Cardiac cost of occupational stress among obstetricians: a cross-sectional non-invasive haemodynamic study in a tertiary hospital

Objectives To identify early cardiovascular changes in normotensive obstetricians, a high-stress group, using non-invasive haemodynamic monitoring, and to examine the association between burnout and haemodynamic parameters. Design Cross-sectional study. Setting A single tertiary hospital in China. Participants A total of 120 healthy Han Chinese adults (aged 25–45 years, both sexes) were enrolled using stratified random sampling by age and categorised into three groups: obstetricians, clinical support staff and administrative personnel. Of these, 105 (87.5%) completed the study and entered the final analysis (obstetricians n=40; clinical support staff n=33; administrative personnel n=32); 15 were excluded due to incomplete questionnaire data. Key exclusion criteria were chronic medical conditions, medication use, acute illness, a clinical shift within 24 hours before measurement, pregnancy or lactation, body mass index extremes (≤18.5 or ≥ 28 kg/m 2 ) and major life events within the past 6 months. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey; workload, lifestyle and family history were collected via questionnaire. Primary and secondary outcome measures Advanced haemodynamics were assessed via Ultrasonic Cardiac Output Monitor. The primary outcome was cardiac power output (CPO). Secondary outcomes included other non-invasive haemodynamic parameters, such as cardiac index (CI), systemic vascular resistance index, Smith–Madigan inotropy index and corrected flow time. Results Severe burnout was associated with reduced CPO and CI (−0.152 W and −0.403 L/min/m 2 , respectively; both p<0.05). Increased weekly exercise independently predicted higher CPO and CI (B=0.046 W and 0.155 L/min/m 2 , respectively; both p<0.001). This protective association remained significant in obstetricians and clinical support staff, and was stronger for CI in obstetricians (interaction p=0.03). The severe burnout–haemodynamics association was consistent across all groups. Conclusions In high-stress populations, advanced haemodynamic patterns may serve as an early-warning biomarker for burnout, guiding personalised exercise advice. Longitudinal studies are needed to confirm their predictive value.