Long working hours and pregnancy complications: women physicians survey in Japan

Abstract

BackgroundPrevious studies have investigated the impact of occupational risk factors on health outcomes among physicians. However, few studies have investigated the effects on pregnancy outcomes among physicians. In this study, we examined the association between working hours during pregnancy and pregnancy complications among physicians.MethodsA cross-sectional study was based on a survey conducted in 2009-2011 of 1,684 alumnae (mean age, 44 ± 8 years) who had graduated from 13 private medical schools in Japan. Data on threatened abortion (TA), preterm birth (PTB), and the number of working hours during the first trimester of pregnancy were obtained via retrospective assessments.ResultsOf the 939 physicians with a first pregnancy, 15% experienced TA and 12% experienced PTB. Women who experienced TA (mean weekly working hours: 62 h vs. 50 h, P < .0001) or PTB (62 h vs. 50 h, P < .0001) had longer weekly working hours during the first trimester than did those without pregnancy complications. Compared with women who worked 40 hours or less per week, women who worked 71 hours or more per week had a three-fold higher risk of experiencing TA (95% confidence interval (CI): 1.7-6.0) even after adjusting for medical specialty, maternal age, and current household income. The risk of experiencing PTB was 2.5 times higher (95% CI:1.2-5.2) in women who worked 51-70 hours and 4.2 times higher (95% CI: 1.9-9.2) in women who worked 71 hours or more even after adjusting for specialty, maternal age, and current household income. The trend in the P statistic reflecting the effect of the quartile of hours worked per week (40 hours, 41-50 hours, 51-70 hours, ≥71 hours) on TA or PTB was 0.0001 in the multivariate logistic regression models.ConclusionThese results suggest that working long hours during the first trimester of pregnancy is associated with TA and PTB.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2393-14-245) contains supplementary material, which is available to authorized users.

Reducing the Risk of Preterm Birth by Ambulatory Risk Factor Management

“…In a Japanese study of pregnant doctors in their first trimester, who were working >51-70 hours/week, the risk of preterm birth was 2.5 times (aOR: 2.5; [1.2; 5.2]) higher, and for working hours in excess of 71 hours/week, it was 4.2 times higher (aOR: 4.2; [1.0; 9.1]) (32). No increased risk of preterm birth was found for shift work or standing for long periods of time (>6 hours/day) (30,31).…”

Preterm birth rates in Japan from 1979 to 2014: Analysis of national vital statistics

“…28 In light of the increasing employment rate among Japanese women, especially among those in their late 20s (46.6% in 1979 and 78.2% in 2016) and early 30s (46.3% in 1979 and 70.3% in 2016), 29 future research should examine the potential impact of various work conditions on pregnancy outcome. A number of cross-sectional studies conducted overseas have established an association between preterm birth and long working hours, [30][31][32][33][34][35][36][37][38][39] shift work 30,32,34,36,40,41 and prolonged standing. 31,32,34,36,37 A more direct reason for the rising preterm birth rate, especially among younger mothers, might be related to changes in clinical practice, such as labor induction and cesarian section at earlier stages of pregnancy, which should also be examined in future studies.…”

Comparison of Labor and Delivery Complications and Delivery Methods Between Physicians and White-Collar Workers

“…Physicians often work in environments where they are exposed to various occupational and environmental hazards, including radiation, cytotoxic drugs, anesthetic gases, and infectious materials or blood [ 1 , 2 , 3 ]. In addition, physicians also entail long working hours, extended work shifts, and a high workload, thereby they encounter more psychologically and physically stressful conditions [ 4 , 5 ], especially the increasing proportion of female doctors [ 6 ]. The impact of these exposures may increase the risks of maternal and fetal complications during pregnancy and delivery [ 1 , 2 , 4 , 5 , 6 , 7 ].…”

“…In addition, physicians also entail long working hours, extended work shifts, and a high workload, thereby they encounter more psychologically and physically stressful conditions [ 4 , 5 ], especially the increasing proportion of female doctors [ 6 ]. The impact of these exposures may increase the risks of maternal and fetal complications during pregnancy and delivery [ 1 , 2 , 4 , 5 , 6 , 7 ]. In addition, female physicians’ medical knowledge and practice in a profession may influence their health-related behaviors and their use of healthcare services [ 6 , 7 ].…”