Did you have a Preemie or Pre Term Labor while working?

I just read an article and had a disscussion with some preemie moms on if on the job stress/exertion can cause PROM.

I had planned on working until 39 weeks with my first, but PROMed at 36 weeks after a day of working ICU. In, "Every Pregnant Woman's Guide to Preventing Premature Birth", the author, an RN, writes of how many NICU nurses she knows that had preemies.

I am the only RN I know that did not carry to term, so I thought I'd take an informal survey.

Were you working when your labor started?

What unit did you work?

What week did your Pre Term Labor start?

When did you deliver?

Were you given a reason for your PTL?

Thanks for responses! I am pg now and if I go on bedrest, maybe I'll write a paper! : p

[OBNURSE81]

Well add me to the list. First time was many many years ago, Worked ICU with heavy lifting loads went into pre term labor at 34 weeks. Lasted to 40 weeks and had a 9.6 lb baby. I had to take a leave of absence, was on bedrest on and off for weeks. I DO think that the lifting and standing on my feet was a major problem. 9 years ago I still worked ICU, 12 hour shifts. Went into pre term again at 32 weeks. Same story. Walked around dilated 3-4 for weeks, had a small baby, who spent 9 days in the NICU. Did work stress play a factor YOU BET! It would be interesting to see if there is a link between nurses and OB problems. I remember coming home from those 12 hour shifts with my legs, etc. so achy I thought I would die. I do have co-workers though that worked till they went into normal labor and walked from the unit to the OB unit and had a baby. They were just as miserable as I was, but managed to last through a normal pregnancy. Maybe I was just a whimp..

[505rn]

You were not a whimp!!!! This has been very interesting reading. I began a new job on a busy inpatient geripsych unit (fortunately we all are considerate about whoever is pregnant not being involved with getting control of or even having a patient who is out of control/a risk to become out of control) working night shift and shortly after found out I was pregnant. I lost 12 pounds before they admitted me for hyperemesis and dehydration and was on home IV's for a week, sick the entire pregnancy and on zofran, every month the doctor made me quit the zofran and every month I got sick again. I firmly believe I was as sick as I was because of working nights, now I did not have preterm labor but did work up until 2 days before I delivered and had some difficulties at delivery with meconium stained fluid and dropping heart rate, they got NICU staff in for the delivery but he was fine and still is. I am in a different job now and plan to become pregnant in the fall, will be interesting to see if I am as sick (I know mere chance could be the cause of not being sick as every pregnancy is different but still....)

[JennieBSN]

Case in point, you guys...one of our nurses is 12wks. preggers, and just had to be hospitalized for hyperemesis. Got IV zofran, compazine, multivites, the whole nine. She's been forced to cut down her hours (doc's orders). Here's the kicker...some of the evil b****es we work with have been giving her CRAP about it!! We're labor and delivery nurses, for cryin' out loud!! I definitely think pressure from fellow STAFF to work beyond your limits can cause problems, too. Why are we such jerks to eachother all the time? Man...

[karenrndmc]

Hi,

With my first pregnancy I worked in an aggressive SICU and went into labor at 31 weeks after coding a patient several times on a 12 hour midnight shift. I was hospitalized and they stopped the labor with drugs and bed rest. They kept me on the drugs till 37 weeks because I came down with the chicken pox's at 35 weeks (imagine that!). I went into labor the day after stopping the drugs and my labor lasted only 5 hours. My second pregnancy I was working days on a fast paced step-down unit and dilated to 3cm at 27 weeks and had many regular brakston hicks . I went off on bed rest and drugs and delivered at 36 weeks the evening after I stopped taking my drugs. (A precipitous 45 min labor). With my third pregnancy I was working in a nice "cardiac rehabilitation" job where I could pace myself. I worked till 35 weeks when I dilated to 3 cm but only stayed off on semi bed rest (because I had two other children at home) and opted not to take the drugs this time since I was already 35 weeks. I walked around till 39 weeks dilated to 3 cm and at 39 weeks with tons of "false labor" scares which would subside when I rested...the doctors decided to induce b/c of my previous labor being so precipitous (and I was driving them crazy). I do believe that my job and stress level had a lot to do with the nature of my labors.

[dawngloves, BSN, RN]

Well, there goes my therory that nurses in high acuity areas only have PTL.

I wonder what the prevelance is amongst those in say, LTC facilites?

The Pre E therory also surprises me. I agree about drinking water. I would think that a great deal of PTL amongst health care workers is caused by UTIs.

[dawngloves, BSN, RN]

Here is a copy of the article printed in the American Journal of OB/GYN for those interested.

Obstetrics

Occupational fatigue and preterm premature rupture of membranes

Objective: The aim of this study was to prospectively determine the relationship between occupational fatigue and spontaneous preterm delivery segregated into the etiologically distinct categories of spontaneous preterm labor, preterm premature rupture of membranes, and indicated preterm delivery.

Study Design: A total of 2929 women with singleton pregnancies at 22 to 24 weeks' gestation were enrolled in a multicenter (10 sites) Preterm Prediction Study. Patients reported the number of hours worked per week and answered specific questions designed to determine the following 5 sources of occupational fatigue described by Mamelle et al: posture, work with industrial machines, physical exertion, mental stress, and environmental stress. Fatigue was quantified (0-5 index) according to the number of these sources positively reported. Simple and Mantel-Haenszel 2 tests were used to test the univariate association and hypothesis of a linear trend between sources of occupational fatigue and spontaneous preterm delivery.

Covariables were considered by multivariate logistic regression analysis. Women who did not work outside the home were considered separately from those who worked but did not report any sources of occupational fatigue. Results: Each source of occupational fatigue was independently associated with a significantly increased risk of preterm premature rupture of membranes among nulliparous women but not among multiparous women. The risk of preterm premature rupture of membranes increased (P = .002) with an increasing number of sources of occupational fatigue-not working outside the home, 2.1%; working but not reporting fatigue, 3.7%; working with 1 source of fatigue, 3.2%; working with 2 sources of fatigue, 5.2%; working with 3 sources of fatigue, 5.1%; and working with 4 or 5 sources of fatigue, 7.4%.

There was also a significant relationship (P = .01) between preterm premature rupture of membranes and an increasing number of hours worked per week among nulliparous women. Neither spontaneous preterm labor nor indicated preterm delivery was significantly associated with occupational fatigue among either nulliparous or multiparous women.

Conclusion: The occupational fatigue index of Mamelle et al discriminated a group of nulliparous women at increased risk for preterm premature rupture of membranes. The relationship between preterm premature rupture of membranes and occupational fatigue or hours worked may provide guidelines according to which nulliparous women and their employers can be advised. (Am J Obstet Gynecol 2001;184:438-46.)

[dawngloves, BSN, RN]

Originally posted by Tired Nurse:

They were just as miserable as I was, but managed to last through a normal pregnancy. Maybe I was just a whimp.......

Now what made you a wimp? Working 12 hour shifts in ICU while you were uncomfortbably pregnant? Dealing with PTL, bedrest, a baby in NICU? Maybe you just worked harder than the other nurses?

[This message has been edited by dawngloves (edited April 02, 2001).]

[dawngloves, BSN, RN]

Originally posted by 505rn:

I firmly believe I was as sick as I was because of working nights, I am in a different job now and plan to become pregnant in the fall, will be interesting to see if I am as sick (I know mere chance could be the cause of not being sick as every pregnancy is different but still....)

Working nights made me sick when I wasn't pregnant! LOL! That is a definate stressor for everyone, especially a pregnant woman!