{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:40:44Z","timestamp":1793191244426,"version":"4.5.0"},"reference-count":133,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,2,3]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Scoping review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>MEDLINE\/PubMed, EMBASE, CINAHL\/ EBSCO, SciVerse Scopus and Web of Science\/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>English language citations that studied employed pregnant people and any \u2018physician-related occupational hazards\u2019, meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Physician-related occupational hazards included physician work, healthcare work, long work hours, \u2018demanding\u2019 work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-064483","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T10:00:31Z","timestamp":1677060031000},"page":"e064483","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review"],"prefix":"10.1136","volume":"13","author":[{"given":"Candace M","family":"Marsters","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka","family":"Stafl","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Bugden","sequence":"additional","affiliation":[{"name":"Memorial University of Newfoundland, St. John's, Newfoundland, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Gustainis","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8508-6282","authenticated-orcid":false,"given":"Victoria","family":"Nkunu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Reimer","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Fletcher","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moss","family":"Bruton Joe","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Hyde","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Dance","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8122-2910","authenticated-orcid":false,"given":"Shannon M","family":"Ruzycki","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"2025121510261591000_13.2.e064483.1","unstructured":"Association CM . Physicians by specialty, sex, and age group. CMA, 2019."},{"key":"2025121510261591000_13.2.e064483.2","unstructured":"ZealandMDAaN . Student statistics reports medical deans australia and new zealand2019. n.d. Available: https:\/\/medicaldeans.org.au\/data\/student-statistics-reports"},{"key":"2025121510261591000_13.2.e064483.3","unstructured":"Colleges AoAM . Active physicians by sex and specialty in 2017. AAMC 2018."},{"key":"2025121510261591000_13.2.e064483.4","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2015.5638"},{"key":"2025121510261591000_13.2.e064483.5","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1001\/jama.2018.15889","article-title":"Specialty board leave policies for resident physicians requesting parental leave","volume":"320","author":"Varda","year":"2018","journal-title":"JAMA"},{"key":"2025121510261591000_13.2.e064483.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.k4926","article-title":"Physician mothers\u2019 experience of workplace discrimination: a qualitative analysis","volume":"363","author":"Halley","year":"2018","journal-title":"BMJ"},{"key":"2025121510261591000_13.2.e064483.7","doi-asserted-by":"crossref","first-page":"3697","DOI":"10.1007\/s11606-021-06835-0","article-title":"Challenges to navigating pregnancy and parenthood for physician parents: a framework analysis of qualitative data","volume":"36","author":"Freeman","year":"2021","journal-title":"J Gen Intern Med"},{"key":"2025121510261591000_13.2.e064483.8","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1097\/ACM.0000000000003351","article-title":"Pregnancy and parenthood remain challenging during surgical residency: a systematic review","volume":"95","author":"Todd","year":"2020","journal-title":"Acad Med"},{"key":"2025121510261591000_13.2.e064483.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199010113231506"},{"key":"2025121510261591000_13.2.e064483.10","first-page":"790","article-title":"Pregnancies among physicians. A historical cohort study","volume":"34","author":"Miller","year":"1989","journal-title":"J Reprod Med"},{"key":"2025121510261591000_13.2.e064483.11","first-page":"618","article-title":"Outcome of pregnancies experienced during residency","volume":"31","author":"Osborn","year":"1990","journal-title":"J Fam Pract"},{"key":"2025121510261591000_13.2.e064483.12","doi-asserted-by":"publisher","DOI":"10.1080\/073993399245962"},{"key":"2025121510261591000_13.2.e064483.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(87)80350-2"},{"key":"2025121510261591000_13.2.e064483.14","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9369-0"},{"key":"2025121510261591000_13.2.e064483.15","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000277"},{"key":"2025121510261591000_13.2.e064483.16","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/jrsm.1123","article-title":"A scoping review of scoping reviews: advancing the approach and enhancing the consistency","volume":"5","author":"Pham","year":"2014","journal-title":"Res Synth Methods"},{"key":"2025121510261591000_13.2.e064483.