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Cited by 25

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Retrospective cohort study of the association between maternal employment precarity and infant low birth weight in women in the USA

Patil, Divya, Enquobahrie, Daniel A, Peckham, Trevor, Seixas, Noah, Hajat, Anjum·2020·BMJ Open
DOI 10.1136/bmjopen-2019-029584
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Abstract

Objectives: To investigate the association between maternal employment precarity and infant low birth weight (LBW), and to assess if this association differs by race/ethnicity. Methods: Data were collected from 2871 women enrolled in the National Longitudinal Survey of Youth 1979 and the National Longitudinal Survey of Youth 1979 Children and Young Adult Cohort. Employment precarity was evaluated using a summary variable that combined several employment attributes: availability of employer-sponsored insurance, income, long shifts, non-daytime shifts, availability of employer sponsored training or educational benefits and membership in a union or collective bargaining unit. Employment precarity scores (a sum of the number of negative employment attributes) were categorised into low (0–2), medium (3) and high (4-6). LBW was defined as weight less than 2500 g at birth. Modified Poisson models were fit to calculate risk ratios and 95% CIs and adjusted for maternal age, race/ethnicity, educational attainment, nativity, prepregnancy body mass index, alcohol consumption, smoking during pregnancy and infant year of birth. We assessed effect modification by maternal race/ethnicity using a composite exposure-race variable. Results: Women with high employment precarity had higher risk of a LBW delivery compared with women with low employment precarity (RR: 1.48, 95% CI: 1.11 to 1.98). Compared to non-Hispanic/non-black women with low employment precarity, non-Hispanic black women (RR: 2.68; 95% CI: 1.72 to 4.15), Hispanic women (RR: 2.53; 95% CI: 1.54 to 4.16) and non-Hispanic/non-black women (RR: 1.46; 95% CI: 0.98 to 2.16) with high employment precarity had higher risk of LBW. Conclusions: We observed higher risk of LBW in pregnancies of women with high employment precarity; this association was stronger among black and Hispanic mothers compared to non-Hispanic/non-black women. Findings of this study can be used to inform antenatal care and identify workplace policies to better support women who work during pregnancy.

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Metadata

Authors
Patil, D., Enquobahrie, D. A., Peckham, T., Seixas, N., & Hajat, A.
Affiliations
  • Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
  • Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington, USA
ORCID
Hajat, Anjum
Venue
BMJ Open
Publisher
BMJ
Published
2020-01
Volume
10
Issue
1
Pages
e029584
ISSN
2044-6055
DOI
10.1136/bmjopen-2019-029584
Cited by
25
References
8
Language
en
Licence
creativecommons.org/licenses/by-nc/4.0/ (unspecified, 8 d)
Funders
  • National Institute on Aging (R01AG060011)
  • Maternal and Child Health Bureau, Health Resources and Services Administration (T76MC00011)

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