Is occupational stress associated with spontaneous abortion?

Background: Current evidence examining the relationship between stress and spontaneous abortion (SA) is somewhat mixed. While some prior studies provide evidence for an association others have failed to detect a relationship, especially after statistically controlling for maternal health behaviors. In an attempt to address these inconsistent findings the present study examined the relationship between occupational stress and SA using data from the Mount Sinai Study of Women Office Workers. Methods: Data were analyzed from 160 women. At enrollment participants' level of occupational stress was assessed using 3 indices: the Karasek (1998) Job Content Questionnaire measuring degree of job strain and two questionnaire items measuring participants' self-reported occupational stress “in general” and “in the past 2 weeks.” SA was assessed from hCG-assayed urine samples provided by participants on the first 2 days of expected menses each month for the duration of participation in the study. Logistic regressions models were used to investigate the relationship between self-reported occupational stress and spontaneous abortion. Results: Women who reported that they were “stressed” or “very stressed” at work in the two weeks prior to study entry, relative to those who reported that they were “not stressed” or “not very stressed”, were 2.33 times more likely to experience a SA (CI: 1.053-5.166, P = .037), even after adjusting for age, race, marital status, body mass index, alcohol, cigarette and caffeine intake. Conclusions: The findings provide preliminary evidence that occupational stress may be associated with SA. Implications of the findings and directions for future research are discussed.