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2004.09.003"},{"key":"2025121510261591000_13.2.e064483.18","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3402\/rlt.v19i2.10347","article-title":"Using technology to encourage student engagement with feedback: a literature review","volume":"19","author":"Hepplestone","year":"2011","journal-title":"Res Learn Technol"},{"key":"2025121510261591000_13.2.e064483.19","doi-asserted-by":"crossref","unstructured":"ElGilany A , ElKhawaga G , Ghanem A . Incidence and occupational risk factors of preterm delivery among working mothers: a single center study in egypt. TAF Prev Med Bull 2016;15. doi:10.5455\/pmb.1-1441637597","DOI":"10.5455\/pmb.1-1441637597"},{"key":"2025121510261591000_13.2.e064483.20","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S1701-2163(15)30359-5","article-title":"Obstetrical complications in pregnant medical and surgical residents","volume":"37","author":"Behbehani","year":"2015","journal-title":"J Obstet Gynaecol Can"},{"key":"2025121510261591000_13.2.e064483.21","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6874-14-121","article-title":"Reproductive health and burn-out among female physicians: nationwide, representative study from Hungary","volume":"14","author":"Gy\u0151rffy","year":"2014","journal-title":"BMC Womens Health"},{"key":"2025121510261591000_13.2.e064483.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0182341","article-title":"Prevalence of abortion and adverse pregnancy outcomes among working women in Korea: a cross-sectional study","volume":"12","author":"Park","year":"2017","journal-title":"PLoS One"},{"key":"2025121510261591000_13.2.e064483.23","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s00420-017-1213-3","article-title":"Adverse pregnancy outcomes in healthcare workers: a Korean nationwide population-based study","volume":"90","author":"Park","year":"2017","journal-title":"Int Arch Occup Environ Health"},{"key":"2025121510261591000_13.2.e064483.24","first-page":"148","article-title":"Fetal death and work in pregnancy","volume":"45","author":"McDonald","year":"1988","journal-title":"Br J Ind Med"},{"key":"2025121510261591000_13.2.e064483.25","first-page":"1232","article-title":"Spontaneous abortion and occupation","volume":"28","author":"McDonald","year":"1986","journal-title":"J Occup Med"},{"key":"2025121510261591000_13.2.e064483.26","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1056\/NEJM199102283240911","article-title":"Outcomes of pregnancy in resident physicians","volume":"324","year":"1991","journal-title":"N Engl J Med"},{"key":"2025121510261591000_13.2.e064483.27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03460210067031"},{"key":"2025121510261591000_13.2.e064483.28","doi-asserted-by":"crossref","unstructured":"Mortazavi SMJ , Sabetghadam MR , Arvin A , et al . Are radiologists and radiological technologists at greater risk of reproductive health problems? data from seven provinces in iran. IJLR 2010;7. doi:10.1504\/IJLR.2010.034590","DOI":"10.1504\/IJLR.2010.034590"},{"key":"2025121510261591000_13.2.e064483.29","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1093\/oxfordjournals.aje.a117576","article-title":"Psychologic stress in the workplace and spontaneous abortion","volume":"142","author":"Fenster","year":"1995","journal-title":"Am J Epidemiol"},{"key":"2025121510261591000_13.2.e064483.30","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000259988.77314.a4"},{"key":"2025121510261591000_13.2.e064483.31","first-page":"690","article-title":"The effect of occupational risk factors on pregnancy and newborn infants of pregnant midwives and nurses in turkey: A prospective study","volume":"10","author":"Celikkalp","year":"2017","journal-title":"Int J Car Sci"},{"key":"2025121510261591000_13.2.e064483.32","first-page":"2","article-title":"The relationship between spontaneous abortion among nurses and its related factors","volume":"4","author":"Shagheibi","year":"2018","journal-title":"Chronic Diseases J"},{"key":"2025121510261591000_13.2.e064483.33","first-page":"393","article-title":"Outcome of pregnancy in relation to irregular and inconvenient work schedules","volume":"46","author":"Axelsson","year":"1989","journal-title":"Br J Ind Med"},{"key":"2025121510261591000_13.2.e064483.34","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.012137","article-title":"Pregnancy and parenting during cardiology fellowship","volume":"8","author":"Mwakyanjala","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2025121510261591000_13.2.e064483.35","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0140-6736(77)91666-X","article-title":"Outcome of pregnancy among women in anaesthetic practice","volume":"1","author":"Pharoah","year":"1977","journal-title":"Lancet"},{"key":"2025121510261591000_13.2.e064483.