Rotating shift work and night work linked to adverse pregnancy outcomes

  • Cai C & al.
  • Am J Obstet Gynecol
  • 2 Jul 2019

  • International Clinical Digest
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Takeaway

  • Rotating shift work and night work during pregnancy is associated with pregnancy complications.

Why this matters

  • 90% of women remain employed during pregnancy; 21% are engaged in shift work, 14% engaged in night work.
  • Abnormal sleep patterns and long working hours have been associated with disruption of circadian rhythms and neuroendocrine adaptations that may affect fetal growth and parturition.
  • Pregnant women should be able to adjust work schedules to decrease risks.

Key results

  • Fixed night shift:
    • Working night shifts was associated with increased risk for preterm delivery (OR, 1.21; 95% CI, 1.03-1.42) and increased risk for miscarriage (OR, 1.23; 95% CI, 1.03-1.47).
    • Night shifts not associated with stillbirth, preeclampsia, gestational diabetes mellitus, and low birth weight.
  • Rotating shifts:
    • Working rotating shifts was associated with (ORs; 95% CIs):
      • Preterm delivery: 1.13 (1.00-1.28),
      • Small for gestational age: 1.18 (1.01-1.38), 
      • Preeclampsia: 1.75 (1.01-3.01), and
      • Gestational hypertension: 1.19 (1.10-1.29).

Study design

  • Literature review and meta regression analysis (62 observational studies).
  • Funding: Government of Alberta Occupational Health and Safety (OHS) Futures Research Grant.

Limitations

  • Limitations related to limitations of original studies.
  • Confounding variables not addressed.
  • Definitions of shift work may be different across studies.

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