental exposure to various occupational risks. METHODS The study cohort was composed of 399 women admitted to the Obstetrics/Postpartum ward at Hospital La Fe in Valencia, Spain. Face-to-face interviews were conducted to establish associations between workplace exposure during pregnancy and its effects on maternal and newborn health. Sex, anthropometric characteristics, and blood gas analysis in arterial and venous umbilical cord blood at delivery were collected. RESULTS A total of 138 women were exposed to biological and/or chemical risks, 122 to physical risks, and 139 at no risk of exposure. In the group with chemical and/or biological risks, the frequency of women who resorted to in vitro fertilization to achieve the studied pregnancy is less than half of the group exposed to physical risks, with statistically significant differences (p = 0.047). The mean values for the arterial analysis in both exposure groups were within average values, with similar pH values between them, but the mean values of PCO2 and PO2 were lower in the group of neonates of mothers exposed to physical risks, with a significant difference for arterial PO2 (p = 0.027). CONCLUSION Our analysis contributes evidence for planning and prioritizing preventive actions to protect women's reproductive health. The results suggest the continuation of a future project that would consider more factors and potentially increase the sample size.
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Affiliation(s)
- Gabriele Donzelli
- Institute of Clinical Physiology of the National Research Council (CNR-IFC), 56124 Pisa, Italy;
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Beatriz Marcos-Puig
- Department of Gynecology and Obstetrics, La Fé University and Polytechnic Hospital, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain;
| | - Isabel Peraita-Costa
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, Burjassot, 46100 Valencia, Spain;
- Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Spain
| | - Juan Llopis-Morales
- Faculty of Pharmacy, Universidad Alfonso X el Sabio, Avda. de la Universidad 1, Villanueva de la Cañada, 28691 Madrid, Spain;
| | - María Morales-Suarez-Varela
- Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estelles s/n, Burjassot, 46100 Valencia, Spain;
- Biomedical Research Center in Epidemiology and Public Health Network (CIBERESP), Carlos III Health Institute, Av. Monforte de Lemos 3-5 Pabellón 11 Planta 0, 28029 Madrid, Spain
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van Beukering MDM, van Melick MJGJ, Duijnhoven RG, Schuit E, Liem SL, Frings-Dresen MHW, van de Wetering AJP, Spaanderman MEA, Kok M, Mol BW. Working conditions in women with multiple pregnancy-the impact on preterm birth and adherence to guidelines: a prospective cohort study. Am J Obstet Gynecol 2023; 228:734.e1-734.e16. [PMID: 36379267 DOI: 10.1016/j.ajog.2022.11.1281] [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: 06/29/2022] [Revised: 10/22/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women with multiple pregnancies are at risk for maternal complications such as preterm birth. Hazardous working conditions, such as physically demanding work and long and irregular working hours, might increase the risk of preterm birth. OBJECTIVE This study primarily aimed to determine whether certain working conditions up to 20 weeks of pregnancy increase the risk of preterm birth in multiple pregnancies. The secondary objective was to evaluate whether the working conditions of Dutch women with multiple pregnancy have been adjusted to the guidelines of the Netherlands Society of Occupational Medicine. STUDY DESIGN We performed a prospective cohort study alongside the ProTWIN trial, a multicenter randomized controlled trial that assessed whether cervical pessaries could effectively prevent preterm birth. Women with paid work of >8 hours per week completed questionnaires concerning general health and working conditions between 16 and 20 weeks of pregnancy. Univariable and multivariable logistic regression analyses were performed to identify work-related factors associated with preterm birth (32-36 weeks' gestation) and very preterm birth (<32 weeks' gestation). We analyzed a subgroup of participants who worked for more than half of the week (>28 hours). We calculated the proportion of women who reported work-related factors not in accordance with guidelines. RESULTS We studied 383 women, of whom 168 (44%) had been randomized to pessary, 142 (37%) to care as usual, and 73 (19%) did not participate in the randomized part of the study. After adjusting for confounding variables, working >28 hours was associated with very preterm birth (n=33; 78%) (adjusted odds ratio, 3.0; 95% confidence interval, 1.1-8.1), and irregular working times were associated with preterm birth (n=26, 17%) (adjusted odds ratio, 2.0; 95% confidence interval, 1.0-4.1) and very preterm birth (n=10; 24%) (adjusted odds ratio, 2.7; 95% confidence interval, 1.0-7.3). Within a subgroup of 213 participants working >28 hours per week, multivariable analysis showed that irregular working times (n=16; 20%) (adjusted odds ratio, 3.5; 95% confidence interval, 1.2-10.1) and no/little freedom in performance of tasks (n=23; 28%) (adjusted odds ratio, 3.0; 95% confidence interval, 1.3-7.3) were associated with preterm birth. Irregular working times (n=9; 27%) (adjusted odds ratio, 3.4; 95% confidence interval, 1.0-11.1), requiring physical strength (n=9; 27%) (adjusted odds ratio, 5.3; 95% confidence interval, 1.6-17.8), high physical workload (n=7; 21%) (adjusted odds ratio, 3.9; 95% confidence interval, 1.1-13.9), and no/little freedom in performing tasks (n=10; 30%) (adjusted odds ratio, 3.2; 95% confidence interval, 1.1-9.6) were associated with very preterm birth. Before 20 weeks of pregnancy, 224 (58.5%) women with multiple pregnancy continued to work under circumstances that were not in accordance with the guidelines. CONCLUSION In our cohort study, nearly 60% of women with multiple pregnancy continued to work under circumstances not in accordance with the guidelines to avoid physical and job strain and long and irregular working hours. Irregular hours were associated with preterm and very preterm birth, and long hours were associated with preterm birth.
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Affiliation(s)
- Monique D M van Beukering
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| | - Marjo J G J van Melick
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Ruben G Duijnhoven
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ewoud Schuit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Sophie L Liem
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Monique H W Frings-Dresen
- Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health, Amsterdam, the Netherlands
| | | | - Marc E A Spaanderman
- Department of Obstetrics and Gynaecology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marjolein Kok
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia; Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
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Enderle I, De Lauzun V, Metten MA, Monperrus M, Delva F, Blanc-Petitjean P, Dananche B, Paris C, Zaros C, Le Lous M, Béranger R, Garlantézec R. Maternal occupational exposure to organic solvents and intrauterine growth in the ELFE cohort. ENVIRONMENTAL RESEARCH 2023; 224:115187. [PMID: 36587719 DOI: 10.1016/j.envres.2022.115187] [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: 10/26/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In developed countries, about 15% of women are occupationally exposed to solvents. Associations between this maternal occupational exposure and intrauterine fetal growth are inconsistent, but almost no existing study has investigated this relation by solvent family (oxygenated, petroleum, and chlorinated), although they may affect fetal growth differently. OBJECTIVES To investigate the relations between maternal occupational solvent exposure, by solvent family, and the risk of neonates born small for gestational age (SGA), or with low birthweight, or with small head circumference (HC). METHODS Among the 18,040 women enrolled in the Elfe rather than included in the Elfe birth cohort, we included 13,026 women who worked during pregnancy (72% of the cohort). Information about maternal occupations and industrial activities during pregnancy was collected by questionnaire at the maternity ward, and completed at 2-month when necessary. Using Matgéné job-exposure matrices, we assessed maternal occupational exposure to solvents. Logistic and multiple linear regressions were used to assess the association between maternal occupational solvent exposure and SGA status, birth weight, and HC. Analyses were conducted for exposure during pregnancy and also stratified by the trimester that pregnancy leave began. RESULTS We observed a higher risk of SGA newborns among mothers occupationally exposed during pregnancy to petroleum solvents (ORadjusted = 1.26; 95%CI: 1.01 to 1.57). Among women working until the third trimester of pregnancy, we observed a higher risk of SGA newborns to those occupationally exposed to oxygenated solvents (ORadjusted = 1.75; 95%CI: 1.11 to 2.75), a significantly lower birthweight for infants of mothers exposed to petroleum solvents (βadjusted = -47.37 g; -89.33 to -5.42), and a lower HC among newborns of those occupationally exposed to oxygenated solvents (βadjusted = -0.28; -0.49 to -0.07) and to chlorinated solvents (βadjusted = -0.29; -0.53 to -0.05). DISCUSSION Our results suggest that maternal occupational solvent exposure may influence fetal growth, especially exposure into the third trimester of pregnancy.
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Affiliation(s)
- Isabelle Enderle
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Department of Obstetrics and Gynecology and Reproductive Medicine, Anne de Bretagne University Hospital, Rennes, France.
| | - Virginie De Lauzun
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Marie Astrid Metten
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Marion Monperrus
- Department of Obstetrics and Gynecology and Reproductive Medicine, Anne de Bretagne University Hospital, Rennes, France
| | - Fleur Delva
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Bordeaux, F-33000, France
| | - Pauline Blanc-Petitjean
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Brigitte Dananche
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Christophe Paris
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Cécile Zaros
- French Institute for Demographic Studies (Ined), French Institute for Medical Research and Health (Inserm), French Blood Agency, ELFE Joint Unit, F-75020, Paris, France
| | - Maela Le Lous
- Department of Obstetrics and Gynecology and Reproductive Medicine, Anne de Bretagne University Hospital, Rennes, France
| | - Rémi Béranger
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Department of Obstetrics and Gynecology and Reproductive Medicine, Anne de Bretagne University Hospital, Rennes, France
| | - Ronan Garlantézec
- CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
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Wang M, Li L, Kang H, Xu H, Huang Q, Li N, Deng Y, Yu P, Liu Z. Maternal environmental, occupational, and urinary metabolite levels of benzene compounds and their association with congenital heart diseases in offspring: a case‒control study in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:66021-66032. [PMID: 37095212 PMCID: PMC10182929 DOI: 10.1007/s11356-023-27015-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 04/10/2023] [Indexed: 05/03/2023]
Abstract
The conclusions about the association of maternal pregnancy environment, occupation, and benzene compounds with fetal CHD are not entirely consistent. Eight hundred seven CHD cases and 1008 controls were included in this study. All occupations were classified and coded against the Occupational Classification Dictionary of the People's Republic of China (2015 version). Logistic regressions were used to explore the correlation among environmental factors, occupation types, and CHDs in offspring. We found that living near public facilities and having exposure to chemical reagents and hazardous substances were significant risk factors for CHDs in offspring. We found that offspring of mothers who worked in agriculture and similar work during pregnancy suffered from CHD. The risk of all CHDs in the offspring of pregnant women working in production manufacturing and related work was significantly higher than that in unemployed pregnant women, the risk was also observed in 4 subtypes of CHDs. We compared the concentrations of the five metabolite (MA, mHA, HA, PGA, and SPMA) levels of benzene compounds in the urine of mothers in case and control groups and found no significant differences. Our study suggests that maternal exposure during pregnancy and certain environmental and occupational conditions are risk factors for CHD in offspring, but did not support an association between concentrations of metabolites of benzene compounds in the urine of pregnant women and CHDs in their offspring.
