Objective: 

We sought to assess whether lack of workplace support for clinical work reductions during pregnancy was associated with major pregnancy complications.

Background: 

Surgeons are at high risk of major pregnancy complications. Although rigorous operative schedules pose increased risk, few reduce their clinical duties during pregnancy.

Methods: 

An electronic survey was distributed to US surgeons who had at least 1 live birth. Lack of workplace support was defined as: (1) desiring but feeling unable to reduce clinical duties during pregnancy due to failure of the workplace/training program to accommodate and/or concerns about financial penalties, burden on colleagues, requirement to make up missed call, being perceived as weak; (2) disagreeing colleagues and/or leadership were supportive of obstetrician-prescribed bedrest. Multivariate logistic regression determined the association between lack of workplace support and major pregnancy complications.

Results: 

Of 671 surgeons, 437 (65.13%) reported lack of workplace support during pregnancy and 302 (45.01%) experienced major pregnancy complications. Surgeons without workplace support were at higher risk of major pregnancy complications than those who had workplace support (odds ratio: 2.44; 95% confidence interval: 1.58–3.75). Bedrest was prescribed to 110/671 (16.39%) surgeons, 38 (34.55%) of whom disagreed that colleagues and/or leadership were supportive. Of the remaining surgeons, 417/560 (74.5%) desired work reductions but were deterred by lack of workplace support.

Conclusions: 

Lack of workplace support for reduction in clinical duties is associated with adverse obstetric outcomes for surgeons. This is a modifiable workplace obstacle that deters surgeons from acting to optimize their infant’s and their own health. To ensure the health of expectant surgeons, departmental policies should support reduction of clinical workload in an equitable manner without creating financial penalties, requiring payback for missed call duties, or overburdening colleagues.

中文翻译：

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缺乏对产科健康问题的工作场所支持与严重的妊娠并发症有关：一项针对美国女性外科医生的全国性研究

客观的： 

我们试图评估在怀孕期间缺乏工作场所对减少临床工作的支持是否与严重的妊娠并发症有关。

背景： 

外科医生面临重大妊娠并发症的高风险。尽管严格的手术计划会增加风险，但很少有人会在怀孕期间减少他们的临床职责。

方法： 

向至少有 1 名活产婴儿的美国外科医生分发了一份电子调查表。缺乏工作场所支持的定义为：（1）由于工作场所/培训计划未能适应和/或担心经济处罚、同事负担、要求弥补未接来电，希望但感觉无法减少怀孕期间的临床职责，被认为是软弱的；(2) 不同意的同事和/或领导支持产科医生规定的卧床休息。多变量逻辑回归确定了缺乏工作场所支持与主要妊娠并发症之间的关联。

结果： 

在 671 名外科医生中，437 名 (65.13%) 报告在怀孕期间缺乏工作场所支持，302 名 (45.01%) 经历了严重的妊娠并发症。与有工作场所支持的外科医生相比，没有工作场所支持的外科医生发生重大妊娠并发症的风险更高（优势比：2.44；95% 置信区间：1.58-3.75）。110/671 (16.39%) 名外科医生使用卧床休息，其中 38 名 (34.55%) 不同意同事和/或领导的支持。在剩余的外科医生中，417/560 (74.5%) 人希望减少工作量，但因缺乏工作场所支持而望而却步。

结论： 

缺乏对减少临床职责的工作场所支持与外科医生的不良产科结果有关。这是一个可改变的工作场所障碍，它阻止外科医生采取行动来优化他们的婴儿和他们自己的健康。为确保准外科医生的健康，部门政策应支持以公平的方式减少临床工作量，而不会造成经济处罚、要求对未接来电的职责进行补偿或使同事负担过重。