ObstetricsOccupational fatigue and preterm premature rupture of membranes☆,☆☆
Section snippets
Material and methods
The Preterm Prediction Study was a multicenter (10 sites) observational cohort study of 2929 singleton pregnancies sponsored by the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network and approved by the institutional review boards at all sites. Inclusion criteria were as follows: singleton gestation, intact membranes, and enrollment between 22 and 24 weeks’ gestation. Race and parity distributions reflected each participating center, with no single
Results
Of the 3073 women recruited for the Preterm Prediction Study, 71 were unavailable for follow-up and 73 were initially evaluated outside the gestational age window of 22 to 24 weeks’ gestation. Of the remaining 2929 women with singleton pregnancies, 1218 were nulliparous (41.6%) and 1711 were multiparous (58.4%).
The incidence of preterm delivery at <37 weeks’ gestation was 14.4% (12.6% for nulliparous women and 15.8% for multiparous women). Preterm premature rupture of membranes occurred in 4.5%
Comment
Our understanding of the relationship between employment and preterm birth remains enigmatic, despite a dramatic increase in the number of pregnant women in the American workforce. The Preterm Prediction Study was designed to identify risk factors for preterm birth in a large obstetric population with singleton pregnancies. We found that occupational fatigue and an increasing number of hours worked per week were associated with preterm premature rupture of membranes among nulliparous women
Acknowledgements
Protocol Subcommittee members are as follows: R.B. Newman, MD, R.L. Goldenberg, MD (protocol chair), A. Das, MS, A.H. Moawad, MD, J.D. Iams, MD, P.J. Meis, MD, R.L. Copper, MSN, F. Johnson, RN, E. Thom, and D. McNellis, MD. Participating members of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network are as follows: James M. Roberts, MD, Steering Committee Chair, Magee Women’s Hospital, University of Pittsburgh; John C. Hauth, MD, Robert L.
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Supported by grants U10-HD-21410, U10-HD-27917, U10-HD-27860, U10-HD-27869, U10-HD-27905, U10-HD-27861, U10-HD-27860, U10-HD-27889, U10-HD-27883, U10-21414, and U10-HD-19897 from the National Institute of Child Health and Human Development.
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Reprint requests: Roger B. Newman, MD, Department of Obstetrics and Gynecology, Medical University of South Carolina, 96 Jonathan Lucas St, Suite 634, PO Box 250619, Charleston, SC 29425.