Employment, job strain, and preterm delivery among women in North Carolina.

OBJECTIVES: A population-based case-control study was conducted in central North Carolina to assess the relationship between occupational stress and preterm delivery. METHODS: Four hundred twenty-one women delivering infants before 37 weeks' gestation and 612 women delivering infants at term were interviewed a median of 6 months after delivery. Exposure information was collected for all jobs held for at least 1 month during pregnancy. RESULTS: Work in a "high strain" job (i.e., high demand and low control) was not associated with increased risk of preterm delivery compared with work in "low strain" jobs (all other combinations of job demand and control). Narrowing the exposure window to the third trimester did not modify the results. However, women who worked at a high-strain job full-time (odds ratio OR = 1.4, 95% confidence interval CI = 0.9, 2.0) or for 30 or more weeks (OR = 1.4, CI = 1.0, 2.2) had a modestly increased risk. Several analyses suggested that Black women were at greater risk from job strain than White women. CONCLUSIONS: This study suggests that chronic exposure during pregnancy to work characterized by high demand and low control may be modestly associated with preterm delivery.