{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:23:46Z","timestamp":1783704226295,"version":"3.55.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007388","name":"Compagnia di San Paolo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007388","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018693","name":"HORIZON EUROPE Framework Programme","doi-asserted-by":"publisher","award":["874583"],"award-info":[{"award-number":["874583"]}],"id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018693","name":"HORIZON EUROPE Framework Programme","doi-asserted-by":"publisher","award":["733206"],"award-info":[{"award-number":["733206"]}],"id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Maternal occupational exposures during early pregnancy can be detrimental to foetus health and have short- and long-term health effects on the child. This study examined their association with adverse birth outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The study included 3938 nulliparous women from the Italian NINFEA mother-child cohort. Their occupational exposures during the first trimester of pregnancy were assessed through prospectively collected questionnaire information and job-exposure matrices. Associations between maternal exposures and birthweight, preterm birth, and delivery by caesarean section were analysed by multivariable linear and logistic regression models. An exploratory factor analysis was carried out to explore co-exposure profiles in association with birth outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Women exposed to passive smoking at work and those who reduced their working hours during pregnancy were found to have an increased likelihood of all analysed birth outcomes. Children of mothers performing a demanding work were less likely to be born preterm [OR 0.72 (95% CI 0.54 to 0.95)] and more likely to have a higher birthweight [\u03b2 = 40.4 g (95% CI 7.5 to 73.4)]. Maternal exposures to heat and dust were associated with a lower birthweight [\u03b2 = -160.1 g (95% CI -299.6 to -20.7)] and increased odds of caesarean section [OR 6.99 (95% CI 2.36 to 25.47)], respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study provides some evidence of the selection of healthy population into the workforce and of association between work-related passive smoking, heat and dust and adverse birth outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313085","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T18:29:39Z","timestamp":1736879379000},"page":"e0313085","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Maternal occupational exposures during early stages of pregnancy and adverse birth outcomes in the NINFEA birth-cohort"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9805-600X","authenticated-orcid":true,"given":"Antonio","family":"d\u2019Errico","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Popovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costanza","family":"Pizzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovenale","family":"Moirano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Moccia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0316-9402","authenticated-orcid":true,"given":"Lorenzo","family":"Richiardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2142-1288","authenticated-orcid":true,"given":"Milena","family":"Maule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"issue":"1","key":"pone.0313085.ref001","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/1559827619879694","article-title":"The Developmental Origins of Health and Disease (DOHaD).","volume":"14","author":"S. Lacagnina","year":"2020","journal-title":"Am J Lifestyle Med."},{"issue":"1","key":"pone.0313085.ref002","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s12940-023-01001-x","article-title":"Environmental exposures in early-life and general health in childhood.","volume":"22","author":"I Amine","year":"2023","journal-title":"Environmental Health."},{"issue":"5","key":"pone.0313085.ref003","article-title":"Unemployment and pregnancy outcomes: A study within the Danish National Birth Cohort.","volume":"39","author":"MMS Varela","year":"2011","journal-title":"Scand J Public Health."},{"issue":"6","key":"pone.0313085.ref004","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1136\/oem.2009.046300","article-title":"Employment status and the risk of pregnancy complications: the Generation R Study.","volume":"67","author":"PW Jansen","year":"2010","journal-title":"Occup Environ Med."},{"issue":"4","key":"pone.0313085.ref005","doi-asserted-by":"crossref","first-page":"384","DOI":"10.5271\/sjweh.3500","article-title":"Maternal occupation during pregnancy, birth weight, and length of gestation: Combined analysis of 13 European birth cohorts.","volume":"41","author":"M Casas","year":"2015","journal-title":"Scand J Work Environ Health."