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00856-1"},{"key":"2025121510261591000_13.2.e064483.37","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1179\/oeh.2009.15.4.402","article-title":"Hospital work and pregnancy outcomes: a study in the Danish national birth cohort","volume":"15","author":"Su\u00e1rez-Varela","year":"2009","journal-title":"Int J Occup Environ Health"},{"key":"2025121510261591000_13.2.e064483.38","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/j.1471-0528.2002.01262.x","article-title":"Reproductive risk factors, pregnancy characteristics and obstetric outcome in female doctors","volume":"109","author":"Heinonen","year":"2002","journal-title":"BJOG"},{"key":"2025121510261591000_13.2.e064483.39","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1016\/S0140-6736(72)91048-3","article-title":"Anaesthetic practice and pregnancy. controlled survey of women anaesthetists in the United Kingdom","volume":"1","author":"Knill-Jones","year":"1972","journal-title":"Lancet"},{"key":"2025121510261591000_13.2.e064483.40","doi-asserted-by":"publisher","DOI":"10.1136\/oem.53.6.374"},{"key":"2025121510261591000_13.2.e064483.41","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.1811"},{"key":"2025121510261591000_13.2.e064483.42","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/BF00378441","article-title":"Anaesthetic health hazards among Belgian nurses and physicians","volume":"48","author":"Lauwerys","year":"1981","journal-title":"Int Arch Occup Environ Health"},{"key":"2025121510261591000_13.2.e064483.43","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1179\/oeh.1996.2.1.26","article-title":"Occupational exposures and risks of spontaneous abortion among female veterinarians","volume":"2","author":"Steele","year":"1996","journal-title":"Int J Occup Environ Health"},{"key":"2025121510261591000_13.2.e064483.44","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1213\/00000539-197907000-00008","article-title":"Survey of infants born in 1973 or 1975 to Swedish women working in operating rooms during their pregnancies","volume":"58","author":"Ericson","year":"1979","journal-title":"Anesth Analg"},{"key":"2025121510261591000_13.2.e064483.45","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/11.3.250"},{"key":"2025121510261591000_13.2.e064483.46","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1213\/00000539-198510000-00007","article-title":"Hospitalization for miscarriage and delivery outcome among Swedish nurses working in operating rooms 1973-1978","volume":"64","author":"Ericson","year":"1985","journal-title":"Anesth Analg"},{"key":"2025121510261591000_13.2.e064483.47","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198511073131901"},{"key":"2025121510261591000_13.2.e064483.48","unstructured":"McAbee RR . Occupational health hazards in women and pregnancy outcomes. University of Washington, 1991."},{"key":"2025121510261591000_13.2.e064483.49","doi-asserted-by":"publisher","DOI":"10.1136\/jech.39.2.141"},{"key":"2025121510261591000_13.2.e064483.50","first-page":"855","article-title":"Leukaemia and reproductive outcome among nurses handling antineoplastic drugs","volume":"49","author":"Skov","year":"1992","journal-title":"Br J Ind Med"},{"key":"2025121510261591000_13.2.e064483.51","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1093\/oxfordjournals.aje.a115241","article-title":"Effect of parents\u2019 occupational exposures on risk of stillbirth, preterm delivery, and small-for-gestational-age infants","volume":"129","author":"Savitz","year":"1989","journal-title":"Am J Epidemiol"},{"key":"2025121510261591000_13.2.e064483.52","doi-asserted-by":"publisher","DOI":"10.1136\/oem.53.2.73"},{"key":"2025121510261591000_13.2.e064483.53","article-title":"Occupational exposure to anesthetic gases, antineoplastic drugs, antiviral drugs, sterilizing agents, and x-rays and risk of spontaneous abortion among nurses","volume":"173","author":"Lawson","year":"2011","journal-title":"Am J Epidemiol"},{"key":"2025121510261591000_13.2.e064483.54","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-007-0281-1"},{"key":"2025121510261591000_13.2.e064483.55","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000246827.44093.c1"},{"key":"2025121510261591000_13.2.e064483.56","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6955-9-15","article-title":"Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs","volume":"9","author":"Ratner","year":"2010","journal-title":"BMC Nurs"},{"key":"2025121510261591000_13.2.e064483.