Maternal occupation and risk of adverse fetal outcomes in Tanzania: A hospital-based cross-sectional study

坦桑尼亚孕妇职业与不良胎儿结局风险:一项基于医院的横断面研究

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Abstract

BACKGROUND: Women constitute a large proportion of the workforce in today's world. Hazardous working environment conditions for these women pose threat to their reproductive health. Despite efforts to address maternal health in Tanzania, the impact of occupational risks during pregnancy remains unclear. We assessed whether maternal occupation during pregnancy is associated with adverse Foetal outcomes. METHODS: A cross-sectional study was conducted among 400 self-referred post-delivery women at a referral Hospital in Tanzania. Information on socio-demographic characteristics and maternal occupational characteristics was assessed through the use of a pre-tested questionnaire. Questions on physical demanding work and prolonged standing were obtained from the standardized Musculoskeletal Questionnaire. To assess occupational exposure to chemicals, job titles and task descriptions were linked to a job-exposure-matrix, an expert judgment on exposure to chemicals at the workplace. Information relating to obstetric characteristics and pregnancy outcomes was obtained from the medical files and clinic cards. Data was analyzed by using Statistical Package for Social Sciences (SPSS) version 23. Odds ratios >  1 was considered risk while Odds ratios <  1 was considered protective and P value < 0.05 was considered significant. RESULTS: The mean age was 28.0 ±  6.3. Out of 400 post-delivery women studied, 174 (43.5%) were engaged in various occupations. Agriculture (22.4%) was the most prevalent occupation followed by tailoring (19.0%). Relative to the referent group of other occupations, agriculture workers, had higher adjusted odds ratios of congenital malformation (AOR = 4.5, 95% CI; 1.6-12.8)preterm babies (AOR = 2.8, 95% CI; 1.3-7.9), low birth weight (AOR = 3.1, 95% CI; 1.4-8.4) and low Apgar score (AOR = 3.5, 95% CI; 1.3-9.5). Food vendors: low birth weight (AOR = 8.6, 95% CI; 2.7-24.8) and low Apgar score (AOR = 13.5, 95% CI; 4.5-39.4). CONCLUSION: Understanding occupational characteristics and their relation to adverse Foetal outcomes is important to formulate appropriate strategies to promote and protect maternal and infant health at work.

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