},{"issue":"4","key":"pone.0313085.ref006","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20043632","article-title":"Occupational Risk Factors by Sectors: An Observational Study of 20,000 Workers.","volume":"20","author":"L Dogbla","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0313085.ref007","article-title":"Risk Factors for Working Pregnant Women and Potential Adverse Consequences of Exposure: A Systematic Review.","volume":"68","author":"R Corchero-Falc\u00f3n M del","year":"2023","journal-title":"Int J Public Health."},{"issue":"3","key":"pone.0313085.ref008","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1136\/oem.2009.046516","article-title":"The effects of work-related maternal risk factors on time to pregnancy, preterm birth and birth weight: The seneration R study.","volume":"68","author":"A Burdorf","year":"2011","journal-title":"Occup Environ Med."},{"issue":"4","key":"pone.0313085.ref009","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1038\/s41390-022-02089-6","article-title":"Maternal occupational exposure to chemicals and child cognitive function","volume":"92","author":"J Ish","year":"2022","journal-title":"Pediatr Res"},{"issue":"1","key":"pone.0313085.ref010","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1002\/(SICI)1097-0274(199907)36:1<213::AID-AJIM30>3.0.CO;2-A","article-title":"Maternal occupational exposure to chemical substances and the risk of infants small-for-gestational-age.","volume":"36","author":"A Seidler","year":"1999","journal-title":"Am J Ind Med."},{"issue":"1","key":"pone.0313085.ref011","doi-asserted-by":"crossref","first-page":"51.e1","DOI":"10.1016\/j.ajog.2008.08.006","article-title":"Occupational factors and risk of preterm birth in nurses.","volume":"200","author":"CC Lawson","year":"2009","journal-title":"Am J Obstet Gynecol."},{"issue":"12","key":"pone.0313085.ref012","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s10654-007-9194-2","article-title":"Feasibility of recruiting a birth cohort through the Internet: the experience of the NINFEA cohort","volume":"22","author":"L Richiardi","year":"2007","journal-title":"Eur J Epidemiol"},{"issue":"2","key":"pone.0313085.ref013","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.2196\/resprot.3873","article-title":"Internet-Based Birth-Cohort Studies: Is This the Future for Epidemiology?","volume":"4","author":"R Firestone","year":"2015","journal-title":"JMIR Res Protoc."},{"key":"pone.0313085.ref014","first-page":"304","article-title":"Population-based study on occupational risk factors for preeclampsia and gestational hypertension","author":"Edwige Haelterman","year":"2007","journal-title":"Scandinavian journal of work"},{"issue":"3","key":"pone.0313085.ref015","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1093\/humrep\/der437","article-title":"Occupational exposure to chemicals and fetal growth: the Generation R Study","volume":"27","author":"Claudia A. Snijder","year":"2012","journal-title":"Human reproduction"},{"issue":"2019","key":"pone.0313085.ref016","first-page":"253","article-title":"Maternal exposure to fine particulate matter and the risk of fetal distress","volume":"170","author":"Hongxiu Liu","journal-title":"Ecotoxicology and Environmental Safety"},{"key":"pone.0313085.ref017","unstructured":"Elias P. Occupational Classification (ISCO-88): Concepts, Methods, Reliability, Validity and Cross-National Comparability. Paris; 1997."},{"key":"pone.0313085.ref018","author":"Instituto Nacional de Estad\u00edstica","year":"1994","journal-title":"Clasificaci\u00f3n nacional de ocupaciones 1994 (CNO-94)."},{"issue":"10","key":"pone.0313085.ref019","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1002\/ajim.22213","article-title":"A job-exposure matrix for research and surveillance of occupational health and safety in Spanish workers: MatEmESp.","volume":"56","author":"AM Garc\u00eda","year":"2013","journal-title":"Am J Ind Med"},{"issue":"5","key":"pone.0313085.ref020","first-page":"465","article-title":"A job-exposure matrix for potential endocrine-disrupting chemicals developed for a study into the association between maternal occupational exposure and hypospadias","volume":"46","author":"M Van Tongeren","year":"2002","journal-title":"Annals of Occupational Hygiene"},{"issue":"11","key":"pone.0313085.ref021","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1289\/EHP208","article-title":"Occupational exposure to endocrine-disrupting chemicals and birth weight and length of gestation: A european meta-analysis","volume":"124","author":"L Birks","year":"2016","journal-title":"Environ Health Perspect"},{"key":"pone.0313085.ref022","first-page":"1","author":"R. Fabrigar Leandre","year":"2011","journal-title":"Exploratory Factor Analysis"},{"issue":"1","key":"pone.0313085.ref023","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1207\/s15327906mbr1401_4","article-title":"Hierarchical Cluster Analysis And The Internal Structure Of Tests.","volume":"14","author":"W. Revelle","year":"1979","journal-title":"Multivariate Behav Res"},{"key":"pone.0313085.ref024","first-page":"1","author":"W. Revelle","year":"2023","journal-title":"How to: Use the psych package for factor analysis and data reduction"},{"key":"pone.0313085.ref025","doi-asserted-by":"crossref","DOI":"10.1037\/10018-000","volume-title":"The vectors of mind: Multiple-factor analysis for the isolation of primary traits","author":"LL Thurstone","year":"1935"},{"issue":"6","key":"pone.0313085.ref026","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1097\/01.AOG.0000189080.76998.f8","article-title":"Physical Exertion at Work and the Risk of Preterm Delivery and Small-for-Gestational- Age Birth.","volume":"106","author":"LA Pompeii","year":"2005","journal-title":"Obstetrics & Gynecology."