{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:13:59Z","timestamp":1788444839247,"version":"build-2803163510"},"reference-count":47,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["2024J08308"],"award-info":[{"award-number":["2024J08308"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Xiamen Health Care projects","award":["3502Z20244ZD1218"],"award-info":[{"award-number":["3502Z20244ZD1218"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,15]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify early cardiovascular changes in normotensive obstetricians, a high-stress group, using non-invasive haemodynamic monitoring, and to examine the association between burnout and haemodynamic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single tertiary hospital in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      A total of 120 healthy Han Chinese adults (aged 25\u201345 years, both sexes) were enrolled using stratified random sampling by age and categorised into three groups: obstetricians, clinical support staff and administrative personnel. Of these, 105 (87.5%) completed the study and entered the final analysis (obstetricians n=40; clinical support staff n=33; administrative personnel n=32); 15 were excluded due to incomplete questionnaire data. Key exclusion criteria were chronic medical conditions, medication use, acute illness, a clinical shift within 24 hours before measurement, pregnancy or lactation, body mass index extremes (\u226418.5\u2009or \u2265 28\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) and major life events within the past 6 months. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey; workload, lifestyle and family history were collected via questionnaire.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Advanced haemodynamics were assessed via Ultrasonic Cardiac Output Monitor. The primary outcome was cardiac power output (CPO). Secondary outcomes included other non-invasive haemodynamic parameters, such as cardiac index (CI), systemic vascular resistance index, Smith\u2013Madigan inotropy index and corrected flow time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Severe burnout was associated with reduced CPO and CI (\u22120.152 W and \u22120.403\u2009L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      , respectively; both p&lt;0.05). Increased weekly exercise independently predicted higher CPO and CI (B=0.046 W and 0.155\u2009L\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      , respectively; both p&lt;0.001). This protective association remained significant in obstetricians and clinical support staff, and was stronger for CI in obstetricians (interaction p=0.03). The severe burnout\u2013haemodynamics association was consistent across all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In high-stress populations, advanced haemodynamic patterns may serve as an early-warning biomarker for burnout, guiding personalised exercise advice. Longitudinal studies are needed to confirm their predictive value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117014","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T17:50:39Z","timestamp":1780422639000},"page":"e117014","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac cost of occupational stress among obstetricians: a cross-sectional non-invasive haemodynamic study in a tertiary hospital"],"prefix":"10.1136","volume":"16","author":[{"given":"Xiaoling","family":"Zhong","sequence":"first","affiliation":[{"name":"Xiamen Maternal and Child Health Hospital, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[{"name":"Xiamen Maternal and Child Health Hospital, Xiamen, Fujian, 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