Abstract
Methods: From 1 March 1998 to 1 May 2000, 39 913 pregnant women were enrolled in the DNBC. Data on job characteristics and TTP (0–2, 3–5, 6–12, and >12 months) were used for 17 531 daytime workers and 3907 shift workers who had planned the pregnancy. Fecundity odds ratios (ORs) were calculated with 95% confidence intervals using the discrete time survival analysis techniques performed by logistic regression. An OR above 1 expresses a shorter TTP and then a higher fecundity. Potential confounders, such as age at conception, gravidity, prepregnant body mass index, smoking, and alcohol consumption, as well as occupational characteristics, were also included in the model.
Results: Fixed evening workers and fixed night workers had a longer TTP. Compared with daytime workers, the adjusted ORs were 0.80 (95% CI 0.70 to 0.92) for fixed evening workers, 0.80 (95% CI 0.63 to 1.00) for fixed night workers, 0.99 (95% CI 0.91 to 1.07) for rotating shift (without night) workers, and 1.05 (95% CI 0.97 to 1.14) for rotating shift (with night) workers. When analysis was restricted to nulliparous women, the estimates remained unchanged. The proportions of unplanned pregnancies and contraceptive failures were higher among fixed evening and fixed night workers.
Conclusions: There was no unequivocal evidence of a causal association between shift work and subfecundity. The slightly reduced fecundity among fixed evening workers and fixed night workers may be mediated by pregnancy planning bias or differential options for sexual contacts.
Full Text
The Full Text of this article is available as a PDF (107.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ahlborg G., Jr, Axelsson G., Bodin L. Shift work, nitrous oxide exposure and subfertility among Swedish midwives. Int J Epidemiol. 1996 Aug;25(4):783–790. doi: 10.1093/ije/25.4.783. [DOI] [PubMed] [Google Scholar]
- Arendt J. Melatonin and the pineal gland: influence on mammalian seasonal and circadian physiology. Rev Reprod. 1998 Jan;3(1):13–22. doi: 10.1530/ror.0.0030013. [DOI] [PubMed] [Google Scholar]
- Baird D. D., Wilcox A. J., Weinberg C. R. Use of time to pregnancy to study environmental exposures. Am J Epidemiol. 1986 Sep;124(3):470–480. doi: 10.1093/oxfordjournals.aje.a114417. [DOI] [PubMed] [Google Scholar]
- Basso O., Juul S., Olsen J. Time to pregnancy as a correlate of fecundity: differential persistence in trying to become pregnant as a source of bias. Int J Epidemiol. 2000 Oct;29(5):856–861. doi: 10.1093/ije/29.5.856. [DOI] [PubMed] [Google Scholar]
- Bisanti L., Olsen J., Basso O., Thonneau P., Karmaus W. Shift work and subfecundity: a European multicenter study. European Study Group on Infertility and Subfecundity. J Occup Environ Med. 1996 Apr;38(4):352–358. doi: 10.1097/00043764-199604000-00012. [DOI] [PubMed] [Google Scholar]
- Bolumar F., Olsen J., Boldsen J. Smoking reduces fecundity: a European multicenter study on infertility and subfecundity. The European Study Group on Infertility and Subfecundity. Am J Epidemiol. 1996 Mar 15;143(6):578–587. doi: 10.1093/oxfordjournals.aje.a008788. [DOI] [PubMed] [Google Scholar]
- Bolúmar F., Olsen J., Rebagliato M., Sáez-Lloret I., Bisanti L. Body mass index and delayed conception: a European Multicenter Study on Infertility and Subfecundity. Am J Epidemiol. 2000 Jun 1;151(11):1072–1079. doi: 10.1093/oxfordjournals.aje.a010150. [DOI] [PubMed] [Google Scholar]
- Bracken M. B., Hellenbrand K. G., Holford T. R. Conception delay after oral contraceptive use: the effect of estrogen dose. Fertil Steril. 1990 Jan;53(1):21–27. [PubMed] [Google Scholar]
- Brzezinski A., Lynch H. J., Seibel M. M., Deng M. H., Nader T. M., Wurtman R. J. The circadian rhythm of plasma melatonin during the normal menstrual cycle and in amenorrheic women. J Clin Endocrinol Metab. 1988 May;66(5):891–895. doi: 10.1210/jcem-66-5-891. [DOI] [PubMed] [Google Scholar]
- Bøggild H., Burr H., Tüchsen F., Jeppesen H. J. Work environment of Danish shift and day workers. Scand J Work Environ Health. 2001 Apr;27(2):97–105. doi: 10.5271/sjweh.595. [DOI] [PubMed] [Google Scholar]
- Del Rio G. Adrenomedullary function and its regulation in obesity. Int J Obes Relat Metab Disord. 2000 Jun;24 (Suppl 2):S89–S91. doi: 10.1038/sj.ijo.0801287. [DOI] [PubMed] [Google Scholar]
- Gold E. B., Tomich E. Occupational hazards to fertility and pregnancy outcome. Occup Med. 1994 Jul-Sep;9(3):435–469. [PubMed] [Google Scholar]
- Henriksen T. B. General psychosocial and work-related stress and reduced fertility. Scand J Work Environ Health. 1999;25 (Suppl 1):38–39. [PubMed] [Google Scholar]
