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

Shift work and pregnancy outcomes: a systematic review with meta-analysis of currently available epidemiological studies
Shift work and pregnancy outcomes: a systematic review with meta-analysis of currently available epidemiological studies
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
1470-0328
1429-1437
Bonzini, M.
0cd0ca2c-a67c-4ec4-95ee-7c93060d47a1
Palmer, K.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Cromi, A.
df66ede2-fffb-4736-8055-0b2c7cb3f690
Ferrario, M.
9ee5942f-85b4-4742-b253-2defa133f8ef
Bonzini, M.
0cd0ca2c-a67c-4ec4-95ee-7c93060d47a1
Palmer, K.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Coggon, D.
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Cromi, A.
df66ede2-fffb-4736-8055-0b2c7cb3f690
Ferrario, M.
9ee5942f-85b4-4742-b253-2defa133f8ef

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. British Journal of Obstetrics and Gynaecology, 118 (12), 1429-1437. (doi:10.1111/j.1471-0528.2011.03066.x). (PMID:21790955)

Record type: Article

Abstract

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

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More information

e-pub ahead of print date: 27 July 2011
Published date: November 2011
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 201977
URI: http://eprints.soton.ac.uk/id/eprint/201977
ISSN: 1470-0328
PURE UUID: b59c7557-30d9-4247-b6bc-eafe2403d21c
ORCID for D. Coggon: ORCID iD orcid.org/0000-0003-1930-3987

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Date deposited: 03 Nov 2011 11:09
Last modified: 15 Mar 2024 02:52

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Contributors

Author: M. Bonzini
Author: K. Palmer
Author: D. Coggon ORCID iD
Author: A. Cromi
Author: M. Ferrario

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