Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2002 May;56(5):389–393. doi: 10.1136/jech.56.5.389

The relation between maternal work, ambulatory blood pressure, and pregnancy hypertension

J Higgins 1, J Walshe 1, R Conroy 1, M Darling 1
PMCID: PMC1732156  PMID: 11964438

Abstract

Study objective: The purpose of the study was to determine the relations between maternal work, ambulatory blood pressure in mid-pregnancy, and subsequent pregnancy outcome.

Design: Data were studied on 933 healthy normotensive primigravidas who had been enrolled into a study on the predictive value of ambulatory blood pressure measurement performed between 18 and 24 weeks gestation. They were classified into three groups depending on whether they were at work (working group, n=245), not working (not working group, n=289), or normally employed but chose not to work (ENK group, n=399), on the day monitoring was performed.

Setting: The Rotunda Hospital (a large maternity hospital), Dublin, Ireland.

Main results: Adjusted for age, body mass index, smoking, drinking, and marital status, women at work had higher mean daytime systolic (p<0.01) and diastolic (p<0.01) and 24 hour systolic pressures (p=0.03) compared with those not working. The rate of subsequent development of pre-eclampsia was significantly higher (odds ratio 4.1, 95% CI 1.1 to 15.2, p=0.03) among those at work compared with those not working. The association between pre-eclampsia and maternal work remained significant (odds ratio 5.5, 95% CI 1.1 to 27.8, p=0.04) even after allowing for the confounding factors of age, smoking, body mass index, and marital status. When daytime systolic and diastolic blood pressure were added to the regression analysis the risk ratios for pre-eclampsia remained high but did not quite reach statistical significance (odds ratio 4.7, 0.90 to 24.8, p=0.066). Birth weight and placental weight were not predicted by work status or blood pressure.

Conclusions: A significant independent relation was found between maternal work and ambulatory blood pressure levels in mid-pregnancy. In addition, it was found that maternal work was significantly associated with the subsequent development of pre-eclampsia

