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首页> 外文期刊>Occupational and environmental medicine >Work activities and risk of prematurity, low birth weight and pre-eclampsia: An updated review with meta-analysis
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Work activities and risk of prematurity, low birth weight and pre-eclampsia: An updated review with meta-analysis

机译：工作活动和早产，低出生体重和先兆子痫的风险：荟萃分析的最新综述

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Objectives We assessed the evidence relating preterm delivery (PTD), low birth weight, small for gestational age (SGA), pre-eclampsia and gestational hypertension to five occupational exposures (working hours, shift work, lifting, standing and physical workload). We conducted a systematic search in Medline and Embase (1966 to 2011), updating a previous search with a further 6 years of observations. Methods As before, combinations of keywords and medical subject headings were used. Each relevant paper was assessed for completeness of reporting and potential for important bias or confounding, and its effect estimates abstracted. Where similar definitions of exposure and outcome existed we calculated pooled estimates of relative risk (RR) in meta-analysis. Results Analysis was based on 86 reports (32 cohort investigations, 57 with usable data on PTD, 54 on birth weight and 11 on pre-eclampsia/gestational hypertension); 33 reports were new to this review. For PTD, findings across a substantial evidence base were generally consistent, effectively ruling out large effects (eg, RR>1.2). Larger and higher quality studies were less positive, while meta-estimates of risk were smaller than in previous analyses and best estimates pointed to modest or null effects (RR 1.04 to 1.18). For SGA, the position was similar but meta-estimates were even closer to the null (eight of nine RRs??1.07). For pre-eclampsia/gestational hypertension the evidence base remains insufficient. Conclusions The balance of evidence is against large effects for the associations investigated. As the evidence base has grown, estimates of risk in relation to these outcomes have become smaller.
机译：目的我们评估了早产（PTD），低出生体重，小胎龄（SGA），先兆子痫和妊娠高血压与五种职业暴露（工作时间，轮班工作，举重，站立和身体工作量）的证据。我们在Medline和Embase（1966年至2011年）中进行了系统的搜索，并通过对6年的观察结果进行了更新。方法与以前一样，使用关键词和医学主题词的组合。对每篇相关论文的报告完整性和潜在的重大偏见或混淆进行了评估，并对其影响估计进行了抽象。在存在相似的暴露和结果定义的地方，我们在荟萃分析中计算了相对风险（RR）的汇总估计。结果分析基于86份报告（32项队列研究，57项有关PTD的可用数据，54项出生体重和11项先兆子痫/妊娠高血压的数据）; 33份报告是该评价的新报告。对于PTD，在大量证据基础上的发现通常是一致的，有效地排除了较大的影响（例如RR> 1.2）。规模更大，质量更高的研究没有那么积极，而风险的荟萃估计值则比以前的分析要小，最佳估计值则显示出中等或无效的影响（RR 1.04至1.18）。对于SGA，位置相似，但元估计甚至更接近零值（9个RR中的8个≈1.07）。对于先兆子痫/妊娠高血压，证据基础仍然不足。结论证据的平衡不利于所研究的协会的巨大影响。随着证据基础的增长，与这些结果相关的风险估计值越来越小。

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