First-trimester occupational exposures and hypertensive disorders of pregnancy among US nurses

Occup Med (Lond). 2023 Oct 20;73(7):419-426. doi: 10.1093/occmed/kqad089.


Background: Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP).

Aims: To investigate whether first-trimester night shift work, work hours and work-related activities are associated with HDP.

Methods: We conducted a cross-sectional analysis of 6610 women within the Nurses' Health Study II. We used multiple logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of occupational exposures to HDP.

Results: Nine per cent of respondents reported an HDP in the index pregnancy (gestational hypertension: n = 354, 5%, preeclampsia: n = 222, 3%). First-trimester fixed or rotating night shift work was not significantly associated with gestational hypertension or preeclampsia compared to day shift work only. Compared to those working 21-40 h/week, working overtime (≥41 h/week) was not associated with gestational hypertension but was associated with 43% higher odds of preeclampsia (95% CI 1.02, 2.00). For part-time work (≤20 h/week), the OR was 0.76 (95% CI 0.56, 1.02) for gestational hypertension and 0.64 (95% CI 0.43, 0.97) for preeclampsia. The odds of preeclampsia were 3% higher per additional hour worked per week (95% CI 1.01-1.04). Compared to 0-4 h spent standing or walking per day, standing or walking ≥9 h daily was associated with 32% lower odds of gestational hypertension (95% CI 0.47, 0.99) but was not significantly associated with preeclampsia. Frequency of heavy lifting was not associated with either hypertensive disorder or pregnancy.

Conclusions: Among nurses, working overtime was associated with higher odds of preeclampsia.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced* / epidemiology
  • Hypertension, Pregnancy-Induced* / etiology
  • Occupational Exposure* / adverse effects
  • Pre-Eclampsia* / epidemiology
  • Pre-Eclampsia* / etiology
  • Pregnancy
  • Pregnancy Trimester, First