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Affiliation(s)
- Meixian Wang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Lu Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Hong Kang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Hongmei Xu
- Department of Gynaecology and Obstetrics, Leshan People's Hospital, Leshan, 614003, China
| | - Qian Huang
- Department of Gynaecology and Obstetrics, Shehong People's Hospital, Shehong, 629299, China
| | - Nana Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Ying Deng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Ping Yu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Zhen Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
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Women's occupational status during pregnancy and preventive behaviour and health outcomes between 1998 and 2016 in France. J Gynecol Obstet Hum Reprod 2023; 52:102545. [PMID: 36707030 DOI: 10.1016/j.jogoh.2023.102545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Despite an improvement in preventive care and perinatal health in previous decades, social inequalities persist, particularly to the disadvantage of isolated or unemployed women. The objective was to analyse the evolution between 1998 and 2016 of the association between women's occupational status and perinatal outcomes. METHODS Data came from four national surveys performed in 1998, 2003, 2010 and 2016. Occupational status was defined by maternal employment status and type of occupation during pregnancy. Preventive behaviours (initiation of antenatal care, antenatal classes, breast feeding) and health outcomes (hospitalization, preterm birth, birth weight below the 10th percentile) were analysed by occupational status adjusted for other maternal characteristics, for each study year. RESULTS The studied sample included 12,497 women in 1998, 13,290 in 2003, 13,209 in 2010 and 11,179 in 2016. The proportion of employed women increased from 66% to 75% between 1998 and 2016, and that of housewives decreased from 22% to 12%. The proportion of preterm births globally increased between 1998 and 2016, especially for housewives. The proportion of low birthweight for gestational age (LBWGA) remained similar over the years. From 1998 to 2016, the differences between occupational groups persisted for preterm births and LBWGA. CONCLUSIONS Occupational groups exhibited strong social differences in preventive care over the entire study period and persisted in the recent data. As a major social indicator, women's occupational status during pregnancy has to be considered as a risk factor of poor preventive behaviour and unfavourable perinatal outcomes.
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Genowska A, Strukcinskiene B, Jamiołkowski J, Abramowicz P, Konstantynowicz J. Emission of Industrial Air Pollution and Mortality Due to Respiratory Diseases: A Birth Cohort Study in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1309. [PMID: 36674065 PMCID: PMC9859275 DOI: 10.3390/ijerph20021309] [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: 11/02/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Air pollution is a major risk factor for public health worldwide, but evidence linking this environmental problem with the mortality of children in Central Europe is limited. OBJECTIVE To investigate the relationship between air pollution due to the emission of industry-related particulate matter and mortality due to respiratory diseases under one year of age. METHODS A retrospective birth cohort analysis of the dataset including 2,277,585 children from all Polish counties was conducted, and the dataset was matched with 248 deaths from respiratory diseases under one year of age. Time to death during the first 365 days of life was used as a dependent variable. Harmful emission was described as total particle pollution (TPP) from industries. The survival analysis was performed using the Cox proportional hazards model for the emission of TPP at the place of residence of the mother and child, adjusted individual characteristics, demographic factors, and socioeconomic status related to the contextual level. RESULTS Infants born in areas with extremely high emission of TPP had a significantly higher risk of mortality due to respiratory diseases: hazard ratio (HR) = 1.781 [95% confidence interval (CI): 1.175, 2.697], p = 0.006, compared with those born in areas with the lowest emission levels. This effect was persistent when significant factors were adjusted at individual and contextual levels (HR = 1.959 [95% CI: 1.058, 3.628], p = 0.032). The increased risk of mortality was marked between the 50th and 150th days of life, coinciding with the highest exposure to TPP. CONCLUSIONS The emission of TPP from industries is associated with mortality due to respiratory diseases under one year of age. A considerable proportion of children's deaths could be prevented in Poland, especially in urban areas, if air pollution due to the emission of particle pollution is reduced.
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Affiliation(s)
- Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
| | | | - Jacek Jamiołkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Paweł Abramowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Clinical Hospital, 15-274 Bialystok, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Clinical Hospital, 15-274 Bialystok, Poland
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Maternal risk factors associated with term low birth weight in India: A review. ANTHROPOLOGICAL REVIEW 2023. [DOI: 10.18778/1898-6773.85.4.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Low birth weight is one of the leading factors for infant morbidity and mortality. To a large extent affect, various maternal risk factors are associated with pregnancy outcomes by increasing odds of delivering an infant with low birth weight. Despite this association, understanding the maternal risk factors affecting term low birth weight has been a challenging task. To date, limited studies have been conducted in India that exert independent magnitude of these effects on term low birth weight. The aim of this review is to examine the current knowledge of maternal risk factors that contribute to term low birth weight in the Indian population. In order to identify the potentially relevant articles, an extensive literature search was conducted using PubMed, Goggle Scholar and IndMed databases (1993 – Dec 2020). Our results indicate that maternal age, educational status, socio-economic status, ethnicity, parity, pre-pregnancy weight, maternal stature, maternal body mass index, obstetric history, maternal anaemia, gestational weight gain, short pregnancy outcome, hypertension during pregnancy, infection, antepartum haemorrhage, tobacco consumption, maternal occupation, maternal psychological stress, alcohol consumption, antenatal care and mid-upper arm circumference have all independent effects on term low birth weight in the Indian population. Further, we argue that exploration for various other dimensions of maternal factors and underlying pathways can be useful for a better understanding of how it exerts independent association on term low birth weight in the Indian sub-continent.
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Kim C, Choe S, Kim T, Kim M, Ryu J, Oh J, Yoon J. Risk of adverse pregnancy outcomes by maternal occupational status: A national population-based study in South Korea. J Occup Health 2023; 65:e12380. [PMID: 36694993 PMCID: PMC9874245 DOI: 10.1002/1348-9585.12380] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE This study examined the association between maternal occupational status and adverse pregnancy outcomes in the general South Korean population. METHODS We analyzed 1 825 845 employed and non-employed women with a diagnostic code for pregnancy in the National Health Insurance Service (NHIS) database (2010-2019) of South Korea. Based on their employment status and type of occupation, we calculated risk ratios for three adverse outcomes: early abortive outcomes (miscarriage, ectopic pregnancy, and molar pregnancy), stillbirth, and no live birth (diagnosis of pregnancy with no record of live birth thereafter, which include early abortive outcomes and stillbirth) with adjusting for covariates. RESULTS Overall, 18.0%, 0.7%, and 39.8% ended in early abortive outcomes, stillbirths, and no live births, respectively. The risk of early abortive outcomes and stillbirths was higher in non-employed women than in employed women, while no live births were more frequent in employed women. Those in the health and social work industry showed the highest risk of no live births. Manufacturing jobs (1.030, 95% CI: 1.013, 1.047) and health/social work (1.029, 95% CI: 1.012, 1.046) were associated with an increased risk of early abortive outcomes compared with financial and insurance jobs. Consistently higher risks of no live births were observed in the manufacturing, wholesale/retail trade, education, health/social work, and public/social/personal service occupation. CONCLUSION Employment during pregnancy and several occupation types were associated with a higher risk of pregnancy loss. Additional research using detailed job activity data is needed to determine specific occupational causes of adverse pregnancy outcomes.
