2023-09-28 14:46:10 +00:00
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abstract: 'Background: Rising rates of labor induction and cesarean delivery,
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especially when used without a medical reason, have generated concern
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among clinicians, women, and policymakers. Whether employment status
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affects pregnant women''s childbirth-related care is not known. We
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estimated the relationship between prenatal employment and obstetric
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procedures, distinguishing whether women reported that the induction or
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cesarean was performed for medical reasons.
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Methods: Using data from a nationally representative sample of women who
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gave birth in U. S. hospitals (n = 1,573), we used propensity score
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matching to reduce potential bias from nonrandom selection into
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employment. Outcomes were cesarean delivery and labor induction, with
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and without a self-reported medical reason. Exposure was prenatal
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employment status (full-time employment, not employed). We conducted
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separate analyses for unmatched and matched cohorts using multivariable
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regression models.
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Findings: There were no differences in labor induction based on
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employment status. In unmatched analyses, employed women had higher odds
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of cesarean delivery overall (adjusted odds ratio {[}AOR], 1.45; p =
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.046) and cesarean delivery without medical reason (AOR, 1.94; p =
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.024). Adding an interaction term between employment and college
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education revealed no effects on cesarean delivery without medical
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reason. There were no differences in cesarean delivery by employment
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status in the propensity score-matched analysis.
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Conclusions: Full-time prenatal employment is associated with higher
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odds of cesarean delivery, but this association was not explained by
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socioeconomic status and no longer existed after accounting for
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sociodemographic differences by matching women employed full time with
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similar women not employed during pregnancy. Copyright (C) 2014 by the
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Jacobs Institute of Women''s Health. Published by Elsevier Inc.'
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affiliation: 'Kozhimannil, KB (Corresponding Author), Univ Minnesota, Sch Publ Hlth,
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Div Hlth Policy \& Management, 420 Delaware St SE,MMC 729, Minneapolis, MN 55455
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USA.
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Kozhimannil, Katy Backes; Attanasio, Laura B., Univ Minnesota, Sch Publ Hlth, Div
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Hlth Policy \& Management, Minneapolis, MN 55455 USA.
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Johnson, Pamela Jo, Med Res Inst, Minnetonka, MN USA.
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Gjerdingen, Dwenda K., Univ Minnesota, Sch Med, Dept Family Med \& Community Hlth,
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St Paul, MN 55108 USA.
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McGovern, Patricia M., Univ Minnesota, Sch Publ Hlth, Div Environm Hlth Sci, Minneapolis,
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MN USA.'
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author: Kozhimannil, Katy Backes and Attanasio, Laura B. and Johnson, Pamela Jo and
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Gjerdingen, Dwenda K. and McGovern, Patricia M.
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author-email: kbk@umn.edu
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author_list:
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- family: Kozhimannil
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given: Katy Backes
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- family: Attanasio
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given: Laura B.
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- family: Johnson
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given: Pamela Jo
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- family: Gjerdingen
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given: Dwenda K.
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- family: McGovern
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given: Patricia M.
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da: '2023-09-28'
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doi: 10.1016/j.whi.2014.06.010
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eissn: 1878-4321
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files: []
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issn: 1049-3867
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journal: WOMENS HEALTH ISSUES
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keywords-plus: 'MATERNITY LEAVE; BIRTH OUTCOMES; SOCIOECONOMIC DISPARITIES;
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AMERICAN-COLLEGE; UNITED-STATES; CHILD-HEALTH; HIGH-QUALITY; SCORE;
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WORK; RISK'
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language: English
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month: SEP-OCT
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number: '5'
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number-of-cited-references: '58'
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orcid-numbers: Johnson, Pamela Jo/0000-0003-3034-1378
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pages: 469-476
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papis_id: 023e7e2d746475e897aa66e698bddff9
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ref: Kozhimannil2014employmentpregnancy
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times-cited: '1'
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title: 'Employment During Pregnancy and Obstetric Intervention Without Medical Reason:
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Labor Induction and Cesarean Delivery'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000345157500002
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usage-count-last-180-days: '1'
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usage-count-since-2013: '4'
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volume: '24'
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web-of-science-categories: Public, Environmental \& Occupational Health; Women's Studies
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year: '2014'
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