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.09.978"},{"key":"2025121510261591000_13.2.e064483.58","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/0020-7292(96)02717-8","article-title":"Female health workers: an obstetric risk group","volume":"54","author":"Ortayl\u00ec","year":"1996","journal-title":"Int J Gynaecol Obstet"},{"key":"2025121510261591000_13.2.e064483.59","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/birt.12118","article-title":"Do nurses have worse pregnancy outcomes than non-nurses?","volume":"41","author":"Yang","year":"2014","journal-title":"Birth"},{"key":"2025121510261591000_13.2.e064483.60","first-page":"56","article-title":"Prematurity and work in pregnancy","volume":"45","author":"McDonald","year":"1988","journal-title":"Br J Ind Med"},{"key":"2025121510261591000_13.2.e064483.61","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199605000-00009"},{"key":"2025121510261591000_13.2.e064483.62","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/BF03404379","article-title":"Rates of congenital anomalies and other adverse birth outcomes in an offspring cohort of registered nurses from British Columbia, Canada","volume":"101","author":"Arbour","year":"2010","journal-title":"Can J Public Health"},{"key":"2025121510261591000_13.2.e064483.63","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.2105\/AJPH.2013.301457","article-title":"Preterm birth and prenatal maternal occupation: the role of hispanic ethnicity and nativity in a population-based sample in los angeles, california","volume":"104","author":"von Ehrenstein","year":"2014","journal-title":"Am J Public Health"},{"key":"2025121510261591000_13.2.e064483.64","first-page":"852","article-title":"Is being a health-care worker a risk factor for women\u2019s reproductive system?","volume":"4","author":"Assadi","year":"2013","journal-title":"Int J Prev Med"},{"key":"2025121510261591000_13.2.e064483.65","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ajog.2008.08.006","article-title":"Occupational factors and risk of preterm birth in nurses","volume":"200","author":"Lawson","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"2025121510261591000_13.2.e064483.66","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm171"},{"key":"2025121510261591000_13.2.e064483.67","article-title":"Pregnancy outcomes in nurses and nursing assistants","volume":"131","author":"Kongwattanakul","year":"2015","journal-title":"Int J Gynecol Obstet"},{"key":"2025121510261591000_13.2.e064483.68","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199907000-00012"},{"key":"2025121510261591000_13.2.e064483.69","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.01079.x"},{"key":"2025121510261591000_13.2.e064483.70","first-page":"363","article-title":"A prospective-controlled study of pregnant veterinary staff exposed to inhaled anesthetics and x-rays","volume":"15","author":"Shuhaiber","year":"2002","journal-title":"Int J Occup Med Environ Health"},{"key":"2025121510261591000_13.2.e064483.71","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2003.008029"},{"key":"2025121510261591000_13.2.e064483.72","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1055\/s-0034-1383065","article-title":"\u201c pregnant and operating \u201d: evaluation of a germany-wide survey among female gynaecologists and surgeons","volume":"74","author":"Knieper","year":"2014","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"2025121510261591000_13.2.e064483.73","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.amjsurg.2017.06.016","article-title":"Pregnancy outcomes in female physicians in procedural versus non-procedural specialties","volume":"214","author":"Scully","year":"2017","journal-title":"Am J Surg"},{"key":"2025121510261591000_13.2.e064483.74","first-page":"1191","article-title":"Infertility and pregnancy outcome among magnetic resonance imaging workers","volume":"35","author":"Evans","year":"1993","journal-title":"J Occup Med"},{"key":"2025121510261591000_13.2.e064483.75","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000321"},{"key":"2025121510261591000_13.2.e064483.76","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03066.x"},{"key":"2025121510261591000_13.2.e064483.77","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2006.026872"},{"key":"2025121510261591000_13.2.e064483.78","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.08.059"},{"key":"2025121510261591000_13.2.e064483.79","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/jmwh.12052","article-title":"Night work and the reproductive health of women: an integrated literature review","volume":"59","author":"Chau","year":"2014","journal-title":"J Midwifery Womens Health"},{"key":"2025121510261591000_13.2.e064483.80","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000000249"},{"key":"2025121510261591000_13.2.e064483.81","doi-asserted-by":"publisher","DOI":"10.1191\/1078155205jp155oa"},{"key":"2025121510261591000_13.2.e064483.82","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-200304000-00021"},{"key":"2025121510261591000_13.2.e064483.83","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1517\/14740338.7.4.447","article-title":"Genotoxic effects of anesthetic agents","volume":"7","author":"Fodale","year":"2008","journal-title":"Expert Opin Drug Saf"},{"key":"2025121510261591000_13.2.e064483.84","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1002\/ca.22623","article-title":"Formaldehyde exposure and its effects during pregnancy: recommendations for laboratory attendance based on available data","volume":"28","author":"Haffner","year":"2015","journal-title":"Clin