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Affiliation(s)
- Chae‐Bong Kim
- Department of Preventive MedicineKorea University College of MedicineSeoulRepublic of Korea
| | - Seung‐Ah Choe
- Department of Preventive MedicineKorea University College of MedicineSeoulRepublic of Korea
- Division of Life ScienceKorea UniversitySeoulRepublic of Korea
| | - Taemi Kim
- Department of Preventive MedicineKorea University College of MedicineSeoulRepublic of Korea
| | - Myoung‐Hee Kim
- Center for Public Health Data Analytics, National Medical CenterSeoulRepublic of Korea
| | - Jia Ryu
- Department of Occupational and Environmental MedicineInternational St. Mary's Hospital, Catholic Kwandong UniversityIncheonRepublic of Korea
| | - Jeong‐Won Oh
- Department of Obstetrics and GynecologySoonchunhyang University Seoul HospitalSeoulRepublic of Korea
| | - Jung‐won Yoon
- Department of Obstetrics and GynecologyNational Medical CenterSeoulRepublic of Korea
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Krief P, Mediouni Z, Abderhalden-Zellweger A, Kerr D, Nesi S, Renteria SC, Vonlanthen J, Danuser B. Evaluation of a pilot consultation for maternity protection at work in Switzerland. Swiss Med Wkly 2022; 152:w30160. [PMID: 35704946 DOI: 10.4414/smw.2022.w30160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
STUDY AIMS Switzerland's Labour Law and its Ordonnance on Maternity Protection aim to protect the health of pregnant employees and their unborn children while enabling them to continue to pursue their professional activities. Some companies encounter difficulties implementing the law's provisions. The Department of Occupational and Environmental Health, part of the Center for Primary Care and Public Health (Unisanté), has provided specialist occupational medicine consultations for pregnant employees since 2015. This study aimed to evaluate how well Swiss' maternity protection legislation is implemented by examining a list of relevant indicators measured during the occupational health consultation. The study also sought to investigate the consultation support provided to the relevant stakeholders and the adjustments made to pregnant employees' working conditions. METHODS Descriptive variables and indicators relative to the application of the Swiss maternity protection legislation for 83 pregnant employees were collected during the consultation's pilot phase (between 2015 and 2016). Descriptive statistics and cross-analyses of these indicators were made. RESULTS Most pregnant employees faced multiple exposures to occupational risks. Preventive risk analyses were rare. Few adjustments to workstations were proposed. We found a tendency for employees to leave their workstations early on in their pregnancies due to sick leave certificate prescriptions. Specialist consultation and collaboration with occupational health physicians to recommend interventions for pregnant employees can provide significant benefits and help some pregnant women to continue at their workstations with appropriate adjustments. DISCUSSION A specialised occupational health consultation is a useful instrument for identifying occupational hazards for both the pregnant woman and her unborn child. It is also an opportunity to explain employers' legal responsibilities and obligations to safeguard the health of their pregnant employees and to give specific advice for their company's situation. This consultation also enables employers to maintain their employees' valuable professional competencies in the workplace for as long as possible. Finally, occupational health consultation helps and supports healthcare providers who must, according to the law, make decisions about whether pregnant employees can continue working safely or not.
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Affiliation(s)
- Peggy Krief
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | - Zakia Mediouni
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | - Alessia Abderhalden-Zellweger
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland.,School of Health Sciences (HESAV,) University of Applied Sciences and Arts of Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Dominique Kerr
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | | | - Saira-Christine Renteria
- Psychosocial Unit, Department of Women's, Mothers' and Children's Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Vonlanthen
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
| | - Brigitta Danuser
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University of Lausanne (Unil), Epalinges-Lausanne, Switzerland
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11
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Ish J, Gimeno Ruiz de Porras D, Symanski E, Ballester F, Casas M, Delclos GL, Guxens M, Ibarluzea J, Iñiguez C, Santa-Marina L, Swartz MD, Whitworth KW. Maternal occupational exposures and fetal growth in a Spanish birth cohort. PLoS One 2022; 17:e0264530. [PMID: 35390005 PMCID: PMC8989310 DOI: 10.1371/journal.pone.0264530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/11/2022] [Indexed: 01/14/2023] Open
Abstract
While the epidemiologic literature suggests certain maternal occupational exposures may be associated with reduced measures of size at birth, the occupational literature employing fetal biometry data to assess fetal growth is sparse. The present study examines associations between maternal occupational exposures and ultrasound-measured fetal growth. We included 1,739 singleton pregnancies from the INfancia y Medio Ambiente (INMA) project (2003-2008). At 32 weeks of pregnancy, interviewers ascertained mothers' employment status and assessed job-related physical loads, work schedules, and job strain during pregnancy. Job titles were linked to a job-exposure matrix to estimate exposure to 10 endocrine disrupting chemical (EDC) groups. We calculated z-scores from longitudinal growth curves representing trajectories from 0-12, 12-20 and 20-34 gestational weeks for abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW). Linear mixed models clustered by IMNA region (i.e., Gipuzkoa, Sabadell, Valencia) were used to examine associations between occupational exposures and fetal growth. Effect estimates are presented as percentage change in fetal growth. There was limited evidence of associations between work-related non-chemical stressors and fetal growth. We observed associations of similar magnitude between multiple EDC groups and decreased EFW trajectories during 20-34 gestational weeks (phthalates: -1.4% [-3.5, 0.6%]; alkylphenolic compounds (APCs): -1.1% [-2.3, 0.1%]; miscellaneous chemicals: -1.5% [-3.7, 0.8%]), while miscellaneous chemicals were associated with increased BPD from 12-20 weeks (2.1% [0.8, 3.5%]). Notably, 67% of women exposed to phthalates were hairdressers; 68% of women exposed to APCs worked as domestic cleaners. In conclusion, we found limited evidence that maternal occupational exposures impact fetal growth. Further research should consider the combined impact of multiple workplace exposures.
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Affiliation(s)
- Jennifer Ish
- Southwest Center for Occupational and Environmental Health (SWCOEH), Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in San Antonio, San Antonio, TX, United States of America
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - David Gimeno Ruiz de Porras
- Southwest Center for Occupational and Environmental Health (SWCOEH), Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in San Antonio, San Antonio, TX, United States of America
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States of America
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Elaine Symanski
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States of America
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States of America
| | - Ferran Ballester
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Department of Nursing, Universitat de València, Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO–Universitat Jaume I Universitat de València, València, Spain
| | - Maribel Casas
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- ISGlobal, Barcelona, Spain
| | - George L. Delclos
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain
- Southwest Center for Occupational and Environmental Health (SWCOEH), Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX, United States of America
| | - Mònica Guxens
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- ISGlobal, Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jesús Ibarluzea
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Environmental Epidemiology and Child Development Group, Biodonostia, San Sebastian, Spain
- Health Department of the Basque Government, Sub-directorate of Public Health of Gipuzkoa, San Sebastian, Spain
- Faculty of Psychology, Universidad del País Vasco (UPV/EHU), San Sebastian, Spain
| | - Carmen Iñiguez
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO–Universitat Jaume I Universitat de València, València, Spain
- Department of Statistics and Operational Research, Universitat de València, València, Spain
| | - Loreto Santa-Marina
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- Environmental Epidemiology and Child Development Group, Biodonostia, San Sebastian, Spain
- Health Department of the Basque Government, Sub-directorate of Public Health of Gipuzkoa, San Sebastian, Spain
| | - Michael D. Swartz
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, TX, United States of America
| | - Kristina W. Whitworth
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States of America
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States of America
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12
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Abderhalden-Zellweger A, Politis Mercier MP, Probst I, Wild P, Danuser B, Krief P. Midwives and protection of pregnant workers in Western Switzerland: Practices, difficulties and contributions. Midwifery 2021; 102:103125. [PMID: 34428629 DOI: 10.1016/j.midw.2021.103125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Switzerland's maternity protection legislation aims to protect the health of pregnant employees and their unborn children by regulating their potential occupational exposure to hazards and strenuous activities. This legislation provides a role for obstetricians, but not for midwives. AIMS Identify the practices of Switzerland's French-speaking midwives that favour the implementation of maternity protection legislation and reflect on the profession's role in supporting pregnant employees. METHODS 356 midwives answered an online questionnaire. The analysis focuses on the 205 midwives who perform pregnancy consultations in their practice. Data were analysed in two stages using STATA software: 1) simple descriptive and correlational statistics and 2) hierarchical cluster analysis to identify typologies of practices by grouping similar responses. FINDINGS Despite having no officially defined role in Switzerland's maternity protection legislation, its midwives actively participate in protecting pregnant employees , especially those with more knowledge of the legislation, those with more years of experience and those practicing independently. The barriers that midwives face when trying to provide greater support for pregnant employees are linked significantly to their lack of knowledge about the legislation, a lack of recognition for their role in the current legislation and a lack of continuing education about the occupational health risks associated with pregnancy at work. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Their profession and specific practices give midwives privileged access to pregnant employees. Midwives' knowledge of the legislation, their awareness of the occupational risks and hazards facing pregnant employees and the conviction that their profession has the potential to make a difference could all be improved. The role of midwives should be-and deserves to be-formally and legally recognised and integrated into Switzerland's maternity protection legislation.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011 Lausanne, Switzerland; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland.
| | - Maria-Pia Politis Mercier
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Isabelle Probst
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Pascal Wild
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; INRS Scientific Management Unit, Nancy, France
| | - Brigitta Danuser
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland
| | - Peggy Krief
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland
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13
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Franco J, Morris L, Lee J, Williams JC. The Health Care Provider's Role in Securing Work Accommodations for Pregnant and Postpartum Patients. J Midwifery Womens Health 2021; 65:474-486. [PMID: 32841486 DOI: 10.1111/jmwh.13131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/23/2020] [Accepted: 04/08/2020] [Indexed: 11/30/2022]
Abstract
Most women today are the primary, sole, or cobreadwinners for their families; their continued ability to work during and after pregnancy is crucial for their families' well-being. Midwives and other health care providers are regularly asked to provide work notes for patients who need adjustments to how, when, or where their job is done to continue working while maintaining a healthy pregnancy or breastfeeding. Whereas an improperly written work note can result in the patient being forced out on leave or losing their job, an effectively written work note from a health care provider can ensure the patient will receive the adjustments they need to stay safe and healthy on the job. Health care providers can also play an important role by incorporating discussions about workplace issues into care conversations. This article provides an overview of pregnancy-related employment rights, guidelines for writing effective work notes, and a discussion of common workplace issues patients face and how health care providers can respond.
