Testing the association between psychosocial job strain and adverse birth outcomes - design and methods

BMC Public Health

Study Protocol

Ane M Thulstrup¹  Jens P Bonde²  Carsten Obel³  Karin S Hougaard⁴  Harald Hannerz⁴  Ann D Larsen⁵ 

[1] Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark;Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark;Faculty of Health Sciences, Aarhus University, Aarhus, Denmark;National Research Centre for the Working Environment, Copenhagen, Denmark;National Research Centre for the Working Environment, Copenhagen, Denmark;Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark;

关键词: Preterm Birth;    Multinomial Logistic Regression;    Full Term;    Coffee Consumption;    Estimate Odds Ratio;   

DOI  :  10.1186/1471-2458-11-255

 received in 2010-11-30, accepted in 2011-04-21,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundA number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the risk of giving birth to a child born preterm or small for gestational age.Methods and designWe will use the Danish National Birth Cohort where 100.000 children are included at baseline. In the present study 49,340 pregnancies will be included. Multinomial logistic regression will be applied to estimate odds ratios for the outcomes: preterm; full term but small for gestational age; full term but large for gestational age, as a function of job-strain (high strain, active and passive versus low strain). In the analysis we control for maternal age, Body Mass Index, parity, exercise, smoking, alcohol use, coffee consumption, type of work (manual versus non-manual), maternal serious disease and parents' heights as well as gestational age at interview.DiscussionThe prospective nature of the design and the high number of participants strengthen the study. The large statistical power allows for interpretable results regardless of whether or not the hypotheses are confirmed. This is, however, not a controlled study since all kinds of 'natural' interventions takes place throughout pregnancy (e.g. work absence, medical treatment and job-redesign). The analysis will be performed from a public health perspective. From this perspective, we are not primarily interested in the effect of job strain per se but if there is residual effect of job strain after naturally occurring preventive measures have been taken.

【 授权许可】

CC BY   
© Larsen et al; licensee BioMed Central Ltd. 2011