High rate of pregnancy loss associated with type of employment
A South Korean study of nearly 1.8 million women examined the relationship between pregnancy loss and type of employment, and found that the risk of miscarriage and stillbirth was higher among unemployed women, while the risk of not having a live birth was higher among working women.
Women in the social worker industry were at greater risk of not giving birth. In addition, manufacturing and health/social work jobs were associated with an increased risk of an early miscarriage outcome compared to finance/insurance jobs. Consistently higher risks of no live birth have been found in manufacturing, wholesale/retail trade, education and health/social work, and public/social service/employee occupations.
“The good news is that South Korea’s Ministry of Labor and Labor is now revising the Work Accident Compensation Insurance Act to cover all abortion outcomes for pregnant workers,” corresponding author Jung Won-yeon, MD, Seoul National Medical Center, said in a statement. statment. “Our study modified this law, presenting the influence of the occupational environment on adverse pregnancy outcomes.”
This retrospective cohort study has been published in Occupational Health Journal.
The data was obtained from the National Health Information Service (NHIS) in South Korea, which includes about 97% of the population of Korea as a universal health insurance system. The study included information from nearly 1.8 million pregnant women ages 20 to 49 from 2010-2019. About 1.2 million of these women are employed, and the remaining 600,000 are unemployed.
The researchers calculated the risks of three pregnancy loss outcomes: early miscarriage (miscarriage, ectopic pregnancy, and molar pregnancy), stillbirth, and no live birth (pregnancy with no record of live birth afterwards, which includes early miscarriage outcomes and stillbirth).
Working pregnant women were more likely to be younger, have lower incomes, and have a normal body mass index (BMI) than unemployed pregnant women. In addition, unemployment was associated with a higher prevalence of anemia and smoking history than employment.
Overall, 18%, 0.7%, and 39.8% of pregnancies ended with an early miscarriage outcome, stillbirth, and no live birth, respectively, from 2010 to 2019. The risks of miscarriage outcomes and stillbirths were higher among unemployed women, while the risks for unemployed women were not. There was a higher live birth among working women. Women in the social worker industry were at greater risk of not giving birth. Manufacturing (1.030; 95% CI, 1.013–1.047) and health/social work (1.029; 95% CI, 1.012–1.046) jobs were associated with a higher risk of early miscarriage outcomes than finance/insurance jobs. Consistently higher risks of no live birth have been found in manufacturing, wholesale/retail trade, education and health/social work, and public/social service/employee occupations.
The authors note that these associations may be influenced by working conditions found in many of these types of jobs, such as physical labor in retail work, irregular work schedules for healthcare workers, or hazardous materials in manufacturing.
The researchers acknowledge that this study has limitations, and that their results should be interpreted with caution. First, misclassification of the type of unemployment may have led to the bias. Second, the diagnostic codes for pregnancy may be invalid, particularly in health and social work, as better access to obstetric care may have affected outcomes by enabling better detection of early pregnancy loss.
Despite these limitations, the researchers believe their study was able to identify several types of jobs that may have a high risk of pregnancy loss.
“Our findings highlight the urgent need to assess working conditions to prevent adverse pregnancy outcomes in female workers. The authors conclude that more studies using detailed work environment data are necessary to identify the specific causes of adverse pregnancy outcomes associated with each occupation.
Kim CB, Choi Sa, Kim T, et al. Risk of adverse pregnancy outcomes by maternal occupational status: a national population study in South Korea. J Occupation Health. Posted online January 25, 2023. doi: 10.1002 / 1348-9585.12380