Employment status of pregnant women in central Poland and the risk of preterm delivery and small-for-gestational-age infants

BACKGROUND: Unemployment is one of the consequences of the ongoing transformation of the Polish economy. The main objective of the present study was to investigate the relationship between women's employment status and preterm delivery (PD) and/or small-for-gestational-age (SGA) infants, in Central Poland during the socio-economic transition. METHODS: The study population comprised 8% random sample of 2,080 women from the Lodz macro region who gave birth to a child during a one-year period (1996-1997). Based on the employment status, three groups were distinguished: the employed (n = 1238), the unemployed (n = 128)--women who lost their job before pregnancy (at least 12 months prior to delivery) and were actively seeking employment, and the housewives (n = 714). Women with chronic medical problems diagnosed before pregnancy were excluded from the study. RESULTS: The rates of preterm delivery were found to be 6.3%, 11.7% and 4.9%, respectively for the employed, unemployed, and housewives. After adjustment for age, marital status, education, maternal height, smoking, own apartment, presence of cervical insufficiency and uterine irritability, an excess risk of PD was observed among the unemployed women (OR = 1.92, 95% CI: 1.01-3.64). Unemployment was associated, though not significantly, with higher rates of SGA births. CONCLUSION: In Central Poland, the unemployed pregnant women are characterised by an excess risk of preterm delivery. The impact of unemployment on the community's health, which seems to be underestimated, should be given more consideration in the national and local policies for public health.