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Shift work, long working hours and preterm birth: a systematic review and meta-analysis
M J G J van Melick1, M D M van Beukering, B W Mol
1Maastricht University Medical Centre, Department of Obstetrics and Gynaecology, PO Box 5800, Maastricht, 6202 AZ, The Netherlands, mvmelick@viecuri.nl.
Summary
Shift work during pregnancy did not significantly increase preterm birth (PTB) risk. Long working hours showed a marginal association with PTB, but more high-quality research is needed for firm conclusions on these occupational exposures.
Area of Science:
- Occupational Health
- Reproductive Epidemiology
- Perinatal Studies
Background:
- Specific occupational exposures like shift work and long working hours are suspected to increase preterm birth (PTB) risk.
- Understanding these associations is crucial for maternal and infant health.
- Existing evidence requires synthesis to clarify the impact of these working conditions on pregnancy outcomes.
Purpose of the Study:
- To systematically review and synthesize existing evidence on the association between shift work or long working hours and the risk of preterm birth.
- To quantify the risk of PTB associated with these occupational exposures through meta-analysis.
Main Methods:
- Systematic literature search conducted in MEDLINE and EMBASE databases (1990-2013).
- Inclusion of observational and intervention studies with original data meeting specific quality and data criteria.
- Meta-analysis pooling data from included high-quality and moderate-quality studies.
Main Results:
- No clear or statistically significant relationship was found between shift work during pregnancy and preterm birth (summary OR 1.04, 95% CI 0.90-1.20).
- Long working hours during pregnancy showed a marginally statistically significant association with preterm birth (summary OR 1.25, 95% CI 1.01-1.54), indicating a slightly elevated risk.
- Eight high-quality and eight moderate-quality studies were included in the meta-analysis.
Conclusions:
- Shift work, including night shifts, during pregnancy was not significantly associated with an increased risk of preterm birth in the reviewed studies.
- A marginally significant association was observed between long working hours and preterm birth, but the elevated risk was slight.
- A definitive conclusion regarding the association between these occupational factors and PTB cannot be stated due to a lack of high-quality studies, particularly those examining risks per trimester (e.g., third trimester).
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