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APHA Scientific Session and Event Listing

Carina Jacob¹, Birgit Reime, ScD MPH², Karin M. Zinsmeister¹, Beate Schuecking, MD³, and Paul Wenzlaff, MSc⁴. (1) Healthcare and Nursing, University of Applied Sciences at Fulda, Germany, Marquardstr. 35, Fulda, 36039, Germany, **0171-6094759, carina.jacob@pg.fh-fulda.de, (2) Centre for Healthcare Innovation and Improvement, Child and Family Research Institute, E414A - 4480 Oak Street, Vancouver, BC V6H 3V4, Canada, (3) Vice-President, University of Osnabrueck, Albrechtstr. 28, Osnabrueck, 49069, Germany, (4) Physicians' Chamber of Lower Saxony, PB 4749, Hanover, 30047, Germany

Most studies of the association between parental employment status and perinatal outcomes did not examine differences between unemployment and homemaking status. We explored whether maternal, paternal, or both parents' employment status is related to stillbirths by separately comparing the stillbirth rates of professional mothers, fathers and couples to mothers, fathers and couples who were homemakers, unemployed, or blue collar employees. We analysed perinatal data routinely collected during pregnancy and birth on singletons born in the federal state of Lower Saxony, Germany, from 1990-1999 (n=632,864). Chi square tests, bivariate and multivariable logistic regression models were performed using the infants of professional mothers, fathers and couples as reference groups. In multivariable analyses, adjusted for age, parity, nationality, smoking, and chronic conditions, infants of housewives (OR=1.91,95%-CI=1.65, 2.21), unemployed (OR=1.95, 95%-CI 1.57, 2.41) and blue collar mothers (OR=1.54, 95%-CI=1.29, 1.84) had increased risks for stillbirths. Infants of male homemakers (OR=1.69, 95%-CI=1.35, 2.11), unemployed fathers (OR=1.78, 95%-CI 1.54, 2.07), and blue collar workers (OR=1.58, 95%-CI=1.41, 1.78) were at higher risks for stillbirths. Stillbirths rates were increased for infants of couples who both were homemakers (OR=2.42,95%-CI=1.73, 3.40), unemployed (OR=2.53, 95%-CI=1.78, 3.60), or blue collar workers (OR=1.74, 95%-CI=1.36, 2.23). Non-employment is associated with an increased risk for stillbirths, especially if both parents are involved. For social desirability reasons, self-reported employment status may be related to misclassifications of unemployed individuals as homemakers. In the context of mass unemployment in Germany, parental non-employment is a strong statistical predictor for pregnancy outcomes and may be relevant for public health professionals.

Learning Objectives:

• 1. Recognize that maternal, paternal, and both parents’ employment status is related to stillbirths.
• 2. Consider confounders we measured in our study and discuss potential unmeasured confounders that may affect the association between employment status and stillbirths.
• 3. Discuss the level of relevance our findings from a non-randomized study may have for public health professionals.

Keywords: Pregnancy Outcomes, Social Inequalities

Presenting author's disclosure statement:

Not Answered