Deprivation, occupational hazards and perinatal outcomes in pregnant workers

<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Background</div>Recent global economic difficulties have widened social inequalities, but their impact on pregnant workers is not known.<div class="boxTitle">Aims</div>To investigate the association between deprivation, exposure to occupational hazards and adverse perinatal outcomes in pregnant workers.<div class="boxTitle">Methods</div>A cross-sectional study performed in 2014 in French occupational health services. Eligible workers were women who had worked during their pregnancy and had a medical visit by occupational health physicians (OHPs) after delivery and at the time of returning to work. Deprivation was measured using the EPICES scale (Evaluation of Precariousness and Inequalities in Health Examination Centres). Information on birth outcomes was self-reported. Occupational risks for pregnancy were assessed by OHPs. Jobs were coded by the occupational health team using standardized French nomenclature. The groups (deprivation/no deprivation) were compared using univariate (chi-squared test) and multivariate Poisson regression analyses.<div class="boxTitle">Results</div>Of 1402 pregnant workers, 293 (21%) were classed as deprived. This group more frequently encountered occupational hazards, particularly for physical exposures (<span style="font-style:italic;">P</span> < 0.001), and had a higher risk of cumulated occupational hazards of three or more for pregnancy [adjusted relative risk (RRa) = 4.2; 95% confidence interval (CI) 2.2–7.9]. Our findings suggest that deprivation and exposure to three or more occupational hazards during pregnancy cumulatively increased the risk of pre-term birth (RRa = 3.9; 95% CI 1.2–12.4).<div class="boxTitle">Conclusions</div>Our data suggest that deprived pregnant workers are an occupationally vulnerable group.</span>

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