Shift work and pregnancy outcomes: a systematic review with meta-analysis of currently available epidemiological studies

Bonzini, M., Palmer, K., Coggon, D., Cromi, A. and Ferrario, M. (2011) Shift work and pregnancy outcomes: a systematic review with meta-analysis of currently available epidemiological studies. An International Journal of Obstetrics & Gynaecology, 118, (12), 1429-1437. (doi:10.1111/j.1471-0528.2011.03066.x). (PMID:21790955).


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Background: varying work schedules are suspected of increasing risks to pregnant women and to fetal wellbeing. In particular, maternal hormonal disturbance arising from sleep deprivation or circadian rhythm disruption might impair fetal growth or lead to complications of pregnancy. Two independent meta-analyses (from 2000 to 2007) reported a small adverse effect of shift work on the risk of preterm delivery (PTD). However, these reviews were based on few high-quality studies.

Objectives: to provide an updated review of the associations of shift work with PTD, low birthweight (LBW), small-for-gestational-age (SGA) infants and pre-eclampsia.

Search strategy and selection criteria: we conducted a systematic search of MEDLINE using combinations of keywords and MeSH terms.

Data collection and analysis: for each relevant paper we abstracted standard details, used to summarise design features and rate methodological quality. We calculated pooled estimates of relative risk (RR) in random-effect meta-analyses.

Main results: we retrieved 23 relevant studies. The pooled estimate of RR for PTD was 1.16 (95% CI 1.00–1.33, 16 studies), but when five reports of poorer methodological quality were excluded, the estimated RR decreased to 1.03 (95% CI 0.93–1.14). We also observed increased RRs for LBW (RR 1.27, 95% CI 0.93–1.74) and for SGA (RR 1.12, 95% CI 1.03–1.22), which varied little by study quality. Little evidence was found on pre-eclampsia.

Conclusions: these findings suggest that overall, any risk of PTD, LBW, or SGA arising from shift work in pregnancy is small

Item Type: Article
Digital Object Identifier (DOI): doi:10.1111/j.1471-0528.2011.03066.x
ISSNs: 1470-0328 (print)
1471-0528 (electronic)
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions : Faculty of Medicine
ePrint ID: 201977
Accepted Date and Publication Date:
27 July 2011Made publicly available
November 2011Published
Date Deposited: 03 Nov 2011 11:09
Last Modified: 31 Mar 2016 13:46

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