Do Nurses Have Worse Pregnancy Outcomes?

Purpose: Nurses encounter multiple occupational exposures in their daily work which may harm their reproductive health. The purpose of the study was to compare pregnancy complications and outcomes including cesarean deliveries, tocolysis, abortion, and preterm births between female nurses and non-nurse comparative women in Taiwan. 

Methods: This nationwide population-based study was performed using the National Health Insurance Research Database from 1997 to 2008. We identified 3,656 pregnancies among 2,326 nurses and 111,889 pregnancies among 74,919 non-nurses. Generalized estimating equation was used to compare risks between the two groups. 

Results: The rate of tocolysis (28.61% vs. 22.30%), abortion (6.21% vs. 5.37%), and preterm birth (8.07% vs. 5.66%) were significantly higher among nurses than non-nurses. After adjustment for background differences, nurses had significantly higher risk for cesarean section (adjusted OR=1.12, 95% confidence interval [CI] 1.03-1.22), tocolysis (OR=1.18, 95% CI 1.09-1.29), and preterm birth (OR=1.46, 95% CI 1.28-1.67). When labor/delivery morbidities were further adjusted for, risk for cesarean section became insignificant, while the risk for tocolysis and preterm birth remained. 

Conclusion: Nurses are at higher risk for tocolysis, cesarean section, and preterm birth than non-nurses. Occupational exposures related to those adverse pregnancy outcomes should be examined. Strategies to decrease the risk should be developed in order to improve reproductive health among nurses.