Deprivation, occupational hazards and perinatal outcomes in pregnant workers

Background. In France, economic difficulties during recent decades have caused a rise in social and economic insecurity affecting workers.
Aims. To describe deprivation in pregnant women at work by measuring their prevalence, occupational exposure with risks for pregnancy, preventive measures and relationships with selected birth outcomes.
Methods. A cross-sectional descriptive study of the occupational health service was performed in 2014. Pregnant workers were received after their delivery by occupational health physicians (OHP) and responded to a self-administered questionnaire. Information on birth outcome was self-reported by workers. Deprivation was measured by using the EPICES scale. Occupational exposure with risk for pregnancy was assessed by OHPs. Using French nomenclature, job coding was applied by the occupational health team and controlled by an experienced coder. The two groups (deprivation/no deprivation) were compared using univariable (test chi2) and multivariable analyses conducted with Poisson regression.
Results. Of 1402 pregnant workers, 293 workers (21 %) were classed in a “deprivation” group. Deprived situations were distributed in all professional sectors but especially among employees and manual workers. Significant associations (p<0,001) emerged between deprivation and a set of occupational exposures with risk for pregnancy, notably physical risks. The workers in the deprivation group had a four-fold higher risk of cumulating occupational risks ( 3) for the evolution of pregnancy. There were no differences between the two groups regarding the implementation of preventive measures.
Conclusions. Our data suggest the interest of identifying social deprivation in pregnant workers at work.