Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
22 02 2023
Historique:
entrez: 22 2 2023
pubmed: 23 2 2023
medline: 25 2 2023
Statut: epublish

Résumé

Evidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between physician-related occupational hazards with pregnancy, obstetrical and neonatal outcomes. Scoping review. MEDLINE/PubMed, EMBASE, CINAHL/ EBSCO, SciVerse Scopus and Web of Science/Knowledge were searched from inception to 2 April 2020. A grey literature search was performed on 5 April 2020. The references of all included articles were hand searched for additional citations. English language citations that studied employed pregnant people and any 'physician-related occupational hazards', meaning any relevant physical, infectious, chemical or psychological hazard, were included. Outcomes included any pregnancy, obstetrical or neonatal complication. Physician-related occupational hazards included physician work, healthcare work, long work hours, 'demanding' work, disordered sleep, night shifts and exposure to radiation, chemotherapy, anaesthetic gases or infectious disease. Data were extracted independently in duplicate and reconciled through discussion. Of the 316 included citations, 189 were original research studies. Most were retrospective, observational and included women in any occupation rather than healthcare workers. Methods for exposure and outcome ascertainment varied across studies and most studies had a high risk of bias in data ascertainment. Most exposures and outcomes were defined categorically and results from different studies could not be combined in a meta-analysis due to heterogeneity in how these categories were defined. Overall, some data suggested that healthcare workers may have an increased risk of miscarriage compared with other employed women. Long work hours may be associated with miscarriage and preterm birth. There are important limitations in the current evidence examining physician-related occupational hazards and adverse pregnancy, obstetrical and neonatal outcomes. It is not clear how the medical workplace should be accommodated to improve outcomes for pregnant physicians. High-quality studies are needed and likely feasible.

Identifiants

pubmed: 36813500
pii: bmjopen-2022-064483
doi: 10.1136/bmjopen-2022-064483
pmc: PMC9950931
doi:

Types de publication

Review Meta-Analysis Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e064483

Informations de copyright

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Candace M Marsters (CM)

Department of Neurology, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada.

Lenka Stafl (L)

Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

Sarah Bugden (S)

Memorial University of Newfoundland, St. John's, Newfoundland, Canada.

Rita Gustainis (R)

University of Toronto, Toronto, Ontario, Canada.

Victoria Nkunu (V)

Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada.

Renee Reimer (R)

University of British Columbia, Vancouver, British Columbia, Canada.

Sarah Fletcher (S)

University of British Columbia, Vancouver, British Columbia, Canada.

Stephanie Smith (S)

Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada.

Moss Bruton Joe (M)

Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Christine Hyde (C)

Department of Pediatrics, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada.

Erica Dance (E)

Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.

Shannon M Ruzycki (SM)

Department of Medicine, University of Calgary, Calgary, Alberta, Canada shannon.ruzycki@ucalgary.ca.
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

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