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Women's occupational status during pregnancy and preventive behaviour and health outcomes between 1998 and 2016 in France - 25/01/23

Doi : 10.1016/j.jogoh.2023.102545 
Solène Vigoureux 1, 2, , Elsa Lorthe 3, 4, Béatrice Blondel 3, Virginie Ringa 2, Marie-Josèphe Saurel-Cubizolles 3
1 Department of Gynecology and Obstetrics, University Hospital of Nantes, Nantes, France. 
2 CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Saclay University, UVSQ, Villejuif, France 
3 Obstetrical, Perinatal, and Pediatric Epidemiology Team, Center of Research in Epidemiology and Statistics (U1153), Paris Cité University, INSERM, INRAE, Paris, France 
4 Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland 

Correspondence author.
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 25 January 2023

Edited by: Pr. Herve Fernandez

Abstract

Background

Despite an improvement in preventive care and perinatal health in previous decades, social inequalities persist, particularly to the disadvantage of isolated or unemployed women.

The objective was to analyse the evolution between 1998 and 2016 of the association between women's occupational status and perinatal outcomes.

Methods

Data came from four national surveys performed in 1998, 2003, 2010 and 2016. Occupational status was defined by maternal employment status and type of occupation during pregnancy. Preventive behaviours (initiation of antenatal care, antenatal classes, breast feeding) and health outcomes (hospitalization, preterm birth, birth weight below the 10th percentile) were analysed by occupational status adjusted for other maternal characteristics, for each study year.

Results

The studied sample included 12,497 women in 1998, 13,290 in 2003, 13,209 in 2010 and 11,179 in 2016. The proportion of employed women increased from 66% to 75% between 1998 and 2016, and that of housewives decreased from 22% to 12%. The proportion of preterm births globally increased between 1998 and 2016, especially for housewives. The proportion of low birthweight for gestational age (LBWGA) remained similar over the years. From 1998 to 2016, the differences between occupational groups persisted for preterm births and LBWGA.

Conclusions

Occupational groups exhibited strong social differences in preventive care over the entire study period and persisted in the recent data. As a major social indicator, women's occupational status during pregnancy has to be considered as a risk factor of poor preventive behaviour and unfavourable perinatal outcomes.

Le texte complet de cet article est disponible en PDF.

Keywords : women’ employment, occupational status, perinatal outcomes, social inequalities, preventive behaviour


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© 2023  Publié par Elsevier Masson SAS.
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