Occupational Risk Factors of Prenatal Depression in Pregnant Women in the New York City Metropolitan Area

BACKGROUND AND AIM: Approximately 80% of women become pregnant at some point during their career in the United States. Prenatal depression (PD) has been associated with adverse health outcomes in pregnant women and their offspring, particularly in lower sociodemographic (SES) populations. We examined the occupational risk factors associated with PD in a population of lower SES pregnant workers in New York City. METHODS: Analyses included 487 women aged ≥18 years visiting obstetrics and gynecology clinics during pregnancy or within 2 months of child delivery between March to September 2017, with employment status at the time or after January 2014, when the Pregnant Workers Fairness Act legislation was enforced in NYC. Detailed occupational and sociodemographic data were collected via in-person interviews. Women completed a 10-item Edinburgh Depression Scale (EDS); EDS score ≥13 was classified as probable PD. Scores for established subconstructs of EDS (anxiety, anhedonia, classical depression) were also calculated. Multivariable adjusted regressions were used to identify the occupational factors that predict higher scores of EDS and its subconstructs, adjusting for age, race/ethnicity, education, marital status, and manager status. RESULTS: Majority of women were black and/or Hispanic (84%), reporting <$30,000 annual household income (64%). Unconventional work shifts (night/evening or rotating shiftwork) [adjusted odds ratio {aOR} (95% CI)=2.01(1.14-3.55)], higher perceived work stress [aOR=2.91(1.27-6.70)], and health, science, or technology-related industry [aOR=2.74 (1.07-7.03)] were independently associated with elevated EDS score. For EDS subconstructs, higher perceived stress level at job was significantly positively associated with all three subconstructs, while job duty of lifting/pulling heavy objects was significantly associated with classical depression subconstruct (all p<0.05). CONCLUSIONS: As more women continue to work during pregnancy, workplace policies to decrease hours of unconventional work shifts or physically demanding duties may be particularly important for protecting pregnant women and their children’s well-being. KEYWORDS: pregnant worker, occupational factors, stress, depression