Travail et grossesse dans la profession médicale : revues de la littérature et enquête en Nouvelle-Aquitaine

Abstract : Introduction: medical literature finds proven or suspected occupational risk factors may impact the pregnancy of physicians women. Currently, no study has described the prevalence of exposure to these various risk factors. In this study, we examined the prevalence of exposure to reproductive risk factors and pregnancy complications in the New Aquitaine medical population. In a second time, we studied the association between the organizational constraints and the psychosocial risks, and the occurrence of anomaly of the pregnancy. Material and method: using an electronic survey sent by 7 departmental councils of the order of physicians,, we studied the exposures and pregnancy outcomes of 270 doctors and interns in all specialties, practicing in New Aquitaine, and having been at least one pregnancy between 2013 and 2018. The pregnancy complications studied were: gravid arterial hypertension, pre-eclampsia, gestational diabetes, intrauterine growth retardation, small for gestational age (SGA) children, premature birth,preterm premature rupture of membranes (PPROM) , fetal congenital malformation, and gestational cholestasis. Results: the response rate to our survey was approximately 20% (n = 995/4788) and 20.4% of participants had at least one complication during their last pregnancy. -In our cohort, 10.4% of the physicians surveyed had a surgical specialty, 89.6% had a medical specialty: Physicians in surgical specialties had significantly more complicated pregnancies than physicians in medical specialties and biologists (39.3% vs 18.2%, p <0.05, OR = 2.91). - Regarding professional status, 39% of employees were female, 23.2% female and 27.4% were liberal doctors: Physicians practicing a liberal activity had significantly more complicated pregnancies than female substitutes or salaried doctors (28.8%). vs 10.3% and 19.7% respectively, p <0.05, OR = 1.65). -For their last pregnancy, 69.9% of physicians were full-time and 28.3% part-time: There were significantly more complicated pregnancies in the "full-time" group than in the "part-time" group ( 24.6% vs 9.3%, p <0.05, OR = 3.17). - During their last pregnancy, 25.6% of women had an activity during the 6 weeks preceding their delivery: There were more complicated pregnancies among doctors who had a professional activity during the 6 weeks preceding childbirth (30). , 4% vs 18.8%, p <0.05, OR = 1.90). -As regards work stress, 51% of physicians felt overwhelmed by their work during pregnancy and there were more complicated pregnancies in their pregnancies (36% vs. 19%, p <0.05, OR = 2.10) . As for the infectious risk, 3 doctors were infected with potentially teratogenic infectious agents and all the infected women had a complication of pregnancy (p <0.05). 10.7% reported chemical contact with anesthetic gases and significantly more complicated pregnancies (37.9% vs 18.3%, p <0.05; OR= 2.74). Conclusion: these results suggest that women practicing a surgical specialty were almost 3 times more likely to have a complicated pregnancy than the others, as were those practicing full-time and those who had come into contact with anesthetic gases. Similarly, those who had exercised a liberal activity, and those who had worked during the 6 weeks before the term, were nearly twice as likely to have a complicated pregnancy than those who worked as paid employees and those who did not work during the same period. 6 weeks prepartum. Occupational stress significantly impacted the outcome of the pregnancies studied and exposed women had nearly 3 times more complications of pregnancy. The risk of infection was also significant, but the number of people concerned was particularly low.
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Master Thesis
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Rivana Auguste-Virginie, Fanny Lairez, Pauline Mouton. Travail et grossesse dans la profession médicale : revues de la littérature et enquête en Nouvelle-Aquitaine. Médecine humaine et pathologie. 2019. ⟨dumas-02151011⟩

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