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Affiliation(s)
- Juliana Franco
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California
| | - Liz Morris
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California
| | - Jessica Lee
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California
| | - Joan C Williams
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California
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14
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Hawkins D. Disparities in the usage of maternity leave according to occupation, race/ethnicity, and education. Am J Ind Med 2020; 63:1134-1144. [PMID: 33020984 DOI: 10.1002/ajim.23188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Unlike almost all other countries, the United States does not mandate paid maternity leave for mothers. Lack of access to maternity leave may be a risk factor for adverse maternal and child health outcomes. This study sought to assess disparities in the usage of maternity leave according to maternal occupation, race/ethnicity, and education, and to explore the relationships between these factors. METHODS We used data from the Pregnancy Risk Assessment Monitoring System from the years 2016 and 2017. We calculated the prevalence of usage of maternity leave and paid maternity leave according to the mother's age, race/ethnicity, education, state, and occupation. We constructed regression models to explore the bivariate and mutually adjusted associations between these factors and usage of maternal leave. RESULTS Usage of maternity leave and paid maternity leave were estimated at 89.3% and 49.0%, respectively. Usage of paid maternity leave was lower in younger mothers, in Black and Hispanic mothers, and in mothers with fewer years of education. Workers in several occupations, including building and grounds cleaning and maintenance, personal care, and food preparation and serving, used maternity leave at rates significantly lower than the average of all workers. Adjustment for education and occupation reduced, but did not obviate, racial/ethnic differentials in usage of paid maternity leave. CONCLUSIONS There are substantial differentials in usage of maternity leave. Further research could examine whether these differences contribute to disparities in maternal and child health outcomes.
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Affiliation(s)
- Devan Hawkins
- Public Health Program, School of Arts and Sciences MCPHS University Boston Massachusetts USA
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15
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Lamichhane DK, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Quantile regression analysis of the socioeconomic inequalities in air pollution and birth weight. ENVIRONMENT INTERNATIONAL 2020; 142:105875. [PMID: 32590283 DOI: 10.1016/j.envint.2020.105875] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/02/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND An association between maternal exposure to air pollution and the birth weight distribution has been reported, but the extent to which this relationship varies according to socioeconomic status (SES) is unknown. This study examined the relationship using the data from a Korean birth cohort. METHODS Data for singleton births in Seoul from 2007 to 2017 (n = 1739) were analyzed. Maternal exposures to particulate matter with an aerodynamic diameter <10 µm (PM10) and <2.5 µm (PM2.5), as well as to nitrogen dioxide (NO2) and ozone (O3) for each trimester and the entire pregnancy were estimated using residential address, gestational age, and the birth date. The associations between the interquartile range (IQR) increases in pollutant concentrations and the changes in birth weight were examined using linear regression and quantile regression models. The socioeconomic disparities in the associations were investigated using a derived SES variable based on the composite of parental education and occupation. This SES variable was then interacted with the air pollutant. RESULTS In the gestational age-adjusted models, particulate air pollutants (PM10 and PM2.5) and O3 were associated with birth weight decreases for the lower birth weight percentiles. For example, the decrease in mean birthweight per IQR increase in PM2.5 during second trimester was -21.1 g (95% confidence interval (CI) = -41.8, -0.4), whereas the quantile-specific associations were: 10th percentile -27.0 g (95% CI = -46.6, -7.3); 50th percentile -22.2 g (95% CI = -39.6, -4.8); and 90th percentile -22.9 g (95% CI = -45.5, -0.2). Particulate air pollutants and O3 showed a pattern of socioeconomic inequalities; the reduced birth weight was of greater magnitude for children from a low SES group. CONCLUSIONS Negative associations between particulate air pollutants and O3 and birth weight were consistently greater at the lower quantiles of the birth weight distribution, especially in lower SES group.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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Buen M, Amaral E, Souza RT, Passini R, Lajos GJ, Tedesco RP, Nomura ML, Dias TZ, Rehder PM, Sousa MH, Cecatti JG. Maternal Work and Spontaneous Preterm Birth: A Multicenter Observational Study in Brazil. Sci Rep 2020; 10:9684. [PMID: 32546709 PMCID: PMC7297738 DOI: 10.1038/s41598-020-66231-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 05/18/2020] [Indexed: 02/07/2023] Open
Abstract
Spontaneous preterm birth (sPTB) is a major pregnancy complication involving biological, social, behavioural and environmental mechanisms. Workload, shift and intensity may play a role in the occurrence of sPTB. This analysis is aimed addressing the effect of occupational activities on the risk for sPTB and the related outcomes. We conducted a secondary analysis of the EMIP study, a Brazilian multicentre cross-sectional study. For this analysis, we included 1,280 singleton sPTB and 1,136 singleton term birth cases. Independent variables included sociodemographic characteristics, clinical complications, work characteristics, and physical effort devoted to household chores. A backward multiple logistic regression analysis was applied for a model using work characteristics, controlled by cluster sampling design. On bivariate analysis, discontinuing work during pregnancy and working until the 7th month of pregnancy were risks for premature birth while working during the 8th - 9th month of pregnancy, prolonged standing during work and doing household chores appeared to be protective against sPTB during pregnancy. Previous preterm birth, polyhydramnios, vaginal bleeding, stopping work during pregnancy, or working until the 7th month of pregnancy were risk factors in the multivariate analysis. The protective effect of variables compatible with exertion during paid work may represent a reverse causality. Nevertheless, a reduced risk associated with household duties, and working until the 8th-9th month of pregnancy support the hypothesis that some sort of physical exertion may provide actual protection against sPTB.
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Affiliation(s)
- Mariana Buen
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | - Eliana Amaral
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | - Renato T Souza
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | - Renato Passini
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | - Giuliane J Lajos
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | | | - Marcelo L Nomura
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | - Tábata Z Dias
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | - Patrícia M Rehder
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil
| | | | - José Guilherme Cecatti
- Department of Obstetrics & Gynecology, University of Campinas (Unicamp), School of Medicine, São Paulo, Brazil.
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Abderhalden-Zellweger A, Probst I, Politis Mercier MP, Danuser B, Wild P, Krief P. Implementation of maternity protection legislation: Gynecologists' perceptions and practices in French-speaking Switzerland. PLoS One 2020; 15:e0231858. [PMID: 32353865 PMCID: PMC7192633 DOI: 10.1371/journal.pone.0231858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background In several countries, maternity protection legislations (MPL) confer an essential role to gynecologist-obstetricians (OBGYNs) for the protection of pregnant workers and their future children from occupational exposures. This study explores OBGYNs’ practices and difficulties in implementing MPL in the French-speaking part of Switzerland. Methods An online survey was sent to 333 OBGYNs. Data analysis included: 1) descriptive and correlational statistics and 2) hierarchical cluster analysis to identify patterns of practices. Results OBGYNs evoked several problems in MPL implementation: absence of risk analysis in the companies, difficult collaboration with employers, lack of competencies in the field of occupational health. Preventive leave was underused, with sick leave being prescribed instead. Training had a positive effect on OBGYNs’ knowledge and implementation of MPL. Hierarchical cluster analysis highlighted three main types of practices: 1) practice in line with legislation; 2) practice on a case-by-case basis; 3) limited practice. OBGYNs with good knowledge of MPL more consistently applied its provisions. Conclusion The implementation of MPL appears challenging for OBGYNs. Collaboration with occupational physicians and training might help OBGYNs to better take on their role in maternity protection. MPL in itself could be improved.
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Affiliation(s)
- Alessia Abderhalden-Zellweger
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
- * E-mail:
| | - Isabelle Probst
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Brigitta Danuser
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
| | - Pascal Wild
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
- INRS Research and Studies Management, Vandoeuvre les Nancy, France
| | - Peggy Krief
- Occupational Health and Environment Department (OHED), Center for Primary Care and Public Health (Unisanté), Epalinges, Switzerland
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18
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Patil D, Enquobahrie DA, Peckham T, Seixas N, Hajat A. Retrospective cohort study of the association between maternal employment precarity and infant low birth weight in women in the USA. BMJ Open 2020; 10:e029584. [PMID: 31924630 PMCID: PMC6955480 DOI: 10.1136/bmjopen-2019-029584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 11/08/2019] [Accepted: 12/11/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate the association between maternal employment precarity and infant low birth weight (LBW), and to assess if this association differs by race/ethnicity. METHODS Data were collected from 2871 women enrolled in the National Longitudinal Survey of Youth 1979 and the National Longitudinal Survey of Youth 1979 Children and Young Adult Cohort. Employment precarity was evaluated using a summary variable that combined several employment attributes: availability of employer-sponsored insurance, income, long shifts, non-daytime shifts, availability of employer sponsored training or educational benefits and membership in a union or collective bargaining unit. Employment precarity scores (a sum of the number of negative employment attributes) were categorised into low (0-2), medium (3) and high (4-6). LBW was defined as weight less than 2500 g at birth. Modified Poisson models were fit to calculate risk ratios and 95% CIs and adjusted for maternal age, race/ethnicity, educational attainment, nativity, prepregnancy body mass index, alcohol consumption, smoking during pregnancy and infant year of birth. We assessed effect modification by maternal race/ethnicity using a composite exposure-race variable. RESULTS Women with high employment precarity had higher risk of a LBW delivery compared with women with low employment precarity (RR: 1.48, 95% CI: 1.11 to 1.98). Compared to non-Hispanic/non-black women with low employment precarity, non-Hispanic black women (RR: 2.68; 95% CI: 1.72 to 4.15), Hispanic women (RR: 2.53; 95% CI: 1.54 to 4.16) and non-Hispanic/non-black women (RR: 1.46; 95% CI: 0.98 to 2.16) with high employment precarity had higher risk of LBW. CONCLUSIONS We observed higher risk of LBW in pregnancies of women with high employment precarity; this association was stronger among black and Hispanic mothers compared to non-Hispanic/non-black women. Findings of this study can be used to inform antenatal care and identify workplace policies to better support women who work during pregnancy.
