Profesionální expozice těhotných žen ve vztahu k vývoji těhotenství a plodu

Occupational Exposure of Pregnant Woman in Relation to the Evolution of Pregnancy and Fetus

The international study ELSPAC (European Longitudinal Study of Pregnancy and Childhood) included occupational history,which followed exposure of the woman to selected factors of the work environment before conception and during pregnancy. Theobstetricians and pediatricians filled out extensive questionnaires on the course of pregnancy, delivery and the newborn.The results presented in this study include only the 3,897 women from the Czech Republic. Most reported indices related tooccupation represent certain sources of stress (shift work, monotonous work, work at noise environment, metal strain). Smokingwomen were more frequently exposed to these stressogenic factors than the non - smoking women. The work with personalcomputer may be considered as a certain kind of stress. Exposure to chemical substances represented other potential risk.Conditions at work were also subjectively evaluated by the women of the ELSPAC study. There was no difference between theexposed and unexposed groups, respectively, as far as signs characterising pathological course of pregnancy, when the smokingbehaviour was not considered.When the basic cohort of the pregnant women was divided according to smoking behavious women, statistically significantdifferences in the frequency of pathological signs became apparent. The frequency of abnormal placenta and fetus malformationsin the smokers was higher in those working permanently in the sitting position (OR =1.59), growth retardation of the fetus washigher in women working in shifts (OR = 1.98) and bleeding during pregnancy was associated with exposure to chemicalsubstances (OR = 2.00).In the non-smokers exposed to chemical substances there was a higher incidence of malformations (OR = 2.33) and growthretardation of the fetus was present in those having worked with personal computers (OR = 2.29).The results are considered as preliminary so far and will be subject to further analysis including confounding factors.

Key words:
pregnancy, smoking, occupational stress, chemical exposure