},{"issue":"4","key":"pone.0313085.ref027","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1136\/jech.41.4.312","article-title":"Healthy worker effect and pregnancy: role of adverse obstetric history and social characteristics.","volume":"41","author":"B Stengel","year":"1987","journal-title":"J Epidemiol Community Health (1978)."},{"issue":"5","key":"pone.0313085.ref028","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/01.ede.0000135174.63482.43","article-title":"A Structural Approach to Selection Bias.","volume":"15","author":"MA Hern\u00e1n","year":"2004","journal-title":"Epidemiology"},{"issue":"2","key":"pone.0313085.ref029","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023879","article-title":"Occupational exposure to inorganic particles during pregnancy and birth outcomes: A nationwide cohort study in Sweden","volume":"9","author":"F Norl\u00e9n","year":"2019","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0313085.ref030","doi-asserted-by":"crossref","first-page":"e023879","DOI":"10.1136\/bmjopen-2018-023879","article-title":"Occupational exposure to inorganic particles during pregnancy and birth outcomes: a nationwide cohort study in Sweden.","volume":"9","author":"F Norl\u00e9n","year":"2019","journal-title":"BMJ Open"},{"key":"pone.0313085.ref031","article-title":"Environmental Tobacco Smoke and Low Birth Weight: A Hazard in the Workplace? Population and Family Health Sciences (formerly Maternal and","volume":"107","author":"DP Misra","year":"1999","journal-title":"Environmental Health Perspectives a"},{"key":"pone.0313085.ref032","author":"EUROSTAT","year":"2021","journal-title":"Employed persons working at nights as a percentage of the total employment, by sex, age and professional status (%)."},{"key":"pone.0313085.ref033","doi-asserted-by":"crossref","first-page":"i5210","DOI":"10.1136\/bmj.i5210","article-title":"Health consequences of shift work and insufficient sleep","author":"G Kecklund","year":"2016","journal-title":"BMJ"},{"issue":"7","key":"pone.0313085.ref034","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s10654-019-00525-2","article-title":"Night shift work before and during pregnancy in relation to depression and anxiety in adolescent and young adult offspring","volume":"34","author":"S Strohmaier","year":"2019","journal-title":"Eur J Epidemiol"},{"key":"pone.0313085.ref035","article-title":"Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis","volume":"m3811","author":"MF Chersich","year":"2020","journal-title":"BMJ"},{"issue":"7","key":"pone.0313085.ref036","doi-asserted-by":"crossref","first-page":"550","DOI":"10.5271\/sjweh.3980","article-title":"Working life, health and well-being of parents: a joint effort to uncover hidden treasures in European birth cohorts.","volume":"47","author":"M Ubalde-Lopez","year":"2021","journal-title":"Scand J Work Environ Health"},{"key":"pone.0313085.ref037","doi-asserted-by":"crossref","first-page":"106523","DOI":"10.1016\/j.envint.2021.106523","article-title":"Early-life environmental exposure determinants of child behavior in Europe: A longitudinal, population-based study.","volume":"153","author":"L Maitre","year":"2021","journal-title":"Environ Int."},{"issue":"5\u20136","key":"pone.0313085.ref038","first-page":"136","article-title":"Socioeconomic inequalities in reproductive outcomes in the Italian NINFEA birth cohort and the piedmont birth registry.","volume":"44","author":"C Pizzi","year":"2020","journal-title":"Epidemiol Prev"},{"issue":"1","key":"pone.0313085.ref039","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/s12884-018-1902-2","article-title":"Maternal sedentary behavior during pre-pregnancy and early pregnancy and mean offspring birth size: a cohort study.","volume":"18","author":"SE Badon","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"issue":"6","key":"pone.0313085.ref040","first-page":"24","article-title":"Exposure to video display terminals and risk of small-for-gestational-age birth","volume":"72","author":"F Parazzini","year":"2010","journal-title":"J Environ Health"},{"key":"pone.0313085.ref041","doi-asserted-by":"crossref","unstructured":"Rothman Kenneth. Epidemiology\u2014No Adjustments Are Needed for Multiple Comparisons. 1st ed. 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