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By Amy Norton
NEW YORK, Mar 06 (Reuters Health) - New research suggests that on-the-job fatigue may increase a pregnant woman's chances of experiencing a premature rupture of membranes, a condition that often precedes preterm delivery.
Exactly why there is a connection, and whether it extends to all working women, is unclear. However, study author Dr. Roger B. Newman told Reuters Health that the findings highlight work conditions--such as repeated heavy lifting and working with industrial machinery--that pregnant women should avoid whenever possible.
In a study of nearly 3,000 pregnant women, Newman and his colleagues found that for those having their first baby, the risk of premature rupture of membranes grew in tandem with the amount of fatigue women experienced at work. While women who were not working outside the home had a 2% risk of premature rupture, the risk was more than 7% among those with the most fatiguing jobs. These most-draining jobs were labor-intensive, involving physical exertion and long periods of standing, and often caused mental stress as well.
The findings were published in the February issue of the American Journal of Obstetrics and Gynecology.
Premature rupture of membranes refers to a break of the amniotic sac that protects the fetus during pregnancy. Often, preterm labor shortly follows. But in the current study, job fatigue was linked only to premature rupture of membranes, and not preterm labor in general. And it only affected women having their first babies. The reasons for this are unclear, according to Newman, an associate professor of obstetrics and gynecology at the Medical University of South Carolina in Charleston.
It is also unknown whether job fatigue early in pregnancy would show the same link to premature rupture of membranes, Newman noted. The women were questioned on their work conditions late in their second trimesters.
In fact, Newman said, no one knows the point in pregnancy at which women should start shunning heavy exertion and, when possible, stress. He recommends that women avoid regularly lifting heavy loads and working on machinery that produces "vibrations" throughout pregnancy.
One problem with the study, according to Newman, is that the questionnaire used to gauge the women's on-the-job fatigue focused mainly on labor-intensive work.
"It may not translate to an urban population in the US," he said.
However, there is evidence that job stress may increase the risk of preterm delivery. And one recent study showed that pregnant women with the most stress at work were at greater risk for pregnancy-induced high blood pressure, a potentially dangerous condition for the woman and fetus.
What is needed, Newman said, is better data on how work inside and outside of the home relates to pregnancy complications. For instance, he noted, some women may come home from work only to take on all the household responsibilities. According to Newman, this so-called "second-shift effect" could be a key factor in which working women may be at risk for pregnancy problems.
SOURCE: American Journal of Obstetrics and Gynecology 2001;184:438-446.
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