• A D Larsen, H Hannerz, A M Thulstrup, J P Bonde, C Obel, and K S Hougaard.
• National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark.
• BJOG. 2014 Jun 1; 121 (7): 830-8; discussion 839.

ObjectiveTo investigate if maternal exposure to psychosocial job strain at work (high demands and low control) measured by questionnaire early in pregnancy (median week 15) is associated with malformations in the offspring.DesignPopulation-based cohort study.SettingThe Danish National Birth Cohort.PopulationA cohort of 60,386 singleton children with full information on mother's occupational status, exposure to psychosocial job strain and all covariates during pregnancy.MethodsLogistic regression analysis was used to calculate the odds of congenital malformations as a function of job strain with adjustment for maternal age, body mass index, parity, smoking, alcohol use, manual versus nonmanual work, maternal serious disease and gestational age at interview.Main Outcome MeasuresCirculatory malformation, musculoskeletal malformation or any malformation.ResultsLogistic regression analyses, both crude and adjusted, indicated no associations between working under high strain and giving birth to a child with circulatory malformation (adjusted odds ratio [OR] 1.04, 95% confidence interval [95% CI] 0.75-1.44), musculoskeletal malformation (aOR 0.88, 95% CI 0.71-1.10) or any malformation (aOR 0.99, 95% CI 0.85-1.15). Supplementary analyses including restriction to first-borns and a stratified analysis with respect to manual and nonmanual work did not change the results.ConclusionsAssociation between exposure to high job strain during pregnancy and elevated risk of circulatory, muscle and any malformations is not supported by this study.© 2014 Royal College of Obstetricians and Gynaecologists.

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