- Hjollund N. H., Jensen T. K., Bonde J. P., Henriksen T. B., Andersson A. M., Kolstad H. A., Ernst E., Giwercman A., Skakkebaek N. E., Olsen J. Distress and reduced fertility: a follow-up study of first-pregnancy planners. Fertil Steril. 1999 Jul;72(1):47–53. doi: 10.1016/s0015-0282(99)00186-7. [DOI] [PubMed] [Google Scholar]
- Joffe M., Li Z. Male and female factors in fertility. Am J Epidemiol. 1994 Nov 15;140(10):921–929. doi: 10.1093/oxfordjournals.aje.a117180. [DOI] [PubMed] [Google Scholar]
- Joffe M. Time to pregnancy: a measure of reproductive function in either sex. Asclepios Project. Occup Environ Med. 1997 May;54(5):289–295. doi: 10.1136/oem.54.5.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Juhl M., Nyboe Andersen A. M., Grønbaek M., Olsen J. Moderate alcohol consumption and waiting time to pregnancy. Hum Reprod. 2001 Dec;16(12):2705–2709. doi: 10.1093/humrep/16.12.2705. [DOI] [PubMed] [Google Scholar]
- Linn S., Schoenbaum S. C., Monson R. R., Rosner B., Ryan K. J. Delay in conception for former 'pill' users. JAMA. 1982 Feb 5;247(5):629–632. [PubMed] [Google Scholar]
- Madokoro S., Nakagawa H., Misaki K., Ihara H., Ito T., Isaki K. Nocturnal melatonin profiles before and one year after beginning shift-work. Psychiatry Clin Neurosci. 1997 Feb;51(1):17–22. doi: 10.1111/j.1440-1819.1997.tb02360.x. [DOI] [PubMed] [Google Scholar]
- Miyauchi F., Nanjo K., Otsuka K. [Effects of night shift on plasma concentrations of melatonin, LH, FSH and prolactin, and menstrual irregularity]. Sangyo Igaku. 1992 Nov;34(6):545–550. doi: 10.1539/joh1959.34.545. [DOI] [PubMed] [Google Scholar]
- Mozurkewich E. L., Luke B., Avni M., Wolf F. M. Working conditions and adverse pregnancy outcome: a meta-analysis. Obstet Gynecol. 2000 Apr;95(4):623–635. doi: 10.1016/s0029-7844(99)00598-0. [DOI] [PubMed] [Google Scholar]
- Nurminen T. Shift work and reproductive health. Scand J Work Environ Health. 1998;24 (Suppl 3):28–34. [PubMed] [Google Scholar]
- Nybo Andersen Anne-Marie, Olsen Jørn. Do interviewers' health beliefs and habits modify responses to sensitive questions? A study using data Collected from pregnant women by means of computer-assisted telephone interviews. Am J Epidemiol. 2002 Jan 1;155(1):95–100. doi: 10.1093/aje/155.1.95. [DOI] [PubMed] [Google Scholar]
- Olsen J. Cigarette smoking, tea and coffee drinking, and subfecundity. Am J Epidemiol. 1991 Apr 1;133(7):734–739. doi: 10.1093/oxfordjournals.aje.a115948. [DOI] [PubMed] [Google Scholar]
- Olsen J. Design options and sources of bias in time-to-pregnancy studies. Scand J Work Environ Health. 1999;25 (Suppl 1):5–78. [PubMed] [Google Scholar]
- Olsen J., Melbye M., Olsen S. F., Sørensen T. I., Aaby P., Andersen A. M., Taxbøl D., Hansen K. D., Juhl M., Schow T. B. The Danish National Birth Cohort--its background, structure and aim. Scand J Public Health. 2001 Dec;29(4):300–307. doi: 10.1177/14034948010290040201. [DOI] [PubMed] [Google Scholar]
- Olsen J. Subfecundity according to the age of the mother and the father. Dan Med Bull. 1990 Jun;37(3):281–282. [PubMed] [Google Scholar]
- Schechter J., Green L. W., Olsen L., Kruse K., Cargo M. Application of Karasek's demand/control model a Canadian occupational setting including shift workers during a period of reorganization and downsizing. Am J Health Promot. 1997 Jul-Aug;11(6):394–399. doi: 10.4278/0890-1171-11.6.394. [DOI] [PubMed] [Google Scholar]
- Scott A. J. Shift work and health. Prim Care. 2000 Dec;27(4):1057–1079. doi: 10.1016/s0095-4543(05)70189-5. [DOI] [PubMed] [Google Scholar]
- Spinelli A., Figà-Talamanca I., Osborn J. Time to pregnancy and occupation in a group of Italian women. Int J Epidemiol. 1997 Jun;26(3):601–609. doi: 10.1093/ije/26.3.601. [DOI] [PubMed] [Google Scholar]
- Touitou Y., Motohashi Y., Reinberg A., Touitou C., Bourdeleau P., Bogdan A., Auzéby A. Effect of shift work on the night-time secretory patterns of melatonin, prolactin, cortisol and testosterone. Eur J Appl Physiol Occup Physiol. 1990;60(4):288–292. doi: 10.1007/BF00379398. [DOI] [PubMed] [Google Scholar]
- Tuntiseranee P., Olsen J., Geater A., Kor-anantakul O. Are long working hours and shiftwork risk factors for subfecundity? A study among couples from southern Thailand. Occup Environ Med. 1998 Feb;55(2):99–105. doi: 10.1136/oem.55.2.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Uehata T., Sasakawa N. The fatigue and maternity disturbances of night workwomen. J Hum Ergol (Tokyo) 1982;11 (Suppl):465–474. [PubMed] [Google Scholar]
- Weinberg C. R., Baird D. D., Wilcox A. J. Sources of bias in studies of time to pregnancy. 1994 Mar 15-Apr 15Stat Med. 13(5-7):671–681. doi: 10.1002/sim.4780130528. [DOI] [PubMed] [Google Scholar]