Adverse perinatal outcomes among practical nurses: The Finnish Medical Birth Register Study

Kwegyir-Afful, Emma; Lamminpää, Reeta; Räsänen, Kimmo; Vehviläinen-Julkunen, Katri; Selander, Tuomas; Gissler, Mika

Abstract

Work as a practical nurse (nurse assistant) may have an effect on pregnancy outcomes. Exposure to chemical, physical and biological hazards are common among hospital personnel. Stressful work conditions such as shift work, prolonged standing and long working hours have been reported among practical nurses. The aim of this study was to examine whether working as a practical nurse is associated with adverse perinatal outcomes. Data were obtained from the Finnish Medical Birth Register of 1997-2014. We included 58512 singleton newborns of practical nurses as cases, and 8765 and 39485 newborns of secretaries and housewives, respectively, as controls. Outcomes included preterm birth (<37 weeks), low birthweight (<2500 g), perinatal death (stillbirth or neonatal death within the first seven days), SGA (<2.5th percentile), and breech presentation, among others. Logistic regression analysis was performed and adjusted for confounders such as maternal age, parity, smoking, and diabetes. Being a practical nurse had lower likelihood of low birthweight (OR=0.88; 95% CI: 0.81-0.96), perinatal death (OR=0.77; 95% CI: 0.62-0.96), SGA (OR=0.79; 95% CI: 0.72-0.86) and episiotomy (OR=0.90; 95% CI: 0.86-0.94). Practical nursing was significantly related to higher odds of instrumental delivery (OR=1.08; 95% CI: 1.00-1.17), but not with preterm birth, breech presentation, shoulder presentation, or caesarean section. After adjusting for confounding variables, working as a practical nurse was associated with higher likelihood of instrumental delivery, particularly vacuum delivery. The risk for shoulder presentation was nearly two-fold compared to controls. Further studies to determine when mothers started their maternity leave and the consequent effect on pregnancy outcome is highly recommended. [Abstract copyright: © 2021 Kwegyir-Afful E. et al.]

Citation

Kwegyir-Afful, E., Lamminpää, R., Räsänen, K., Vehviläinen-Julkunen, K., Selander, T., & Gissler, M. (2021). Adverse perinatal outcomes among practical nurses: The Finnish Medical Birth Register Study. European Journal of Midwifery, 5(June), 19. https://doi.org/10.18332/ejm/137355

• Journal Article Type: Article
• Acceptance Date: May 14, 2021
• Publication Date: Jun 25, 2021
• Deposit Date: Jul 19, 2021
• Publicly Available Date: Jul 19, 2021
• Journal: European Journal of Midwifery
• Print ISSN: 2585-2906
• Publisher: EU European Publishing
• Volume: 5
• Issue: June
• Pages: 19
• DOI: https://doi.org/10.18332/ejm/137355
• Publisher URL: https://doi.org/10.18332/ejm/137355
• Related Public URLs: http://www.europeanjournalofmidwifery.eu/
• Additional Information: Additional Information : ** From PubMed via Jisc Publications Router **Journal IDs: eissn 2585-2906 **Article IDs: pubmed: 34222837; pii: 19; pmc: PMC8224530 **History: accepted 14-05-2021; revised 11-05-2021; submitted 21-08-2020