Anat"},{"key":"2025121510261591000_13.2.e064483.85","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.13-1-75"},{"key":"2025121510261591000_13.2.e064483.86","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3337"},{"key":"2025121510261591000_13.2.e064483.87","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2009.1876"},{"key":"2025121510261591000_13.2.e064483.88","doi-asserted-by":"publisher","DOI":"10.1136\/oem.54.8.541"},{"key":"2025121510261591000_13.2.e064483.89","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jhin.2013.12.011","article-title":"Viral infections in pregnancy: advice for healthcare workers","volume":"87","author":"Chin","year":"2014","journal-title":"J Hosp Infect"},{"key":"2025121510261591000_13.2.e064483.90","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.amj.2009.08.007","article-title":"A literature review of air medical work hazards and pregnancy","volume":"29","author":"Van Dyke","year":"2010","journal-title":"Air Med J"},{"key":"2025121510261591000_13.2.e064483.91","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-013-0924-3"},{"key":"2025121510261591000_13.2.e064483.92","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-014-0934-9"},{"key":"2025121510261591000_13.2.e064483.93","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/ajim.22711","article-title":"An update systematic review of fetal death, congenital anomalies, and fertility disorders among health care workers","volume":"60","author":"Warembourg","year":"2017","journal-title":"Am J Ind Med"},{"key":"2025121510261591000_13.2.e064483.94","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2012-101032"},{"key":"2025121510261591000_13.2.e064483.95","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.06.051"},{"key":"2025121510261591000_13.2.e064483.96","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqr198"},{"key":"2025121510261591000_13.2.e064483.97","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0231037","article-title":"Shift work and long work hours and their association with chronic health conditions: a systematic review of systematic reviews with meta-analyses","volume":"15","author":"Rivera","year":"2020","journal-title":"PLoS ONE"},{"key":"2025121510261591000_13.2.e064483.98","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1978.tb12461.x"},{"key":"2025121510261591000_13.2.e064483.99","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(99)00598-0"},{"key":"2025121510261591000_13.2.e064483.100","first-page":"28","article-title":"Shift work and reproductive health","volume":"24","author":"Nurminen","year":"1998","journal-title":"Scand J Work Environ Health"},{"key":"2025121510261591000_13.2.e064483.101","doi-asserted-by":"publisher","DOI":"10.1097\/00001503-200312000-00006"},{"key":"2025121510261591000_13.2.e064483.102","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e31827f2481"},{"key":"2025121510261591000_13.2.e064483.103","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1097\/GRF.0b013e31824f3a07","article-title":"Infection control and postexposure prophylaxis for the pregnant healthcare worker","volume":"55","author":"Bazan","year":"2012","journal-title":"Clin Obstet Gynecol"},{"key":"2025121510261591000_13.2.e064483.104","first-page":"112","article-title":"Curbside consultation. pregnant physicians and infectious disease risk","volume":"75","author":"Garlin","year":"2007","journal-title":"Am Fam Physician"},{"key":"2025121510261591000_13.2.e064483.105","first-page":"271","article-title":"Dealing with pregnancy in radiology: a thin line between science, social and regulatory aspects","volume":"92","author":"Buls","year":"2009","journal-title":"JBR-BTR"},{"key":"2025121510261591000_13.2.e064483.106","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22877"},{"key":"2025121510261591000_13.2.e064483.107","doi-asserted-by":"publisher","DOI":"10.1097\/01.HP.0000327647.74948.49"},{"key":"2025121510261591000_13.2.e064483.108","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jradnu.2019.10.004","article-title":"Understanding and managing occupational radiation exposure for the pregnant interventional radiology nurse","volume":"39","author":"Ghatan","year":"2020","journal-title":"J Radiol Nurs"},{"key":"2025121510261591000_13.2.e064483.109","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1055\/s-0033-1359735","article-title":"Pregnancy and the working interventional radiologist","volume":"30","author":"Vu","year":"2013","journal-title":"Semin Intervent Radiol"},{"key":"2025121510261591000_13.2.e064483.110","first-page":"309","article-title":"Fetal injury and abortion associated with occupational exposure to inhaled anesthetics","volume":"59","author":"Eger","year":"1991","journal-title":"AANA J"},{"key":"2025121510261591000_13.2.e064483.111","first-page":"381","article-title":"Maternal occupation: effects on spontaneous abortions and malformations","volume":"1","author":"Kline","year":"1986","journal-title":"Occup Med"},{"key":"2025121510261591000_13.2.e064483.112","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1001\/jama.2019.0460","article-title":"Promoting sensible parenting policies: leading by example","volume":"321","author":"Diamond","year":"2019","journal-title":"JAMA"},{"key":"2025121510261591000_13.2.e064483.113","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1095821"},{"key":"2025121510261591000_13.2.e064483.114","unstructured":"Qaali H . Motherhood and medicine should mix. so why is it such a struggle? 