Work and pregnancy: The role of fatigue and the “second shift” on antenatal morbidity,

Objective: This study was undertaken to evaluate factors at home and work associated with antenatal morbidity (emergency department visits and hospitalizations) among employed pregnant women. Study Design: This prospective study of 213 women included 3 antenatal interviews at about 16, 24, and 30 weeks’ gestation with questions on health history, lifestyle, housework, working conditions, and emergency department visits and hospitalizations. Work scores and home scores were formulated from each interview. Fatigue was defined as being very tired or extremely tired at the end of a typical workday. The risk of antenatal morbidity was modeled by means of logistic regression; results are presented as adjusted odds ratios with 95% confidence intervals. Results: The risk of antenatal morbidity, which was greatest during the second trimester, was increased by stress (adjusted odds ratio, 2.45; 95% confidence interval, 1.32-4.57), fatigue (adjusted odds ratio, 3.77; 95% confidence interval, 1.98-7.18), work plus home score (adjusted odds ratio, 1.55; 95% confidence interval, 1.22-1.97), and the interaction of fatigue and work plus home score (adjusted odds ratio, 4.61; 95% confidence interval, 2.02-10.50). Conclusions: These findings suggest that maternal fatigue contributes significantly to antenatal morbidity. (Am J Obstet Gynecol 1999;181:1172-9.)