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Affiliation(s)
- Divya Patil
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Daniel A Enquobahrie
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Trevor Peckham
- Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington, USA
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
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Migault L, Garlantézec R, Piel C, Marchand-Martin L, Orazio S, Cheminat M, Zaros C, Carles C, Cardis E, Ancel PY, Charles MA, de Seze R, Baldi I, Bouvier G. Maternal cumulative exposure to extremely low frequency electromagnetic fields, prematurity and small for gestational age: a pooled analysis of two birth cohorts. Occup Environ Med 2019; 77:22-31. [DOI: 10.1136/oemed-2019-105785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 08/12/2019] [Accepted: 11/06/2019] [Indexed: 01/29/2023]
Abstract
BackgroundData on the effects of extremely low frequency electromagnetic fields (ELF-EMF) on pregnancy outcomes are inconclusive.ObjectiveTo study the relation between maternal cumulative exposure to ELF-EMF during pregnancy and the risk of prematurity or small for gestational age (SGA) in a pooled analysis of two French birth cohorts.MethodsElfe and Epipage2 are both population-based birth cohorts initiated in 2011 and included 18 329 and 8400 births, respectively. Health data and household, mother and child characteristics were obtained from medical records and questionnaires at maternity and during follow-up. A job exposure matrix was used to assess cumulative exposure to ELF-EMF during three periods: (1) until 15 weeks of gestation, (2) until 28 weeks of gestation and (3) until 32 weeks of gestation. Analyses were restricted to single live births in mainland France and to mothers with documented jobs (N=19 894). Adjusted logistic regression models were used.ResultsAccording to the period studied, 3.2%–4% of mothers were classified as highly exposed. Results were heterogeneous. Increased risks of prematurity were found among low exposed mothers for the three periods, and no association was observed among the most exposed (OR1=0.92 (95% CI 0.74 to 1.15); OR2=0.98 (95% CI 0.80 to 1.21); OR3=1.14 (95% CI 0.92 to 1.41)). For SGA, no association was observed with the exception of increased risk among the low exposed mothers in period 2 and the most exposed in period 3 (OR=1.25 (95% CI 1.02 to 1.53)).ConclusionSome heterogeneous associations between ELF-EMF exposure and prematurity and SGA were observed. However, due to heterogeneity (ie, their independence regarding the level of exposure), associations cannot be definitely explained by ELF-EMF exposure.
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ACOG Committee Opinion No. 733: Employment Considerations During Pregnancy and the Postpartum Period. Obstet Gynecol 2019; 131:e115-e123. [PMID: 29578986 DOI: 10.1097/aog.0000000000002589] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the United States, it is common for women, including mothers and pregnant women, to work outside the home. Working during pregnancy is generally safe. For those in high-risk occupations or with medically complicated pregnancies, work accommodations often can allow for continued safe employment. The major employment issues concerning pregnant women include pregnancy-related discrimination, work accommodations that allow continued employment, job-protected leave, and wage replacement while on leave. Workplace discrimination related to being pregnant and pregnancy-related harassment, including discrimination in the hiring process, is prohibited by federal and state law. There is no federal law guaranteeing comprehensive accommodations for pregnant and postpartum workers. Current federal and state laws provide protection for some pregnant women, but not others, because of eligibility requirements and state-by-state differences. By writing appropriate notes to employers, obstetrician-gynecologists and other obstetric care providers can be instrumental in obtaining accommodations for their patients who are able to continue working. Accommodations that allow a woman to keep working are the most reliable way to guarantee pay, benefits, and job protection. Obstetrician-gynecologists and other obstetric care providers also can assist pregnant women and their partners by providing them with information and resources that might help them better understand their employment rights. However, in cases for which potential job discrimination has occurred, accommodations are denied, extended medical leave is necessary, or when other complex employment questions arise, legal assistance should be obtained.
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Apte A, Patil R, Lele P, Choudhari B, Bhattacharjee T, Bavdekar A, Juvekar S. Demographic surveillance over 12 years helps elicit determinants of low birth weights in India. PLoS One 2019; 14:e0218587. [PMID: 31291266 PMCID: PMC6619655 DOI: 10.1371/journal.pone.0218587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/06/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Low birth weight is an important predictor of maternal and child health. Birth weight is likely to be affected by maternal health, socioeconomic status and quality of health care facilities. OBJECTIVE To assess trends in the birth weight, the proportion of low birth weight, maternal factors and health care facilities for delivery in villages of Western Maharashtra from the year 2004 to 2016 and to analyze factors associated with low birth weight for total birth data of 2004-2016. METHODS Data collected for 19244 births from 22 villages in Vadu Health and Demographic Surveillance System (HDSS), Pune, Maharashtra, India from the year 2004 to 2016 were used for this analysis. RESULTS There was an overall increase in the annual mean birth weight from 2640.12 gram [95% CI 2602.21-2686.84] in the year 2004 to 2781.19 gram [95% CI 2749.49-2797.95] in the year 2016. There was no secular trend to show increase or decrease in the proportion of low weight at birth. Increasing maternal age (>18 years) compounded with better education, reduced parity and increasing number of institutional deliveries were significant trends observed during the past decade. Low birth weight was found to be associated with female gender, first birth order, poor maternal education and occupation as cultivation. CONCLUSION Changes in maternal age, education, occupation, and increased institutionalized deliveries contributed in to increasing birth weights in rural Maharashtra. Female gender, first birth order, poor maternal education and occupation of cultivation are associated with increased risk of low birth weight.
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Affiliation(s)
- Aditi Apte
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Rutuja Patil
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Pallavi Lele
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Bharat Choudhari
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Tathagata Bhattacharjee
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
- INDEPTH Network, East Legon, Accra, Ghana
| | - Ashish Bavdekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
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Alfano R, Guida F, Galobardes B, Chadeau-Hyam M, Delpierre C, Ghantous A, Henderson J, Herceg Z, Jain P, Nawrot TS, Relton C, Vineis P, Castagné R, Plusquin M. Socioeconomic position during pregnancy and DNA methylation signatures at three stages across early life: epigenome-wide association studies in the ALSPAC birth cohort. Int J Epidemiol 2019; 48:30-44. [PMID: 30590607 PMCID: PMC6443021 DOI: 10.1093/ije/dyy259] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/06/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Socioeconomic experiences are recognized determinants of health, and recent work has shown that social disadvantages in early life may induce sustained biological changes at molecular level that are detectable later in life. However, the dynamics and persistence of biological embedding of socioeconomic position (SEP) remains vastly unexplored. METHODS Using the data from the ALSPAC birth cohort, we performed epigenome-wide association studies of DNA methylation changes at three life stages (birth, n = 914; childhood at mean age 7.5 years, n = 973; and adolescence at mean age 15.5 years, n = 974), measured using the Illumina HumanMethylation450 Beadchip, in relation to pregnancy SEP indicators (maternal and paternal education and occupation). RESULTS Across the four early life SEP metrics investigated, only maternal education was associated with methylation levels at birth, and four CpGs mapped to SULF1, GLB1L2 and RPUSD1 genes were identified [false discovery rate (FDR)-corrected P-value <0.05]. No epigenetic signature was found associated with maternal education in child samples, but methylation levels at 20 CpG loci were found significantly associated with maternal education in adolescence. Although no overlap was found between the differentially methylated CpG sites at different ages, we identified two CpG sites at birth and during adolescence which are 219 bp apart in the SULF1 gene that encodes an heparan sulphatase involved in modulation of signalling pathways. Using data from an independent birth cohort, the ENVIRONAGE cohort, we were not able to replicate these findings. CONCLUSIONS Taken together, our results suggest that parental SEP, and particularly maternal education, may influence the offspring's methylome at birth and adolescence.
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Affiliation(s)
- Rossella Alfano
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Florence Guida
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Bruna Galobardes
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Cyrille Delpierre
- INSERM, UMR1027, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Akram Ghantous
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - John Henderson
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Zdenko Herceg
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Pooja Jain
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- NIHR-Health Protection Research Unit, Respiratory Infections and Immunity, Imperial College London, London, UK
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Caroline Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- IIGM, Italian Institute for Genomic Medicine, Turin, Italy
| | - Raphaële Castagné
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- INSERM, UMR1027, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Michelle Plusquin
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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Manangama G, Migault L, Audignon-Durand S, Gramond C, Zaros C, Bouvier G, Brochard P, Sentilhes L, Lacourt A, Delva F. Maternal occupational exposures to nanoscale particles and small for gestational age outcome in the French Longitudinal Study of Children. ENVIRONMENT INTERNATIONAL 2019; 122:322-329. [PMID: 30459064 DOI: 10.1016/j.envint.2018.11.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/19/2018] [Accepted: 11/12/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To investigate the association between maternal occupational exposures to nanoscale particles (NPs) during pregnancy and small for gestational age (SGA). METHODS This study included 11,224 mothers and singleton birth pairs from the French Longitudinal Study of Children (ELFE cohort), which included infants born after 33 weeks of gestation or more in continental France in 2011. Mothers who did not work during pregnancy were excluded from the analyses. Maternal occupational exposures to NPs was estimated using a job-exposure matrix for the probability (>50%: occupationally exposed group, n = 569; 0%: occupationally non-exposed group, n = 9113; between these two thresholds: uncertain group, n = 1542) and frequency of exposure. Associations were estimated from multivariate logistic regression models for occupationally exposed vs occupationally unexposed groups in a first analysis, and with the frequency-weighted duration of work for the occupationally exposed group only in a second analysis. RESULTS Among working mothers, 5.1% were occupationally exposed to NPs. Maternal occupational exposures to NPs was associated with SGA (ORa = 1.63, 95% CI: 1.22, 2.18). The frequency-weighted duration of work for the occupationally exposed group (n = 569) was not associated with SGA (ORa = 1.02, 95% CI: 0.97, 1.08) in adjusted analyses. CONCLUSIONS These results, showing a significant association between occupational exposures to NPs and SGA, should encourage further studies to examine the adverse effect of NPs exposure on fetal development.
