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Fernandez RC, Moore VM, Marino JL, Whitrow MJ, Davies MJ. Night Shift Among Women: Is It Associated With Difficulty Conceiving a First Birth? Front Public Health 2020; 8:595943. [PMID: 33335878 PMCID: PMC7736040 DOI: 10.3389/fpubh.2020.595943] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Asynchrony in circadian processes alters many physiological systems, including female reproduction. Thus, there are possible reproductive consequences of night shift work for women including menstrual irregularity, endometriosis, and prolonged time to conception. This study examined whether women who worked night shift were more likely than those who did not to require fertility treatment to conceive a first birth, whether they had specific infertility diagnoses, and if such relationships were age-specific. Methods: In a retrospective data linkage study of 128,852 primiparous women, fertility treatment data were linked to the state perinatal registry for South Australia (1986-2002). Potential exposure to night shift work was assessed using a job-exposure matrix. First, the association between night shift work and fertility treatment was assessed among (1) all women, then (2) women in paid employment, using logistic regression. Interactions between age and shift work status were also examined. Secondly, among women who conceived with fertility treatment, we assessed associations between night shift work and type of infertility diagnosis. Potential confounders were considered in all analyses. Results: Among women ≤35 years, night shift workers were more likely to require fertility treatment (all: OR = 1.40, 95% CI 1.19-1.64; in paid employment: OR = 1.27, 95% CI 1.08-1.50). There were no associations among women >35 years. Ethnicity, socioeconomic status and smoking did not affect these results. Among women who underwent fertility treatment, night shift workers were more likely than day workers to have menstrual irregularity (OR = 1.42, 95% CI 1.05-1.91) or endometriosis (OR = 1.34, 95% CI 1.00-1.80). Conclusions: Night shift work may contribute to increased need for fertility treatment in younger women. This increased risk may reflect young women's vulnerability in terms of poor tolerance of night shift work, and/or lack of control and choice about shift schedule.
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Affiliation(s)
- Renae C Fernandez
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia
| | - Vivienne M Moore
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia.,Fay Gale Centre for Research on Gender, Adelaide, SA, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,Royal Women's Hospital, Melbourne, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Melissa J Whitrow
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia
| | - Michael J Davies
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia
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Phillips EA, Nimeh T, Braga J, Lerner LB. Does a surgical career affect a woman's childbearing and fertility? A report on pregnancy and fertility trends among female surgeons. J Am Coll Surg 2014; 219:944-50. [PMID: 25260684 DOI: 10.1016/j.jamcollsurg.2014.07.936] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/03/2014] [Accepted: 07/25/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Increases in pregnancy complication rates and use of assisted reproductive technology (ART) have been demonstrated in female urologists and orthopaedic surgeons when compared with the general US population. To determine if childbearing differences exist across specialties, we evaluated female surgeons in all fields, particularly with regard to fertility. STUDY DESIGN An anonymous, 199-item survey was distributed via specialty female surgeon interest groups and word of mouth to general surgery, gynecology, neurosurgery, ophthalmology, orthopaedics, otolaryngology, plastic surgery, podiatry, and urology. The 1,021 responses were analyzed and compared with Centers for Disease Control National Survey for Family Growth and National Institute of Health data to identify differences between populations. RESULTS Of women surgeons, 32% reported fertility difficulty; 84% of whom underwent infertility workup. Seventy-six percent of these women used ART to attempt pregnancy. In comparison, only 10.9% of women in the general US population report infertility, and 11% seek infertility services. Of all babies born to female surgeons, at least 13% were conceived using ART. Surgeons had 1.4 biological children, less than the national average. Age at first pregnancy was 33 years, compared with a national average of 23. If ART was implemented, surgeon age at first birth increased to 35.4 years. Highest rates of infertility existed in otolaryngology (29%), general surgery (22%), and orthopaedics (18%). CONCLUSIONS Female surgeons have first pregnancies later in life, fewer children, and report more issues with infertility. Assisted reproductive technology is implemented more often by female surgeons than the general population. Differences in fertility exist between specialties and warrant additional study.
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Affiliation(s)
| | - Tony Nimeh
- Department of Surgery, VA Boston Healthcare System, Boston, MA
| | - Julie Braga
- Department of Obstetrics and Gynecology, Dartmouth Hitchcock, Lebanon, NH
| | - Lori B Lerner
- Department of Surgery, VA Boston Healthcare System, Boston, MA
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