Full Text

The Full Text of this article is available as a PDF (93.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baba S., Ozawa H., Nakamoto Y., Ueshima H., Omae T. Enhanced blood pressure response to regular daily stress in urban hypertensive men. J Hypertens. 1990 Jul;8(7):647–655. doi: 10.1097/00004872-199007000-00008. [DOI] [PubMed] [Google Scholar]
  2. Churchill D., Perry I. J., Beevers D. G. Ambulatory blood pressure in pregnancy and fetal growth. Lancet. 1997 Jan 4;349(9044):7–10. doi: 10.1016/s0140-6736(96)06297-6. [DOI] [PubMed] [Google Scholar]
  3. Cnattingius S., Mills J. L., Yuen J., Eriksson O., Salonen H. The paradoxical effect of smoking in preeclamptic pregnancies: smoking reduces the incidence but increases the rates of perinatal mortality, abruptio placentae, and intrauterine growth restriction. Am J Obstet Gynecol. 1997 Jul;177(1):156–161. doi: 10.1016/s0002-9378(97)70455-1. [DOI] [PubMed] [Google Scholar]
  4. Coats A. J. Reproducibility or variability of casual and ambulatory blood pressure data: implications for clinical trials. J Hypertens Suppl. 1990 Dec;8(6):S17–S20. [PubMed] [Google Scholar]
  5. Davey D. A., MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol. 1988 Apr;158(4):892–898. doi: 10.1016/0002-9378(88)90090-7. [DOI] [PubMed] [Google Scholar]
  6. Eskenazi B., Fenster L., Sidney S. A multivariate analysis of risk factors for preeclampsia. JAMA. 1991 Jul 10;266(2):237–241. [PubMed] [Google Scholar]
  7. Gant N. F., Daley G. L., Chand S., Whalley P. J., MacDonald P. C. A study of angiotensin II pressor response throughout primigravid pregnancy. J Clin Invest. 1973 Nov;52(11):2682–2689. doi: 10.1172/JCI107462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Harshfield G. A., Alpert B. S., Willey E. S., Somes G. W., Murphy J. K., Dupaul L. M. Race and gender influence ambulatory blood pressure patterns of adolescents. Hypertension. 1989 Dec;14(6):598–603. doi: 10.1161/01.hyp.14.6.598. [DOI] [PubMed] [Google Scholar]
  9. Henriksen T. B., Hedegaard M., Secher N. J. Standing and walking at work and birthweight. Acta Obstet Gynecol Scand. 1995 Aug;74(7):509–516. doi: 10.3109/00016349509024380. [DOI] [PubMed] [Google Scholar]
  10. Higgins J. R., Walshe J. J., Halligan A., O'Brien E., Conroy R., Darling M. R. Can 24-hour ambulatory blood pressure measurement predict the development of hypertension in primigravidae? Br J Obstet Gynaecol. 1997 Mar;104(3):356–362. doi: 10.1111/j.1471-0528.1997.tb11468.x. [DOI] [PubMed] [Google Scholar]
  11. Homer C. J., James S. A., Siegel E. Work-related psychosocial stress and risk of preterm, low birthweight delivery. Am J Public Health. 1990 Feb;80(2):173–177. doi: 10.2105/ajph.80.2.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. James G. D., Schlussel Y. R., Pickering T. G. The association between daily blood pressure and catecholamine variability in normotensive working women. Psychosom Med. 1993 Jan-Feb;55(1):55–60. doi: 10.1097/00006842-199301000-00010. [DOI] [PubMed] [Google Scholar]
  13. Klebanoff M. A., Shiono P. H., Rhoads G. G. Outcomes of pregnancy in a national sample of resident physicians. N Engl J Med. 1990 Oct 11;323(15):1040–1045. doi: 10.1056/NEJM199010113231506. [DOI] [PubMed] [Google Scholar]
  14. Klonoff-Cohen H. S., Cross J. L., Pieper C. F. Job stress and preeclampsia. Epidemiology. 1996 May;7(3):245–249. doi: 10.1097/00001648-199605000-00005. [DOI] [PubMed] [Google Scholar]
  15. Launer L. J., Villar J., Kestler E., de Onis M. The effect of maternal work on fetal growth and duration of pregnancy: a prospective study. Br J Obstet Gynaecol. 1990 Jan;97(1):62–70. doi: 10.1111/j.1471-0528.1990.tb01718.x. [DOI] [PubMed] [Google Scholar]
  16. Narkiewicz K., Maraglino G., Biasion T., Rossi G., Sanzuol F., Palatini P. Interactive effect of cigarettes and coffee on daytime systolic blood pressure in patients with mild essential hypertension. HARVEST Study Group (Italy). Hypertension Ambulatory Recording VEnetia STudy. J Hypertens. 1995 Sep;13(9):965–970. doi: 10.1097/00004872-199509000-00005. [DOI] [PubMed] [Google Scholar]
  17. Pieper C., Warren K., Pickering T. G. A comparison of ambulatory blood pressure and heart rate at home and work on work and non-work days. J Hypertens. 1993 Feb;11(2):177–183. doi: 10.1097/00004872-199302000-00010. [DOI] [PubMed] [Google Scholar]
  18. Schobel H. P., Fischer T., Heuszer K., Geiger H., Schmieder R. E. Preeclampsia -- a state of sympathetic overactivity. N Engl J Med. 1996 Nov 14;335(20):1480–1485. doi: 10.1056/NEJM199611143352002. [DOI] [PubMed] [Google Scholar]
  19. Shennan A. H., Kissane J., de Swiet M. Validation of the SpaceLabs 90207 ambulatory blood pressure monitor for use in pregnancy. Br J Obstet Gynaecol. 1993 Oct;100(10):904–908. doi: 10.1111/j.1471-0528.1993.tb15104.x. [DOI] [PubMed] [Google Scholar]
  20. Sibai B. M., Gordon T., Thom E., Caritis S. N., Klebanoff M., McNellis D., Paul R. H. Risk factors for preeclampsia in healthy nulliparous women: a prospective multicenter study. The National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol. 1995 Feb;172(2 Pt 1):642–648. doi: 10.1016/0002-9378(95)90586-3. [DOI] [PubMed] [Google Scholar]
  21. Spinillo A., Capuzzo E., Baltaro F., Piazza G., Nicola S., Iasci A. The effect of work activity in pregnancy on the risk of fetal growth retardation. Acta Obstet Gynecol Scand. 1996 Jul;75(6):531–536. doi: 10.3109/00016349609054666. [DOI] [PubMed] [Google Scholar]
  22. Spinillo A., Capuzzo E., Egbe T. O., Nicola S., Piazzi G., Baltaro F. Cigarette smoking in pregnancy and risk of pre-eclampsia. J Hum Hypertens. 1994 Oct;8(10):771–775. [PubMed] [Google Scholar]
  23. Staessen J. A., Fagard R. H., Lijnen P. J., Thijs L., Van Hoof R., Amery A. K. Mean and range of the ambulatory pressure in normotensive subjects from a meta-analysis of 23 studies. Am J Cardiol. 1991 Apr 1;67(8):723–727. doi: 10.1016/0002-9149(91)90529-t. [DOI] [PubMed] [Google Scholar]
  24. Teitelman A. M., Welch L. S., Hellenbrand K. G., Bracken M. B. Effect of maternal work activity on preterm birth and low birth weight. Am J Epidemiol. 1990 Jan;131(1):104–113. doi: 10.1093/oxfordjournals.aje.a115463. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES