Pregnancy Implications of Full-Time Employment in Military Wives

The purpose of this investigation was to evaluate the influence of full-time occupation on pregnancy outcome in a low-risk group of dependent wives of active-duty servicemen. Two hundred forty-five dependent wives worked full time (>37.5 h/week) and 1,021 dependent wives did not work during the pregnancy. All of the patients were cared for by the same group of physicians and nurse midwives over the 19-month study interval. The main outcomes measured included the route of delivery, 5-min Apgar scores, maternal transport to a tertiary care facility, preterm labor, preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, intrauterine growth retardation, fetal demise, and abruptio placenta. Significantly more working women underwent operative vaginal delivery [odds ratio = 2.2, 95% confidence interval (CI) 1.2-4.2; P < 0.02], were transferred to a tertiary care facility (odds ratio = 2.9, 95% CI 1.3-6.4; P < 0.008) for preterm labor unresponsive to tocolytic therapy, and delivered preterm infants (odds ratio = 2.5, 95% CI 1.0-6.3; P < 0.05) than gravid patients in the nonworking group. Relative to unemployed wives, dependent wives of active-duty servicemen who work >37.5 h/week appear to suffer 1) increased preterm labor unresponsive to tocolytic therapy, 2) preterm delivery, and 3) operative vaginal delivery.