Job-Related Fatigue during First Pregnancy May Cause Early Membrane Rupture

Between October 1992 and July 1994 a prospective study was conducted among women who were 22-24 weeks pregnant at enrollment and had a singleton gestation and intact membranes to determine the relationship between occupational fatigue and spontaneous preterm birth. Researchers obtained detailed socioeconomic medical and obstetric data from each woman through interviews and by reviewing medical records. The analyses include data on 2929 women--1218 nulliparous women and 1711 multiparous women. In univariate analyses preterm premature rupture of membranes was linked to each of the five sources of occupational fatigue for nulliparous women. Moreover results of multivariate analyses confirmed that nulliparous women who reported job-related fatigue had a significantly elevated risk of experiencing preterm premature rupture of membranes. On the other hand occupational fatigue was not associated with any of the categories of spontaneous preterm delivery for multiparous women at the univariate level and therefore was not examined in multivariate analysis. Hence studies to determine which nulliparous women may be at risk and why multiparous women appear able to avoid this risk need to be designed.