Physical Job Demands in Pregnancy and Associated Musculoskeletal Health and Employment Outcomes: A Systematic Review

Details

• Personal Author:
  Adam GP ; Johnson CY ; Kimmel HJ ; Lu M-L ; MacDonald, Leslie A. ; Napolitano PG ; Saldanha IJ ; Santiago-Colón, Albeliz
• Description:
  Objective: A decline in musculoskeletal health during pregnancy is an underappreciated adverse outcome of pregnancy that can have immediate and long-term health consequences. High physical job demands are known risk factors for nontraumatic musculoskeletal disorders in the general working population. Evidence from meta-analyses suggest that occupational lifting and prolonged standing during pregnancy may increase risk of adverse pregnancy outcomes. This systematic review examined associations between occupational lifting or postural load in pregnancy and associated musculoskeletal disorders and related sequalae. Data Sources: Five electronic databases (Medline, Embase, CINAHL, NIOSHTIC-2, and Ergonomic Abstracts) were searched from 1990 to July 2022 for studies in any language. A Web of Science snowball search was performed in December 2022. Reference lists were manually reviewed. Study Eligibility Criteria: Eligible studies reported associations between occupational lifting or postural load and musculoskeletal health or sequelae (eg, employment outcomes) among pregnant and postpartum workers. Methods: Data were extracted using a customized form to document study and sample characteristics; and details of exposures, outcomes, covariates, and analyses. Investigators independently assessed study quality for 7 risk-of-bias domains and overall utility, with discrepant ratings resolved through discussion. A narrative synthesis was conducted due to heterogeneity. Results: Sixteen studies (11 cohort studies, 2 nested case-control studies, and 3 cross-sectional studies) from 8 countries were included (N=142,320 pregnant and N=1744 postpartum workers). Limited but consistent evidence with variable quality ratings, ranging from critical concern to high, suggests that pregnant workers exposed to heavy lifting (usually defined as ≥22 lbs or ≥10 kg) may be at increased risk of functionally limiting pelvic girdle pain and antenatal leave. Moreover, reports of dose-response relationships suggest graded risk levels according to lifting frequency, ranging from 21% to 45% for pelvic girdle pain and 58% to 202% for antenatal leave. Limited but consistent evidence also suggests that postural load increases the risk of employment cessation. Conclusion: Limited but consistent evidence suggests that pregnant workers exposed to heavy lifting and postural load are at increased risk of pelvic girdle pain and employment cessation. Job accommodations to reduce exposure levels may promote safe sustainable employment for pregnant workers. Description provided by NIOSH
• Subjects:
  • Ergonomics
  • Musculoskeletal Diseases
  • Musculoskeletal System
  • Occupational Health
  • Pregnancy
  • Safety
• Keywords:
  • Pregnancy
  • Musculoskeletal disorders
  • MSD
  • Systematic reviews
  • Manual lifting
  • Posture
  • Low back pain
  • Ergonomics
  • Author Keywords: analgesics
  • antenatal leave
  More +
• ISSN:
  0002-9378
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; Michigan ; North Carolina ; Ohio ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; Rhode Island ; Washington
  More +
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; WTCHP - World Trade Center Health Program
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  230
• Issue:
  6
• NIOSHTIC Number:
  nn:20069058
• Citation:
  Am J Obstet Gynecol 2024 Jun; 230(6):583-599.e16
• Contact Point Address:
  Leslie MacDonald, MS, Sc.D., Division of Field Studies and Engineering, NIOSH, 1150 Tusculum Avenue, MS R-15, Cincinnati, OH 45226 USA
• Email:
  lmacd5202@icloud.com
• Federal Fiscal Year:
  2024
• Peer Reviewed:
  True
• Source Full Name:
  American Journal of Obstetrics and Gynecology
• Download URL:
  https://stacks.cdc.gov/view/cdc/207607/cdc_207607_DS1.pdf
• File Type:
  [PDF - 733.61 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:afeec40e9b04f5e83a8eaf4dbbf62f8de0d4703c2e25e7e4082796326ac4e1a592999c8702c89ffad68c04e91399e599ba7ab6e92620f6932dff231ea0407129