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Affiliation(s)
- G Manangama
- Epicene, INSERM U1219 and University Bordeaux, France; Service de médecine du travail et de pathologies professionnelles, CHU Bordeaux, France.
| | - L Migault
- Epicene, INSERM U1219 and University Bordeaux, France
| | - S Audignon-Durand
- Epicene, INSERM U1219 and University Bordeaux, France; Service de médecine du travail et de pathologies professionnelles, CHU Bordeaux, France
| | - C Gramond
- Epicene, INSERM U1219 and University Bordeaux, France
| | - C Zaros
- Joint research unit ELFE, Ined-Inserm-EFS, France
| | - G Bouvier
- Epicene, INSERM U1219 and University Bordeaux, France
| | - P Brochard
- Epicene, INSERM U1219 and University Bordeaux, France; Service de médecine du travail et de pathologies professionnelles, CHU Bordeaux, France
| | - L Sentilhes
- Service de gynécologie-obstétrique, CHU Bordeaux, France
| | - A Lacourt
- Epicene, INSERM U1219 and University Bordeaux, France
| | - F Delva
- Epicene, INSERM U1219 and University Bordeaux, France; Service de médecine du travail et de pathologies professionnelles, CHU Bordeaux, France
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Vargas-Prada S, García AM, Ronda E, Estarlich M, Ballester F, Benavides FG. Influence of paid maternity leave on return to work after childbirth. LA MEDICINA DEL LAVORO 2018; 109:243-252. [PMID: 30168497 PMCID: PMC7682161 DOI: 10.23749/mdl.v109i4.7226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/21/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Paid maternity leave (ML) has been associated with better health outcomes in mothers and newborns. However, its protective role in mothers' employment after childbirth remains unclear. OBJECTIVE To assess the association between paid ML and being employed 1-year after childbirth. METHODS As part of the INfancia y Medio Ambiente (INMA) cohort study, 507 Spanish women employed at 12th week of pregnancy, were asked about their employment status and job characteristics at 32nd week of pregnancy. One year after childbirth, they were re-interviewed about their employment status and if they had taken paid ML. Incidence of maternal employment 1-year after childbirth was estimated. Crude and adjusted associations with paid ML were assessed by logistic regression, and characterized by odds ratios (ORs) with associated 95% CIs. RESULTS Information was obtained from 398 women. Of those, 290 (72.9%) were employed 1-year after childbirth. Incidence of maternal employment was lower for those who: i) didn't take paid ML, ii) were younger than 27 years; iii) had temporary contract, iv) had part-time jobs, v) reported less-favoured familiar social class, and vi) left the job before 32 weeks of pregnancy. Being employed 1-year after childbirth was more common in those who took paid ML (OR 2.7, 95%CI 1.6-4.5), also after adjusting for staying at work until advanced stages of pregnancy (OR 1.8, 95%CI 1.0-3.1). CONCLUSIONS Taking paid ML seems to be associated with higher maternal employment rates 1-year after childbirth. Therefore, our findings suggest that protection of maternity might positively influence women's labour market participation after childbirth.
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Weber A, Harrison TM, Steward D, Ludington-Hoe S. Paid Family Leave to Enhance the Health Outcomes of Preterm Infants. Policy Polit Nurs Pract 2018; 19:11-28. [PMID: 30134774 DOI: 10.1177/1527154418791821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Prematurity is the largest contributor to perinatal morbidity and mortality. Preterm infants and their families are a significant vulnerable population burdened with limited resources, numerous health risks, and poor health outcomes. The social determinants of health greatly shape the economic and psychosocial resources that families possess to promote optimal outcomes for their preterm infants. The purposes of this article are to analyze the resource availability, relative risks, and health outcomes of preterm infants and their families and to discuss why universal paid family leave could be one potential public policy that would promote optimal outcomes for this infant population. First, we discuss the history of family leave in the United States and draw comparisons with other countries around the world. We use the vulnerable populations conceptual model as a framework to discuss why universal paid family leave is needed and to review how disparities in resource availability are driving the health status of preterm infants. We conclude with implications for research, nursing practice, and public policy. Although health care providers, policy makers, and other key stakeholders have paid considerable attention to and allocated resources for preventing and treating prematurity, this attention is geared toward individual-based health strategies for promoting preconception health, preventing a preterm birth, and improving individual infant outcomes. Our view is that public policies addressing the social determinants of health (e.g., universal paid family leave) would have a much greater impact on the health outcomes of preterm infants and their families than current strategies.
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Affiliation(s)
- Ashley Weber
- 1 University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Tondi M Harrison
- 2 The Ohio State University College of Nursing, Columbus, OH, USA
| | - Deborah Steward
- 2 The Ohio State University College of Nursing, Columbus, OH, USA
| | - Susan Ludington-Hoe
- 3 Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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Wiener RC, Waters C. Personal Oral Infection Control, Low Birthweight, and Preterm Births in Appalachia West Virginia: A Cross-Sectional Study. Adv Prev Med 2018; 2018:9618507. [PMID: 30174960 PMCID: PMC6106793 DOI: 10.1155/2018/9618507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/11/2018] [Accepted: 07/29/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). METHODS A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes. RESULTS There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis. CONCLUSION There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes.
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Affiliation(s)
- R. Constance Wiener
- Assistant Professor, Dental Practice and Rural Health, School of Dentistry, Department of Epidemiology, School of Public Health, West Virginia University, P.O. Box 9448 Robert C. Byrd Health Sciences Center Addition 104a, Morgantown, WV 26506, USA
| | - Christopher Waters
- Dental Research Labs Director, 106a Health Sciences Addition, P.O. Box 9448, Department of Dental Research, School of Dentistry, West Virginia University, Morgantown, WV 26506, USA
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Probst I, Zellweger A, Politis Mercier MP, Danuser B, Krief P. Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature. Int Arch Occup Environ Health 2018; 91:901-922. [DOI: 10.1007/s00420-018-1339-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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Xiao Q, Chen H, Strickland MJ, Kan H, Chang HH, Klein M, Yang C, Meng X, Liu Y. Associations between birth outcomes and maternal PM 2.5 exposure in Shanghai: A comparison of three exposure assessment approaches. ENVIRONMENT INTERNATIONAL 2018; 117:226-236. [PMID: 29763818 PMCID: PMC6091210 DOI: 10.1016/j.envint.2018.04.050] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/20/2018] [Accepted: 04/28/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Few studies have estimated effects of maternal PM2.5 exposure on birth outcomes in China due to the lack of historical air pollution data. OBJECTIVES We estimated the associations between maternal PM2.5 exposure and birth outcomes using gap-filled satellite estimates in Shanghai, China. METHODS We obtained birth registration records of 132,783 singleton live births during 2011-2014 in Shanghai. PM2.5 exposures were assessed from satellite-derived estimates or central-site measurements. Linear and logistic regressions were used to estimate associations with term birth weight and term low birth weight (LBW), respectively. Logistic and discrete-time survival models were used to estimate associations with preterm birth. Effect modification by maternal age and parental education levels was investigated. RESULTS A 10 μg/m3 increase in gap-filled satellite-based whole-pregnancy PM2.5 exposure was associated with a -12.85 g (95% CI: -18.44, -7.27) change in term birth weight, increased risk of preterm birth (OR 1.27, 95% CI: 1.20, 1.36), and increased risk of term LBW (OR 1.22, 95% CI: 1.06, 1.41). Sensitivity analyses during 2013-2014, when ground PM2.5 measurements were available, showed that the health associations using gap-filled satellite PM2.5 concentrations were higher than those obtained using satellite PM2.5 concentrations without accounting for missingness. The health associations using gap-filled satellite PM2.5 had similar magnitudes to those using central-site measurements, but with narrower confidence intervals. CONCLUSIONS The magnitude of associations between maternal PM2.5 exposure and adverse birth outcomes in Shanghai was higher than previous findings. One reason could be reduced exposure error of the gap-filled high-resolution satellite PM2.5 estimates.
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Affiliation(s)
- Qingyang Xiao
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hanyi Chen
- Science Research and Information Management Section, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China; Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | | | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mitchel Klein
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chen Yang
- Section of Cancer and Injury Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China; Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Xia Meng
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Joas A, Schöpel M, David M, Casas M, Koppen G, Esteban M, Knudsen LE, Vrijheid M, Schoeters G, Calvo AC, Schwedler G, Kolossa-Gehring M, Joas R. Environmental health surveillance in a future European health information system. Arch Public Health 2018; 76:27. [PMID: 29988356 PMCID: PMC6022511 DOI: 10.1186/s13690-018-0272-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/16/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To date Health information (HI) in the European Union does not comprise indicators or other information related to impacts of hazardous chemicals in consumer products, food, drinking water or air on the health status of the population. Therefore, we inventorised and evaluated the potential of environmental health surveillance and research data sources in the European population to provide HBM-based indicators of internal human exposure and health impact of relevant chemicals. METHODS We established an up-dated inventory of European cross-sectional Human Biomonitoring (HBM) surveys and of birth cohorts, and compared chemicals and chemical groups addressed by HBM with indicators and health end points collected via European Core Health Indicators (ECHI), in birth registries, as well as in environmental and food data bases and health registries to see on how data collection could be aligned. Finally, we investigated study designs of HBM survey and health examination surveys for potential synergies. RESULTS The inventory covers a total of 11 European cross-sectional national programmes and a large number of birth cohorts and includes information on study population, age groups, covered substances, sampled matrices, and frequency. The comparison of data collections shows that there are many overlaps between environmental chemicals with environmental and health reporting. HBM data could be linked with ECHI indicators for work-related risks, body mass index (BMI), and low birth weight, with perinatal disease, neurologic disorders, and some chronic diseases, or with data bases for e.g. indoor air, food, or consumer products. Existing initiatives to link data collections at European Environment Agency (EEA) and Joint Research Center (JRC) or at World Health Organization (WHO) are good options to further develop linkage of HBM with exposures sources and health end points. CONCLUSIONS There is potential to use HBM based information in a number of public health policies, and this would help to align reporting to international commitments. Environmental health surveillance based on HBM and HBM-based indicators, is an excellent tool to inform public health policies about risks from environmental chemicals, and the EU health information system would benefit from additional HBM-based indicators for monitoring exposure burden from environmental chemicals. Considerable efforts are needed to align and establish routine data collections and to develop a surveillance system and indicators which may inform public health policies.
