Journal
AMERICAN JOURNAL OF INDUSTRIAL MEDICINE
Volume 60, Issue 4, Pages 329-341Publisher
WILEY
DOI: 10.1002/ajim.22700
Keywords
employment; pregnancy; confounding factors (epidemiology); healthy worker effect
Categories
Funding
- Centers for Disease Control and Prevention [U50/CCU 713238, U01/DD000492]
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BackgroundPotential confounding or effect modification by employment status is frequently overlooked in pregnancy outcome studies. MethodsTo characterize how employed and non-employed women differ, we compared demographics, behaviors, and reproductive histories by maternal employment status for 8,343 mothers of control (non-malformed) infants in the National Birth Defects Prevention Study (1997-2007) and developed a multivariable model for employment status anytime during pregnancy and the 3 months before conception. ResultsSixteen factors were independently associated with employment before or during pregnancy, including: maternal age, pre-pregnancy body mass index, pregnancy intention, periconceptional/first trimester smoking and alcohol consumption, and household income. ConclusionsEmployment status was significantly associated with many common risk factors for adverse pregnancy outcomes. Pregnancy outcome studies should consider adjustment or stratification by employment status. In studies of occupational exposures, these differences may cause uncontrollable confounding if non-employed women are treated as unexposed instead of excluded from analysis. Am. J. Ind. Med. 60:329-341, 2017. (c) 2017 Wiley Periodicals, Inc.
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