Mini-symposium: Research on maternity and work: translating knowledge into preventive recommendations
Thursday 9 October 2025, 9.30 – 10.30 Glow
Moderated by Évelyne Cambron-Goulet
Pregnancy at work, the protection program in the province of Québec (Canada) and the experience of putting in place processes for national guidelines elaboration
Evelyne Cambron-Goulet (presenter)
Maude Lafantaisie, Louise Alain, Aboubacar Sidibé
Abstract
Objectives : The Safe maternity experience program (SMEP) has existed since the 1979 Occupational Health and Safety Act in the province of Québec, Canada. Under SMEP, pregnant or breastfeeding workers can be assigned to another position or other tasks if exposed to an occupational risk factor. If such an assignment is not possible, the worker is entitled to preventive withdrawal with an income compensation. Specific preventive protocols, by occupational category, to be applied in the province are required by a law change since 2023. Our objective was to develop a valid and credible process to translate available knowledge into applicable recommendations to include in the protocols.
Material and methods : Major limitations arising from the nature and quality of available epidemiological data were described from literature syntheses about, among others, pregnancy and standing position: discrepancies in study designs, exposure measurements, control of confounding factors and overall conclusions. Areas of consensus and discordance in current SMEP recommendations were identified with an inventory. Specific questions that require an answer for translating knowledge into recommendations were then formulated by our scientific team and validated by experts who wrote or used previous SMEP guidelines. Processes used by other organizations that make decisions in similar uncertainty context also were reviewed.
Results : Risk management approach based on predefined criteria was favored with a drafted deliberative process to make informed conclusions. A multidisciplinary committee was created including various clinical specialists, ethician, labor law lawyer, etc., and working women, to combine epidemiological data, prepared by the scientific team, with experiential and contextual information held by the committee members. A mechanism to refine questions and criteria after the first deliberations was established.
Conclusion : Risk management is a promising approach to combine all available data in a deliberative process pertaining complex questions such as translating knowledge into preventive guidelines for a safe maternity at work.
Working conditions in low risk nulliparous women and women with multiple pregnancy in the Netherlands: are legislation and guidelines a guarantee for a healthy working environment?
Monique van Beukering (presenter)
Ben Willem Mol
Abstract
Objective: This study evaluates whether the working conditions of Dutch women in two different groups, with low risk and with multiple pregnancies, have been adjusted to legislations and the guidelines of the Netherlands Society of Occupational Medicine (NVAB) and the Social Economic Council (SER).
Material and Methods: We performed two prospective cohort studies, in a group women with low risk pregnancies, and another group women with multiple pregnancies. In both groups women with paid work completed three questionnaires concerning demographics, education, general health and working conditions between 10–16 and 20–24 weeks and 30-34 weeks pregnancy. We calculated the proportion of participants with work-related risk factors not in accordance with legislation and/or guidelines.
Results 50% of working pregnant women with low-risk pregnancies and nearly 60% of women with multiple pregnancies continue to work not in accordance with legislation and guidelines. Many of these women had to deal with physically demanding work, job strain and long and irregular working hours. Successfully implementing MPL and guidelines is a challenge, given the diversity of stakeholders and their interests. The absence of financial incentives for employers, limited access to occupational health care for all working pregnant women and the lack of knowledge and communication about the importance of work adjustment among working pregnant women and their obstetric healthcare providers appear to be the main cause of poor adherence to MPL and guidelines.
Conclusion:
50% of the pregnant women and 60% of women with multiple pregnancies worked under hazardous conditions. Reasons for this limited implementation and areas for improvement are discussed. Given the impact on adverse pregnancy outcomes as well as on the public purse, action to improve compliance must be taken by all stakeholders.
Work related risk factors and miscarriage: a systematic review and meta-analysis
Suzanne Spijkers (presenter)
Monique D. M. van Beukering
Abstract
Objective: (Occupational) physicians are increasingly confronted with questions surrounding (early) pregnancy and work. This systematic review aims to summarize current evidence on occupational risks (long and irregular working times, physically demanding work, jobstrain) and miscarriage. Furthermore, with this review it is our aim to contribute to uniform guidelines for safer workplace practices and to advocate for policies that protect pregnant workers, ultimately reducing the risk of spontaneous abortion attributable to work-related factors.
Materials and methods: The MEDLINE and EMBASE databases were searched for studies up until April 2025. Primary studies in which occupational risk factors were assessed in relation to miscarriage were included. Two independent reviewers selected eligible studies and assessed the quality of the included studies. The association between occupational risks and miscarriage was assessed by calculating odds ratios and corresponding 95% confidence intervals using a random-effects model.
Results: Results are to follow.
Conclusions: Although the existing evidence is still limited, this systematic review shows that pregnant woman who work in various unfavourable circumstances, for example shift work, may have an increased risk of miscarriage.
Do current policies reflect evidence on occupational risks and preterm birth? A policy content analysis
Haimanot Adane (presenter)
Alex Collie, Ross Iles, Jacqueline A Boyle
Abstract
Objectives: Preterm birth is a leading cause of neonatal mortality and the second-leading cause of death among children under five worldwide. Recent systematic reviews have demonstrated an increased risk of preterm birth in women exposed to workplace physical and psychosocial risks during pregnancy. The extent to which this evidence is reflected in policy remains unclear. This study aimed to determine the extent to which current policies reflect the current evidence regarding the association between occupational risks and preterm birth.
Materials and Methods: This study used a three-step search strategy: searching electronic databases (Embase and Scopus), policy databases (Overton, Dimension, and Google Advanced), and websites of global and national agencies/organisations focused on occupational or women’s health policies. Data were analysed through descriptive and interpretive content analyses. Eligible documents were publicly available in full text, published from 2000 onwards by credible sources, and written in English.
Results: Thirteen eligible policy documents were identified. Of these, eight concluded that the evidence for the relationship between occupational risks and preterm birth was inconclusive. The remaining five documents report that occupational risks may be associated with an increased risk of preterm birth. Nine documents offered recommendations to address this risk. These included four recommending job redesign, two information/education, and three a combination of job redesign, job transfer, information/education, and changes to workplace policy. Three were developed by a multidisciplinary stakeholder group, six by a multidisciplinary clinical group, and four by unidisciplinary clinicians.
Conclusions: Most current policies partially reflect the current evidence on the relationship between occupational risks and preterm birth. Development of most policy documents did not use rigorous methods and did not involve multidisciplinary stakeholder groups. There is an urgent need for the development of evidence-based policies grounded in robust research methods.