A screening questionnaire for occupational and hobby exposures during pregnancy

Abstract

Background Occupational and environmental exposures during the prenatal period may be associated with adverse pregnancy outcomes and lifelong health effects. Yet, identification and evaluation of these potential hazards is lacking in routine obstetric care. Aims To assess the feasibility of incorporating a self-administered occupational and environmental exposure questionnaire into obstetric clinics. Methods A cross-sectional survey assessed prenatal clinic patients at a public hospital who were currently employed and <20 weeks gestation. Questionnaires evaluated job characteristics, workplace and hobby exposures, protective equipment use and symptoms during pregnancy. Results Of 69 participants (96% response rate), 46% were predominantly Spanish-speaking. Primary occupations were caregiver (16%), cleaner (14%) and administrative assistant (14%). Overall, 93% were exposed to a workplace hazard, with most participants reporting physical stressors (82%) or organic solvent exposure (78%). Most women (74%) used some personal protective equipment. Nearly half (54%) reported at least one non-pregnancy symptom, and 52% were referred for follow-up with an occupational medicine practitioner. Household and hobby-related chemical exposures were common in our sample (91%). We observed moderate consistency between job task and chemical use responses: 67–99% of intentionally redundant questions were fully or partially matched. Closed- compared to open-ended activity questions identified a higher proportion of physical stressors (82% versus 12%) and cleaning product (76% versus 30%) exposures. Conclusions A self-administered questionnaire is an effective screening tool for identifying women with occupational and hobby-related exposures during pregnancy. Consistent incorporation of exposure assessment into prenatal care can improve clinical communications and early interventions for at-risk pregnant women.

Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

“… 39 , 45 , 51 , 52 Some took place in midwife clinics ( n =3). 44 , 53 , 54 Settings were both private and public and included private obstetric offices ( n =2), 39 , 43 public clinics and hospitals ( n =4), 35 , 49 , 50 , 55 federally qualified health centers ( n =3), 45 , 46 , 51 Women, Infant, and Children (WIC) sites ( n =1), 45 academic settings ( n =7), 25–30 , 49 and community settings ( n =4). 43 , 45 , 46 , 54 Studies were conducted in the United States ( n =17), 25–30 , 31–35 , 39 , 41–43 , 45 , 46 , 48 , 49 , 51 , 52 , 55 Australia ( n =4), 36 , 44 , 50 , 54 the United Kingdom ( n =2), 40 , 53 Canada ( n =1), 47 Hong Kong ( n =1), 37 and Belgium ( n =1).…”

“…Most interventions took place in prenatal care clinics (n =15), [25][26][27][28][29][30][31][32][33][34]39,40,43,47,48 hospitals (n = 8), [36][37][38][41][42][43]49,50 or primary care clinics (n = 5). 39,45,51,52 Some took place in midwife clinics (n = 3).…”

“…44,53,54 Settings were both private and public and included private obstetric offices (n = 2), 39,43 public clinics and hospitals (n = 4), 35,49,50,55 federally qualified health centers (n = 3), 45,46,51 Infant, and Children (WIC) sites (n = 1), 45 academic settings (n = 7), [25][26][27][28][29][30]49 and community settings (n = 4). 43,45,46,54 Studies were conducted in the United States (n = 17), [25][26][27][28][29][30][31][32][33][34][35]39,[41][42][43]45,46,48,49,51,52,55 Australia (n = 4), 36,44,50,…”

“…One study screened for workplace exposures. 49 Two studies addressed health literacy: Sayakhot et al offered a web-based education module for gestational diabetes that was issued during clinic visits and Backonja et al incorporated reproductive health education into regular clinic-based counseling sessions. 31,36 No studies addressed civic participation, discrimination, or incarceration history, which fall under the social and community context domain of Healthy People 2020.…”

“…Another intervention was a computer-based screener with a 15-min informational video and prompting card that was given to the provider. 34 Women in this Validity of screening tool 40,42,49,50,51 Risk identification 28,32,34,41,42 Acceptability 30,32,33,41,44,46,47 Patient-rated helpfulness 32,34,38,43,45,48 Length of administration 30,45,49,51 Referral/patient use of referrals 33,35,45,46,53,54 Screening rate 54 Appointment adherence 45 Health knowledge 31,36 Social support 52,53 ETSE 25,26 IPV (episodes of violence, severity, behaviors) 29,11,35,[37][38][39]55 ...…”