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Is parental unemployment related to an increased risk for stillbirths?

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Abstract

Aims

Although the association between employment status and health has been examined extensively, there is a paucity of research on the association between parental unemployment and the risk for stillbirth. The few existing studies did not access relevant confounders. We explored whether maternal, paternal or both parents’ employment status is related to stillbirth by comparing the stillbirth rates of professional mothers, fathers and couples to mothers, fathers and couples who were homemakers or unemployed, adjusting for maternal age, parity, nationality, chronic conditions, smoking, psychosocial stress and year of observation.

Subjects and methods

Data on singletons born in the Federal State of Lower Saxony, Germany, (1990–1999), were routinely collected by gynecologists and midwives prospectively during pregnancy and after childbirth. Among 632,864 singletons, 297,880 were infants with one or two unemployed, homemaking or professional parents. Chi-square tests, bivariate and multivariable logistic regression models were performed.

Results

In bivariate logistic regression models, compared to infants of professional mothers, infants of housewives (OR = 2.58; 95% CI = 2.25, 2.96) and unemployed (OR = 2.06; 95% CI = 1.68, 2.53) mothers were at higher risks for stillbirth. Compared to infants of professional fathers, infants of male homemakers (OR = 2.41; 95% CI = 1.95, 2.99) and unemployed fathers (OR = 2.75; 95% CI = 2.41, 3.13) had higher risks for stillbirth. Infants of couples who both were working at home (OR = 3.65; 95% CI = 2.75, 4.84) or were unemployed (OR = 3.21; 95% CI = 2.37, 4.35) had higher risks for stillbirths than infants of professional couples. In multivariable logistic regression analyses, compared to infants of professional mothers, infants of housewives (OR = 1.64, 95% CI 1.39, 1.95) and unemployed mothers (OR = 1.55, 95% CI 1.20, 1.98) had increased risks for stillbirths. Compared to infants of professional fathers, infants of male homemakers (OR = 1.27, 95% CI 1.00, 1.62) and unemployed fathers (OR = 1.24, 95% CI 1.05, 1.47) were at higher risks for stillbirths. Stillbirth rates were increased for infants of couples who both were homemakers (OR = 1.61, 95% CI 1.13, 2.28) or unemployed (OR = 1.46, 95% CI 1.01, 2.11), compared to infants of professional couples.

Conclusions

Both unemployment and homemaking statuses are associated with increased risks for stillbirth. In the context of mass unemployment in Germany, to improve infant health, unemployed and homemaking parents may be important target groups for pediatric health promotion strategies.

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Authors and Affiliations

  1. Centre for Healthcare Innovation and Improvement (CHII), Child and Family Research Institute, 4480 Oak Street, E414A, Vancouver B.C., V6H 3V4, Canada

    Birgit Reime

  2. Faculty of Public Health, University of Bielefeld, Universitätsstraße 25, 33615, Bielefeld, Germany

    Carina Jacob

  3. Centre for Quality Management, Physicians’ Chamber of Lower Saxony, Berliner Allee 20, 30175, Hanover, Germany

    Paul Wenzlaff

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  1. Birgit Reime
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  2. Carina Jacob
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  3. Paul Wenzlaff
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Correspondence to Birgit Reime.

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Reime, B., Jacob, C. & Wenzlaff, P. Is parental unemployment related to an increased risk for stillbirths?. J Public Health 17, 363–369 (2009). https://doi.org/10.1007/s10389-009-0262-9

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