{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:58:58Z","timestamp":1788922738771,"version":"build-2803163510"},"reference-count":41,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"crossref","award":["2100.0076"],"award-info":[{"award-number":["2100.0076"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore the association between working conditions during first trimester and total preterm birth (PTB), and subtypes: spontaneous PTB and iatrogenic PTB, additionally to explore the role of hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnant women from the Amsterdam Born Children and their Development study, filled out a questionnaire between January 2003 and March 2004, two weeks after first prenatal screening (singleton liveborn, n=7561). Working conditions were working hours\/week, standing\/walking hours\/week, physical work load and job strain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prolonged standing\/walking during first trimester was associated with an increased risk for total PTB (OR=1.5; 95% CI 1.0\u20132.3, after adjustments). Other working conditions were not related to total PTB. The separation into spontaneous and iatrogenic PTB revealed that standing\/walking was associated with iatrogenic PTB only (OR=2.09; 95% CI 1.00\u20134.97). The highest risk was found for the combination of a long workweek with high physical work load (OR=3.42; 95% CI 1.04\u20138.21). Hypertension did not mediate these associations; however, stratified analysis revealed that high physical work load was only related to iatrogenic PTB when pregnancy-induced hypertension was present (OR=6.44; 95% CI 1.21\u201329.76).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides evidence that high physically demanding work is associated with an increased risk for iatrogenic PTB and not with spontaneous PTB. Pregnancy-induced hypertension may play a role: when present, high physical work load leads to a more severe outcome.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2020-107072","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T18:22:07Z","timestamp":1614190927000},"page":"654-660","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["First trimester employment, working conditions and preterm birth: a prospective population-based cohort 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