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Int J Epidemiol. 2019 Mar 29. pii: dyz045. doi: 10.1093/ije/dyz045. [Epub ahead of print]

Association between maternal shift work and infant neurodevelopmental outcomes: results from the Taiwan Birth Cohort Study with propensity-score-matching analysis.

Wei CF1,2, Chen MH3,4, Lin CC1, Guo YL1,2,5, Lin SJ6, Liao HF7, Hsieh WS4,8, Chen PC1,2,9,10,11.

Author information

1
Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.
2
Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
3
Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
4
Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
5
National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
6
Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.
7
School of Physical Therapy, National Taiwan University.
8
Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.
9
Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan.
10
Office of Occupational Safety and Health, National Taiwan University Hospital, Taipei, Taiwan.
11
Innovation and Policy Center for Population Health and Sustainable Environment, National Taiwan University College of Public Health, Taipei, Taiwan.

Abstract

BACKGROUND:

Maternal shift work is associated with preterm delivery, small-for-gestational-age new-borns, childhood obesity and future behavioural problems. However, the adverse effects on and interactions of maternal shift work with infant neurodevelopment remain uncertain. Therefore, we examined the associations between maternal-shift-work status and infant neurodevelopmental parameters.

METHODS:

The Taiwan Birth Cohort Study is a nationwide birth cohort study following representatively sampled mother-infant pairs in 2005. The participants' development and exposure conditions were assessed by home interviews with structured questionnaires at 6 and 18 months of age. Propensity scores were calculated with predefined covariates for 1:1 matching. Multivariate conditional logistic regression and the Cox proportional-hazards model were used to examine the association between maternal-shift-work status and infant neurodevelopmental-milestone-achievement status.

RESULTS:

In this study, 5637 term singletons were included, with 2098 cases selected in the propensity-score-matched subpopulation. Persistent maternal shift work was associated with increased risks of delays in gross-motor neurodevelopmental milestones [aOR = 1.36, 95% confidence interval (CI) = 1.06-1.76 for walking steadily], fine-motor neurodevelopmental milestones (aOR = 1.39, 95% CI = 1.07-1.80 for scribbling) and social neurodevelopmental milestones (aOR = 1.35, 95% CI = 1.03-1.76 for coming when called upon). Moreover, delayed gross-motor and social development were identified in the propensity-score-matched sub-cohort.

CONCLUSIONS:

This study shows negative associations between maternal shift work and delayed neurodevelopmental-milestone achievement in the gross-motor, fine-motor and social domains at 18 months. Future research is necessary to elucidate the possible underlying mechanisms and long-term health effects.

KEYWORDS:

Shift work; birth cohort; neurodevelopment; propensity-score matching

PMID:
30927436
DOI:
10.1093/ije/dyz045

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