Job control, substantive complexity, and risk for low birth weight and preterm delivery: an analysis from a state birth registry.

BACKGROUND: Indices of job strain have demonstrated a variable relationship to low birth weight (LBW) and prematurity, with conflicting study results. This study sought to examine the associations of psychosocial work environment characteristics with adverse pregnancy outcomes using and comparing the demand-control model and job attributes derived from the O*NET.
METHODS: Job characteristics were imputed to maternal occupation recorded in the 2000 Connecticut state birth registry for 26,408 singleton births, using scores for psychological job demands, control, and physical demands derived from the Job Content Questionnaire, and for substantive complexity of work and physical demands using variables derived from O*NET job attributes. Odds ratios for LBW and preterm delivery were estimated while controlling for relevant covariates.
RESULTS: High psychological demands were not associated with pregnancy outcomes, while high physical demand scores from the O*NET were associated with LBW. Associations of term- and all-LBW with both low control and low substantive complexity were attenuated by adjustment for educational and demographic covariates. A gradient with lower scores was seen for term LBW and substantive complexity, and for prematurity and control. Both constructs were correlated with maternal education.
CONCLUSIONS: These results suggest that low maternal job control and substantive complexity may be modestly associated with LBW and, to a lesser extent, prematurity. A greater association with control may explain why a weak link of birth outcomes to high-strain work has been noted in past studies. Observed associations with occupational are reduced after adjustment for relevant confounding variables, in particular educational level and race/ethnicity. (c) 2007 Wiley-Liss, Inc.