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This Article Full Text Full Text (PDF) Supplemental Data All Versions of this Article: AJPH.2008.138412v1 99/8/1409    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Vrijkotte, T. G. M. Articles by Bonsel, G. J. PubMed PubMed Citation Articles by Vrijkotte, T. G. M. Articles by Bonsel, G. J. Related Collections Epidemiology Birth Outcomes Pregnancy Occupational Health Women's Health

Tanja G. M. Vrijkotte, PhD, Marcel F. van der Wal, PhD, Manon van Eijsden, PhD and Gouke J. Bonsel, MD

At the time of the study, Tanja G. M. Vrijkotte, Manon van Eijsden, and Gouke J. Bonsel were with the Department of Social Medicine, Academic Medical Centre Amsterdam, Amsterdam, Netherlands. Marcel F. van der Wal and M. van Eijsden were with the Department of Epidemiology, Documentation and Health Promotion, Municipal Health Service Amsterdam, Amsterdam.

Correspondence: Correspondence should be sent to Tanja G. M. Vrijkotte, PhD, Department of Social Medicine, Academic Medical Centre Amsterdam, Postbox 22660, 1100 DD Amsterdam, Netherlands (e-mail: t.vrijkotte{at}amc.uva.nl). Reprints can be ordered from http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. We investigated the relationship between women's first-trimester working conditions and infant birthweight.

Methods. Pregnant women (N = 8266) participating in the Amsterdam Born Children and Their Development study completed a questionnaire gathering information on employment and working conditions. After exclusions, 7135 women remained in our analyses. Low birthweight and delivery of a small-for-gestational-age (SGA) infant were the main outcome measures.

Results. After adjustment, a workweek of 32 hours or more (mean birthweight decrease of 43 g) and high job strain (mean birthweight decrease of 72 g) were significantly associated with birthweight. Only high job strain increased the risk of delivering an SGA infant (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.1, 2.2). After adjustment, the combination of high job strain and a long workweek resulted in the largest birthweight reduction (150 g) and the highest risk of delivering an SGA infant (OR = 2.0; 95% CI = 1.2, 3.2).

Conclusions. High levels of job strain during early pregnancy are associated with reduced birthweight and an increased risk of delivering an SGA infant, particularly if mothers work 32 or more hours per week.