2019. Available: https:\/\/www.statnews.com\/2019\/10\/18\/motherhood-medicine-struggle"},{"key":"2025121510261591000_13.2.e064483.115","unstructured":"Wible P . Pregnant physicians punished (& babies die) ideal medical care 2017. 2017. Available: https:\/\/www.idealmedicalcare.org\/pregnant-physicians-punished-babies-die"},{"key":"2025121510261591000_13.2.e064483.116","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-66231-2","article-title":"Maternal work and spontaneous preterm birth: a multicenter observational study in Brazil","volume":"10","author":"Buen","year":"2020","journal-title":"Sci Rep"},{"key":"2025121510261591000_13.2.e064483.117","first-page":"84","article-title":"Shift work effects and pregnancy outcome: a historical cohort study","volume":"12","author":"Davari","year":"2018","journal-title":"J Family Reprod Health"},{"key":"2025121510261591000_13.2.e064483.118","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2018-105592"},{"key":"2025121510261591000_13.2.e064483.119","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(01)00419-5"},{"key":"2025121510261591000_13.2.e064483.120","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/01.ogx.0000458791.93682.2a","article-title":"Long working hours and pregnancy complications: women physicians survey in japan EDITORIAL COMMENT","volume":"69","author":"Takeuchi","year":"2014","journal-title":"Obstetr Gynecolog Survey"},{"key":"2025121510261591000_13.2.e064483.121","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-019-7728-7","article-title":"Spontaneous and repeat spontaneous abortion risk in relation to occupational characteristics among working Korean women: a cross-sectional analysis of nationally representative data from Korea","volume":"19","author":"Lee","year":"2019","journal-title":"BMC Public Health"},{"key":"2025121510261591000_13.2.e064483.122","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199701000-00011"},{"key":"2025121510261591000_13.2.e064483.123","doi-asserted-by":"crossref","first-page":"304","DOI":"10.5271\/sjweh.1147","article-title":"Population-Based study on occupational risk factors for preeclampsia and gestational hypertension","volume":"33","author":"Haelterman","year":"2007","journal-title":"Scand J Work Environ Health"},{"key":"2025121510261591000_13.2.e064483.124","doi-asserted-by":"crossref","first-page":"403","DOI":"10.5271\/sjweh.3728","article-title":"Night work and hypertensive disorders of pregnancy: a national register-based cohort study","volume":"44","author":"Hammer","year":"2018","journal-title":"Scand J Work Environ Health"},{"key":"2025121510261591000_13.2.e064483.125","doi-asserted-by":"publisher","DOI":"10.1136\/jech.56.5.389"},{"key":"2025121510261591000_13.2.e064483.126","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/oxfordjournals.aje.a116284","article-title":"Job stress and adverse outcome of pregnancy: a causal link or recall bias?","volume":"135","author":"Brandt","year":"1992","journal-title":"Am J Epidemiol"},{"key":"2025121510261591000_13.2.e064483.127","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq004"},{"key":"2025121510261591000_13.2.e064483.128","first-page":"196","article-title":"Work in pregnancy and birth weight for gestational age","volume":"46","author":"Armstrong","year":"1989","journal-title":"Br J Ind Med"},{"key":"2025121510261591000_13.2.e064483.129","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12694"},{"key":"2025121510261591000_13.2.e064483.130","doi-asserted-by":"crossref","first-page":"199","DOI":"10.5271\/sjweh.28","article-title":"Influence of occupational physical activity on pregnancy duration and birthweight","volume":"21","author":"Florack","year":"1995","journal-title":"Scand J Work Environ Health"},{"key":"2025121510261591000_13.2.e064483.131","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199401000-00004"},{"key":"2025121510261591000_13.2.e064483.132","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70103-1"},{"key":"2025121510261591000_13.2.e064483.133","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20496"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-064483","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:26:30Z","timestamp":1765823190000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-064483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":133,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,22]]},"published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1136\/bmjopen-2022-064483"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-064483","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]}}}