Physical Stress in the Workplace as Risk Factor in Pregnancy Outcome: Case Control Study of Completed Pregnancies in Owerri, Imo State

ABSTRACT

An association between occupational stress and adverse outcome of pregnancy has been hypothesized overtime by researchers but results from various studies have remained controversial. The aim of this study was to identify the role of occupational stress (exposure) in adverse outcome of pregnancy. This was a retrospective case control study carried out in Owerri Municipal Council, Imo State, Nigeria on 400 working women randomly selected at different levels of health care .A questionnaire was distributed to the subjects for the study with reference to work conditions and adverse outcome of pregnancy. Two hundred and seventy seven out of the 400 respondents were working. Twenty three of all the subjects had low birth weight babies, 7 had miscarriages and 4 had a still birth. Of the 277 working women, 21 had low birth weight babies, 4 had miscarriages and 4 had still birth as their birth outcome. Confounding factors of age and parity were managed by individual matching. Results revealed a statistically insignificant relationship between working as against being unemployed and adverse outcome of pregnancy [OR=1, 95% CI=0.17-5.79, p-value=1.0].All occupational risk factors considered were found not to have a statistically significant relationship with adverse outcome of pregnancy. Results revealed that for working >8hrs [OR=0.66, 95% CI(0.19-2.35),p-value=0.52, (φ)=0.41,(χ2)=0.09].Participation in shift work [OR=7.76,95%CI(0.85-70.75)p-value=0.07, (φ)=0.30,(χ2)=4.21].Poor physical conditions in terms of space, light and ventilation respectively ,Space [OR=0.58,95% CI(0.17-1.90),p-value=0.37,(φ)=-0.13,(χ2)=0.80],Light [OR=0.75,95% CI(0.18-3.28),p-value=0.71, (φ)=-0.05,(χ2)=0.14]. Ventilation [OR=0.75, 95% CI (0.18-3.28),p-value=0.71, (φ)=-0.05,(χ2)=0.14],Poor Cordiality at work place [OR=2.49,95% CI=(0.75-8.34),p-value=0.14, (φ)=0.22,(χ2)=2.24].Work schedules in the form of unclear job responsibility and working regularly above formal work hours [OR=0.34,95% CI=(0.10-1.13),p- value=0.08, (φ)=0.26,(χ2)=3.14] and [OR=0.48,95% CI=(0.12-1.95),p-value=0.30, (φ)=-0.15,(χ2)=1.08] respectively, poor gender sensitive practices in the workplace in the form of unusual workload in spite of being pregnant and deprivation of right to attend ante-natal classes [OR=1.40,95% CI=(0.28-7.11),p-value=0.68, (φ)=0.06,(χ2)=0.17] and [OR=4.59,95% CI=(0.84-25.17),p-value=0.08, (φ)=0.28,(χ2)=3.45].Heavy workload [OR=0.78,95% CI=(0.20-3.06),p- value=0.73, (φ)=-0.05,(χ2)=0.12].Type of work done [OR=0.28,95% CI=(0.06- 1.24),p-value=0.09, (φ)=0.26,(χ2)=2.98].Further studies by other researchers would go a long way in confirming or disputing the results of this study.

KEY WORDS: low birth weight, miscarriages, stillbirth, work schedules etc.

 Title page

Certification page
Dedication
Acknowledgment
List of figures
List of Tables
Table of Contents
Abstract


CHAPTER ONE: INTRODUCTION Background of Study
Statement of Problem
Goal/Purpose of Study
Research Objectives
Research Questions
Research Hypotheses
Significance of the study Scope/Delimitation of the study Definition of variables

CHAPTER TWO: LITERATURE REVIEW
Background of study 20

Stress 24

Occupational Stress 30

Pregnancy Outcomes 35

Occupational Stress and Adverse outcome of Pregnancy; a systematic review 43

CHAPTER THREE: RESEARCH MATERIALS AND METHOD
Research Design
Area of Study
Study Population
Sample size calculation
Sample and Sampling Techniques
Study Instrument
Validation of the instrument
Reliability of the instrument
Administration of the instrument
Data Analysis

CHAPTER FOUR: RESULTS

Socio demographic characteristics of respondents 76

Documentation on physical, physiological factors to workplace stress 78

Computational Analysis on risk factors to workplace stress and adverse outcome of pregnancy 101

CHAPTER FIVE:DISCUSSION OF FINDINGS,CONCLUSION AND RECOMMENDATION

Discussion of findings

Conclusions

Recommendations

Limitations of the Study References

Appendixes