Adverse birth outcomes associated with selected maternal occupations in 12 European birth cohorts - a CHICOS initiative

摘要

Background:Occupational maternal exposures during pregnancy may affect fetal development. The population-based birth cohort design has been used very few times in this field; however, they collect data prospectively and self-reported by the mother, and can follow children up for many years. Aims: To examine the association between selected maternal occupations and adverse birth outcomes and evaluate the heterogeneity between cohorts. Methods: As part of the CHICOS project, a total of 12 European birth cohorts studying more than 200,000 mother-child pairs were included. Nine occupational sectors were defined as being exposed to a range of specific environmental agents: health, day-care, cleaning, agriculture, electricity, laboratory work, food industry, printing and painting, and hairdressers. The reference group was defined as being non-exposed to environmental agents including managers, computer workers, and office clerks. Adverse birth outcomes assessed were: birth weight, small-for-gestational-age, term low birth weight, gestational age, and preterm birth. We performed meta-analyses using a random effects model and explored heterogeneity. Results: Between 74-97% of women worked during pregnancy. The nine selected occupational sectors accounted for 58% of the total workforce. Women working in the health sector had infants with lower risk of being SGA (adj OR=0.93; 95%CI=0.88, 0.99) whereas construction workers had babies with higher risk (OR=1.31; 95%CI=1.00-1.70). Work in food industry and agriculture increased the risk of preterm (OR=1.53, 95%CI=1.13, 2.08) and term low birth weight babies (OR=2.03; 95%CI=1.09, 3.79), respectively. There was little evidence for heterogeneity between cohorts in these analyses (l2＜25%). Conclusions: Work during the pregnancy in certain occupational sectors may adversely affect birth outcomes across Europe. Further analyses based on this dataset will apply job exposure matrices and study health effects in children later in life.