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Affiliation(s)
- Anke Joas
- BiPRO GmbH, Werinherstr. 79, 81541 Munich, Germany
| | | | | | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Valencia, Spain
| | - Gudrun Koppen
- Flemish Institute for Technological Research, Mol, Belgium
| | - Marta Esteban
- CNSA - ISCIII, National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Valencia, Spain
| | | | - Argelia Castaño Calvo
- CNSA - ISCIII, National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
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Villar R, Benavides FG, Serra L, Serra C. [Occupational risk during pregnancy and sick leave in a cohort of workers from Parc de Salut Mar (Barcelona, Spain)]. GACETA SANITARIA 2018; 33:455-461. [PMID: 29914699 DOI: 10.1016/j.gaceta.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To study the use of the Pregnancy occupational risk benefit (PORB) and non-work related sickness absence (NWSA) in a cohort of pregnant workers of Parc de Salut Mar, Barcelona (Spain). METHOD Retrospective cohort study of 428 pregnant workers between 2010 and 2014, who were followed-up until delivery. Absences from work, both PORB and NWSA were recorded until the beginning of their maternity leave. The sequence analysis identifies four trajectories, which are described according to workers demographic and job characteristics. RESULTS Of the total cohort, 56 (13.1%) accessed only the PORB, representing 6.126 days of absence; 68 (15.9%) also accessed PORB, with 7.127 days of absence, but had previously accumulated 102 episodes of NWSA with 1.820 days of absence. The majority of pregnant workers in the sample (69.9%) took only one or several episodes of NWSA without using PORB, with 545 episodes and 26,337 days of absence. Most were active during the first quarter and it is from the second quarter that episodes of long-term NWSA appeared. During the last month of pregnancy more than 80% of the workers were absent from work. CONCLUSIONS Pregnant workers remained at work for two thirds of their pregnancy. Absences were mainly due to episodes of NWSA. PORB represented one third of them. As in other similar countries, our results suggest a change in the management of social protection benefits for pregnant workers.
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Affiliation(s)
- Rocío Villar
- Servicio de Salud Laboral, Parc de Salut Mar, IMIM PSMar, Barcelona, España; Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España
| | - Fernando G Benavides
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Laura Serra
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Consol Serra
- Servicio de Salud Laboral, Parc de Salut Mar, IMIM PSMar, Barcelona, España; Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
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Krief P, Zellweger A, Politis Mercier MP, Danuser B, Wild P, Zenoni M, Probst I. Protection of pregnant women at work in Switzerland: practices, obstacles and resources. A mixed-methods study protocol. BMJ Open 2018; 8:e023532. [PMID: 29903801 PMCID: PMC6009567 DOI: 10.1136/bmjopen-2018-023532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Like most industrialised countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace exposure. This legislation provides for a risk assessment, adaptations to workplaces and, if the danger is not eliminated, preventive leave (prescribed by a gynaecologist). This study's first objective is to analyse the degree to which companies, gynaecologists and midwives implement the law. Its second objective is to understand the obstacles and resources of this implementation, with a focus on how relevant stakeholders perceive protective measures and their involvement with them. METHODS AND ANALYSIS Data will be collected using mixed methods: (1) online questionnaires for gynaecologists and midwives; telephone questionnaires with company human resources (HR) managers in the healthcare and food production sectors; (2a) case studies of 6-8 companies in each sector, including interviews with stakeholders such as women workers, HR managers and occupational health physicians; (2b) two focus groups, one involving occupational physicians and hygienists, one involving labour inspectors.Quantitative data will be analysed statistically using STATA software V.15. Qualitative data will be transcribed and thematically analysed using MaxQDA software. ETHICS AND DISSEMINATION The Human Research Ethics Committee of the Canton Vaud (CER-VD) has certified that this research study protocol falls outside of the field of application of the Swiss Federal Act on Research Involving Humans.The publications and recommendations resulting from this study will form the starting point for future improvements to the protection of pregnant women at work and their unborn children.This study started in February 2017 and will continue until January 2020.
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Affiliation(s)
- Peggy Krief
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
| | - Alessia Zellweger
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Maria-Pia Politis Mercier
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Brigitta Danuser
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
| | - Pascal Wild
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
- Scientific Management, INRS, Vandœuvre-lès-Nancy, France
| | - Michela Zenoni
- Occupational Health, Institute for Work and Health (IST), Lausanne, Switzerland
- University of Lausanne and Geneva, Switzerland
| | - Isabelle Probst
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
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Migault L, Piel C, Carles C, Delva F, Lacourt A, Cardis E, Zaros C, de Seze R, Baldi I, Bouvier G. Maternal cumulative exposure to extremely low frequency electromagnetic fields and pregnancy outcomes in the Elfe cohort. ENVIRONMENT INTERNATIONAL 2018; 112:165-173. [PMID: 29275242 DOI: 10.1016/j.envint.2017.12.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 12/15/2017] [Accepted: 12/15/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To study the relations between maternal cumulative exposure to extremely low frequency electromagnetic fields (ELF EMF) and the risk of moderate prematurity and small for gestational age within the Elfe cohort. METHODS The Elfe study included 18,329 infants born at 33weeks of gestation or more in France in 2011 and was designed to follow the children until 20years of age. Gestational age and anthropometric data at birth were collected in medical records and small for gestational age was defined according to a French customized growth standard. During interviews, mothers were asked to report their job status during pregnancy. If employed, their occupation was coded according to the International Standard Classification of Occupations 1988 and the date on which they stopped their work was recorded. Cumulative exposure to ELF EMF during pregnancy was assessed, for both mothers who worked and those who did not during pregnancy, using a recently-updated job-exposure matrix (JEM). Cumulative exposure was considered as a categorical variable (<17.5, 17.5-23.8, 23.8-36.2, 36.2-61.6 or ≥61.6μT-days), a binary variable (<44.1 and ≥44.1μT-days) and a continuous variable. Associations were analyzed by logistic regression, adjusting for the mother's lifestyle factors, sociodemographic characteristics and some mother's medical history during and before pregnancy. Analyses were restricted to single births and to complete values for the pregnancy outcomes (n=16,733). RESULTS Cumulative exposure was obtained for 96.0% of the mothers. Among them, 37.5% were classified in the 23.8-36.2μT-days category, but high exposures were rare: 1.3% in the ≥61.6μT-days category and 5.5% in the ≥44.1μT-days category. No significant association was observed between maternal cumulative exposure and moderate prematurity and small for gestational age in this exposure range. CONCLUSION This large population-based study does not suggest that maternal exposure to ELF EMF during pregnancy is highly associated with risks of moderate prematurity or small for gestational age.
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Affiliation(s)
- L Migault
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France.
| | - C Piel
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France
| | - C Carles
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France; Bordeaux University Hospital, Service de Médecine du Travail et pathologie professionnelle, 608 avenue Léon Duguit, 33600 Pessac, France
| | - F Delva
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France
| | - A Lacourt
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France
| | - E Cardis
- Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - C Zaros
- Joint research unit Elfe, Ined-Inserm-EFS, 133 Boulevard Davout, 75020 Paris, France
| | - R de Seze
- TOXI PERITOX UMR-I-01 unit, INERIS, Parc ALATA BP2, 60550 Verneuil en Halatte, UPJV, Amiens, France
| | - I Baldi
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France; Bordeaux University Hospital, Service de Médecine du Travail et pathologie professionnelle, 608 avenue Léon Duguit, 33600 Pessac, France
| | - G Bouvier
- University of Bordeaux, Inserm U1219 EPICENE Team, Bordeaux Population Health Research Center, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France
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Maisonneuve E. Mode de vie et règles hygiénodiététiques pour la prévention de la prématurité spontanée chez la femme enceinte asymptomatique. ACTA ACUST UNITED AC 2016; 45:1231-1246. [DOI: 10.1016/j.jgyn.2016.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 12/27/2022]
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Usynina AA, Grjibovski AM, Odland JØ, Krettek A. Social correlates of term small for gestational age babies in a Russian Arctic setting. Int J Circumpolar Health 2016; 75:32883. [PMID: 27906118 PMCID: PMC5131456 DOI: 10.3402/ijch.v75.32883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Small for gestational age (SGA) births have been associated with both short- and long-term adverse health outcomes. Although social risk factors for SGA births have been studied earlier, such data are limited from Northern Russia. OBJECTIVE We assessed maternal social risk factors for term SGA births based on data from the population-based Murmansk County Birth Registry (MCBR). DESIGN Data on term live-born singleton infants born between 2006 and 2011 in Murmansk County were obtained from the MCBR. We applied the 10th percentile for only birth weight (SGAW) or for both birth weight and birth length (SGAWL). Binary logistic regression was used to estimate the effect of independent variables on SGA males and females with adjustment for known risk factors and potential confounders. Both crude and adjusted odds ratios with 95% confidence intervals for the studied risk factors were calculated. RESULTS The proportions of term SGAW and SGAWL births were 9.7 and 4.1%, respectively. After adjustment for potential confounders, the risk of term SGA births among less educated, unemployed, unmarried, smoking and underweight women was higher compared with women from the reference groups. Evidence of alcohol abuse was also associated with birth of SGAWL and SGAW boys. Maternal overweight and obesity decreased the risk of SGA. CONCLUSIONS Maternal low education, unemployment, unmarried status, smoking, evidence of alcohol abuse and underweight increased the risk of term SGA births in a Russian Arctic setting. This emphasizes the importance of both social and lifestyle factors for pregnancy outcomes. Public health efforts to reduce smoking, alcohol consumption and underweight of pregnant women may therefore promote a decrease in the prevalence of SGA births.
