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Women Who Work During Pregnancy Have Higher Risk of Pre-Eclampsia

Women who work during their first pregnancy are at a higher risk of developing pre-eclampsia.

This finding was irrespective of factors such as smoking, drinking, weight, height and age, reports Dr John Higgins and colleagues at the Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland. The clinicians did not assess what type of work was particularly associated with pre-eclampsia.

In western society, more women than ever work during pregnancy but, the effects of maternal employment on outcome remain controversial. There are suggestions that if pregnant women work into the third trimester, this could be associated with an increased incidence of preterm delivery, a decrease in mean birth weight, and an increased incidence of pre-eclampsia.

Dr Higgins assessed 933 healthy normotensive primigravidas enrolled into a study on the predictive value of ambulatory blood pressure measurement performed between 18 and 24 weeks gestation. The women were classified into three groups: 245 were working during their pregnancy; 289 were not working; and 399 were employed, but chose not to work.

When the researchers adjusted for age, body mass index, smoking, drinking, and marital status, they found that women at work had higher mean daytime systolic, and diastolic, and 24-hour systolic pressures compared with women who were not working. Subsequent pre-eclampsia was significantly higher among women who worked compared with those who did not. The association between pre-eclampsia and maternal work remained significant

There were no differences among the three groups in length of pregnancy, birthweight, or method of delivery - induction or caesarean section. But, women in employment were almost five times as likely to develop pre-eclampsia. Older women tended to have higher blood pressures, but there were more smokers among the younger women.

"The homogeneous nature of this cohort (all white, all primigravid), the exclusion of women with important blood pressure confounders (pre-existing hypertension, renal disease, and diabetes mellitus) and the size of the study decrease the chance that the associations described are attributable to bias," the researchers declare.

There is no obvious explanation for the link between pre-eclampsia and work, they add. It has been suggested that the stress of work leads to an increased release of catecholamines and a daylong sympathetic response that increases blood pressure.
Journal of Epidemiology And Community Health 2002; 56: 389-93.

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