Study Finds Stressful Job Not Harmful in Pregnancy : Medicine: Healthy, professional women are at no greater risk than other expectant mothers, report finds.
Professional women who work long hours in high-stress jobs during pregnancy are just as likely as others to have healthy babies, according to a new study that researchers say offers reassurance to prospective mothers among the growing ranks of working women.
The study, published today in the New England Journal of Medicine, found that physicians-in-training who worked about 70 hours a week while pregnant were at no greater risk than others of having their pregnancies end in miscarriage, stillbirth or other problems.
Nor were they more likely to give birth early.
“We can say that for . . . generally healthy, upper-middle class women, that virtually any type of work during pregnancy is probably not going to harm their pregnancy,” said Patricia Shiono, an epidemiologist with the Center for the Future of Children in Los Altos.
Shiono and the other researchers, headed by a pediatrician from the National Institutes of Health, cautioned that their findings apply to healthy, affluent women. They did not study lower-income and disadvantaged women or women with already complicated pregnancies.
They also noted that women in the study who worked especially long hours--100 hours or more a week--were more likely to have a preterm delivery. Babies born early and therefore underweight face a greater risk than other babies of a variety of health problems.
“If there is any sign of complications, obstetricians are likely to advise women to slow down (their work schedules). We would agree with that,” said Dr. George G. Rhoads, a co-author of the paper. “These findings should not be construed (to mean) that you should work through thick and thin.”
It has long been believed that women who become pregnant during a medical residency face an increased risk of complications. Earlier studies have produced mixed results, but some have found an added risk of preterm delivery, delays in fetal development and other problems.
The issue is considered important not only because of the extraordinary demands made upon medical residents, 28% of whom now are women; it is also of interest for what it reflects about the effects of work in general on the ability to bear a healthy child.
Obstetricians say the risk seems to vary from occupation to occupation and that it is difficult to generalize about what women should do, but many believe that jobs requiring heavy lifting and long hours of standing may be especially risky.
“If it’s a sedentary job, people can work until fairly close to delivery unless they run into medical complications,” said Dr. Palmer C. Evans, an obstetrician-gynecologist in Tucson. “But if they’re doing very heavy, manual work, a lot of times they need to stop sooner than that.”
The study, based on a survey of 4,412 women physicians, is the largest conducted, the researchers said. They compared the women to 4,236 wives of male residents, many of whom worked during pregnancy but only about half the hours of the women residents.
The researchers, headed by Dr. Mark A. Klebanoff of the National Institute of Child Health and Human Development, found that 13.8% of the pregnancies among the medical residents and 11.8% of the other women ended in miscarriage--a difference too small to be significant.
Similarly, the two groups had comparable percentages of stillbirths, under-developed babies and ectopic gestations, in which the fertilized egg is deposited outside the uterus. The residents were more likely to have had preterm labor and preeclampsia (pregnancy-induced hypertension), but not preterm birth.
Klebanoff said it was hard to know what to make of the increased risk of preterm labor and preeclampsia without examining each woman’s medical records. But he speculated that the residents and their obstetricians may have been especially alert to symptoms.
The only group that showed significant differences in rates of preterm delivery were the 143 medical residents who worked 100 hours or more a week during pregnancy. They were approximately twice as likely as the others to deliver their baby early.