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Affiliation(s)
- Anna A Usynina
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- International School of Public Health, Northern State Medical University, Arkhangelsk, Russia;
| | - Andrej M Grjibovski
- International School of Public Health, Northern State Medical University, Arkhangelsk, Russia
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan
- Department of Public Health, Hygiene and Bioethics, Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
| | - Jon Øyvind Odland
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Alexandra Krettek
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Delay in Diagnosis of Hemoglobulinopathies (Thalassemia, Sickle Cell Anemia): A Need for Management of Thalassemia Programs. IRANIAN JOURNAL OF PEDIATRICS 2016. [DOI: 10.5812/ijp.6740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Birks L, Casas M, Garcia AM, Alexander J, Barros H, Bergström A, Bonde JP, Burdorf A, Costet N, Danileviciute A, Eggesbø M, Fernández MF, González-Galarzo MC, Hanke W, Jaddoe V, Kogevinas M, Kull I, Lertxundi A, Melaki V, Andersen AMN, Olea N, Polanska K, Rusconi F, Santa-Marina L, Santos AC, Vrijkotte T, Zugna D, Nieuwenhuijsen M, Cordier S, Vrijheid M. Occupational Exposure to Endocrine-Disrupting Chemicals and Birth Weight and Length of Gestation: A European Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1785-1793. [PMID: 27152464 PMCID: PMC5089886 DOI: 10.1289/ehp208] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/07/2015] [Accepted: 04/28/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND Women of reproductive age can be exposed to endocrine-disrupting chemicals (EDCs) at work, and exposure to EDCs in pregnancy may affect fetal growth. OBJECTIVES We assessed whether maternal occupational exposure to EDCs during pregnancy as classified by application of a job exposure matrix was associated with birth weight, term low birth weight (LBW), length of gestation, and preterm delivery. METHODS Using individual participant data from 133,957 mother-child pairs in 13 European cohorts spanning births from 1994 through 2011, we linked maternal job titles with exposure to 10 EDC groups as assessed through a job exposure matrix. For each group, we combined the two levels of exposure categories (possible and probable) and compared birth outcomes with the unexposed group (exposure unlikely). We performed meta-analyses of cohort-specific estimates. RESULTS Eleven percent of pregnant women were classified as exposed to EDCs at work during pregnancy, based on job title. Classification of exposure to one or more EDC group was associated with an increased risk of term LBW [odds ratio (OR) = 1.25; 95% CI: 1.04, 1.49], as were most specific EDC groups; this association was consistent across cohorts. Further, the risk increased with increasing number of EDC groups (OR = 2.11; 95% CI: 1.10, 4.06 for exposure to four or more EDC groups). There were few associations (p < 0.05) with the other outcomes; women holding job titles classified as exposed to bisphenol A or brominated flame retardants were at higher risk for longer length of gestation. CONCLUSION Results from our large population-based birth cohort design indicate that employment during pregnancy in occupations classified as possibly or probably exposed to EDCs was associated with an increased risk of term LBW. Citation: Birks L, Casas M, Garcia AM, Alexander J, Barros H, Bergström A, Bonde JP, Burdorf A, Costet N, Danileviciute A, Eggesbø M, Fernández MF, González-Galarzo MC, Gražulevičienė R, Hanke W, Jaddoe V, Kogevinas M, Kull I, Lertxundi A, Melaki V, Andersen AM, Olea N, Polanska K, Rusconi F, Santa-Marina L, Santos AC, Vrijkotte T, Zugna D, Nieuwenhuijsen M, Cordier S, Vrijheid M. 2016. Occupational exposure to endocrine-disrupting chemicals and birth weight and length of gestation: a European meta-analysis. Environ Health Perspect 124:1785-1793; http://dx.doi.org/10.1289/EHP208.
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Affiliation(s)
- Laura Birks
- ISGlobal, Center for Research in Environmental Epidemiology, Barcelona, Spain
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Address correspondence to L. Birks, ISGlobal, Center for Research in Environmental Epidemiology, Doctor Aiguader, 88, 08003 Barcelona, Spain. Telephone: 34 932 147 319. E-mail:
| | - Maribel Casas
- ISGlobal, Center for Research in Environmental Epidemiology, Barcelona, Spain
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Ana M. Garcia
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
- Center for Research in Occupational Health, Barcelona, Spain
| | | | - Henrique Barros
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Nathalie Costet
- National Institute of Health and Medical Research, InsermU1085 – Irset, University of Rennes, Rennes, France
| | - Asta Danileviciute
- Department of Environmental Science, Vytautas Magnus University, Kaunas, Lithuania
| | | | - Mariana F. Fernández
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, Granada, Spain
| | | | | | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Vincent Jaddoe
- The Generation R Study Group, Department of Epidemiology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Manolis Kogevinas
- ISGlobal, Center for Research in Environmental Epidemiology, Barcelona, Spain
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Hospital Del Mar Medical Research Institute, Barcelona, Spain
- National School of Public Health, Athens, Greece
| | - Inger Kull
- Sachs’ Children’s Hospital, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Aitana Lertxundi
- Faculty of Medicine, University of the Basque Country, Leioa, Basque Country, Spain
- BioDonostia Health Research Institute, San Sebastian, Basque Country, Spain
| | - Vasiliki Melaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece
| | | | - Nicolás Olea
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, Granada, Spain
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | | | - Loreto Santa-Marina
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Health, Government of the Basque Country, San Sebastian, Spain
| | - Ana Cristina Santos
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tanja Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Daniela Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mark Nieuwenhuijsen
- ISGlobal, Center for Research in Environmental Epidemiology, Barcelona, Spain
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Sylvaine Cordier
- National Institute of Health and Medical Research, InsermU1085 – Irset, University of Rennes, Rennes, France
| | - Martine Vrijheid
- ISGlobal, Center for Research in Environmental Epidemiology, Barcelona, Spain
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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Torchin H, Ancel PY. [Epidemiology and risk factors of preterm birth]. ACTA ACUST UNITED AC 2016; 45:1213-1230. [PMID: 27789055 DOI: 10.1016/j.jgyn.2016.09.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 09/14/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To synthesize the available evidence regarding the incidence and several risk factors of preterm birth. To describe neonatal outcomes according to gestational age and to the context of delivery. MATERIALS AND METHODS Consultation of the Medline database. RESULTS In 2010, 11% of live births (15 million babies) occurred before 37 completed weeks of gestation worldwide. About 85% of these births were moderate to late preterm babies (32-36 weeks), 10% were very preterm babies (28-31 weeks) and 5% were extremely preterm babies (<28 weeks). In France, premature birth concerns 60,000 neonates every year, 12,000 of whom are born before 32 completed weeks of gestation. Half of them are delivered after spontaneous onset of labor or preterm premature rupture of the membranes, and the other half are provider-initiated preterm births. Several maternal factors are associated with preterm birth, including sociodemographic, obstetrical, psychological, and genetic factors; paternal and environmental factors are also involved. Gestational age is highly associated with neonatal mortality and with short- and long-term morbidities. Pregnancy complications and the context of delivery also have an impact on neonatal outcomes. CONCLUSION Preterm birth is one of the leading cause of the under-five mortality and of neurodevelopmental impairment worldwide; it remains a major public health issue.
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Affiliation(s)
- H Torchin
- Inserm U1153, DHU risques et grossesse, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique, centre de recherche épidémiologie et statistique Sorbonne Paris Cité, bâtiment Port-Royal, 53, avenue de l'Observatoire, 75014 Paris, France; Université Paris Descartes, Paris, France.
| | - P-Y Ancel
- Inserm U1153, DHU risques et grossesse, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique, centre de recherche épidémiologie et statistique Sorbonne Paris Cité, bâtiment Port-Royal, 53, avenue de l'Observatoire, 75014 Paris, France; URC - CIC P1419, groupe hospitalier Cochin Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 75014 Paris, France; Université Paris Descartes, Paris, France
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Tollånes MC, Strandberg-Larsen K, Forthun I, Petersen TG, Moster D, Andersen AMN, Stoltenberg C, Olsen J, Wilcox AJ. Cohort profile: cerebral palsy in the Norwegian and Danish birth cohorts (MOBAND-CP). BMJ Open 2016; 6:e012777. [PMID: 27591025 PMCID: PMC5020679 DOI: 10.1136/bmjopen-2016-012777] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/27/2016] [Accepted: 08/16/2016] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. FINDINGS TO DATE Initial harmonisation of data from the 2 cohorts has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies investigating various hypotheses regarding CP aetiology are currently on-going. FUTURE PLANS Additional data can be harmonised as necessary to meet requirements of new projects. Biological specimens collected during pregnancy and at delivery are potentially available for assay, as are results from assays conducted on these specimens for other projects. The study size allows consideration of CP subtypes, which is rare in aetiological studies of CP. In addition, MOBAND-CP provides a platform within the context of a merged birth cohort of exceptional size that could, after appropriate permissions have been sought, be used for cohort and case-cohort studies of other relatively rare health conditions of infants and children.
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Affiliation(s)
- Mette C Tollånes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Ingeborg Forthun
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | | | - Dag Moster
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | | | - Camilla Stoltenberg
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Jørn Olsen
- Institute of Public Health, Aarhus University, Aarhus, Denmark
- UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Allen J Wilcox
- National Institutes of Environmental Health Sciences, Durham, North Carolina, USA
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