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OBJECTIVE: This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10–29 completed pregnancy weeks in a large cohort of Danish pregnant women. METHODS: Data from 51 874 pregnancies in the Danish National Birth Cohort collected between 1996–2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first episode of sick leave as the primary outcome. RESULTS: We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HR_range 1.55–2.79), cumulative lifting HR_trend 1.29, 95% CI 1.26–1.31, shift work (HR_evening 1.90, 95% CI 1.73–2.09, HR_night 1.52, 95% CI 1.15–2.01), monthly night shifts HR_trend 1.12, 95% CI 1.11–1.14, increasing weekly work hours HR_trend 0.93, 95% CI 0.91–0.95 and high job strain HR 1.52, 95% CI 1.42–1.63. Some exposures influenced HR in either a positive or negative time-dependent way. CONCLUSION: Our results support previous findings and suggest that initiatives to prevent sick leave during pregnancy could be based on work conditions. Preventive measures may have important implications for pregnant women and workplaces.

OBJECTIVE: The aim of this cohort study was to investigate associations between parity, pre-pregnancy body mass index (BMI), assisted reproductive therapy (ART), time to pregnancy (TTP), and engagement in physical exercise and the risk of sickness absence in pregnancy from 10–29 completed pregnancy weeks. METHODS: Data from 51 874 pregnancies in the Danish National Birth Cohort collected from 1996 until 2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on questionnaires. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression, using time of first episode of sickness absence as the primary outcome. RESULTS: Multiparity 1.26 (95% CI 1.10–1.45), overweight 1.13 (95% CI 1.08–1.18), obesity 1.23 (95% CI 1.15–1.31), ART 1.10 (95% CI 1.01–1.20), and TTP >12 months 1.06 (95% CI 0.99–1.13) were associated with higher HR of sickness absence. Physical exercise of >120 minutes per week was associated with lower HR 0.84 (95% CI 0.75–0.95). CONCLUSION: Risk for sickness absence was higher among women who were multiparous, overweight, obese, received ART, and had prolonged TTP, and lower among women engaged in leisure-time physical exercise. Few studies have investigated these associations, and the results should be confirmed in other studies of pregnant women.

• Pregnancy-related sick leave is common. • Cluster-randomised trial evaluated occupational midwifery support. • Intervention focused on risk assessment and work adjusment. • Pregnancy-related sick leave was not reduced. Sick leave during pregnancy is common and associated with strenuous working conditions and multiple occupational exposures. The aim of this study was to evaluate the effect of midwifery facilitation of sessions with pregnant employees and managers focusing on work adjustment, to reduce discomfort and occupational risks. A cluster randomised controlled trial was conducted. Hospital employees were randomised to intervention or reference. The intervention group received midwifery support in addition to the standard hospital pregnancy policy provided to the reference group. Outcomes were pregnancy-related sick leave and general sick leave. Intention-to-treat analysis was performed with mixed-effect models. Sick leave was similar between the intervention and reference groups, and 51 % of pregnant employees did not take any days of full pregnancy related sick leave, while approximately 21 % took more than 30 days. Group differences in mean estimates for partial sick leave were −0.5 (CI −2.3;1.3) days. Differences in full sick leave was 1.2 (CI −2.9;5.2) days, and 0.6 (CI −1.0;2.1) days for general sick leave. Midwifery support as an add-on to usual pregnancy policy did not decrease sick leave during pregnancy compared to usual practice in a study population of Danish healthcare professionals. Midwifery support tailored towards the specific work environment may perhaps provide better results. [ABSTRACT FROM AUTHOR]

• Sick leave during pregnancy is frequent. • Sick leave during pregnancy is associated with working conditions. • Reasons for sick leave are discomfort such as nausea, Braxton Hicks, Low back and pelvic pain. • The literature lacks knowledge on the effect of interventions with-in the workplace. Sick leave during pregnancy is frequent and 36 % of Danish pregnant employees are on sick leave > 14 days. Health care professionals are considered a risk population. This intervention applies preventive sessions including the pregnant employee, her manager and a midwife in addition to usual practice at Aarhus University Hospital, Denmark (AUH). It is hypothesised that pregnant employees who participate in preventive sessions will have less sick leave and report better wellbeing compared to the reference group. All departments at AUH are cluster randomized. A total of 25 and 24 departments are allocated to the intervention and reference group, respectively. The intervention is protocolled with preventive sessions in addition to usual practice. The reference group receives usual practice. The primary outcome is mean number of days on sick leave during pregnancy. Secondary outcomes are wellbeing measured as physical and mental health, general work ability, work-life balance, manager support, and completed work adjustments during pregnancy. Data on sick leave will be collected from the hospital payment system and survey data will be collected at inclusion and follow-up. This study will contribute to limited experimental research aimed to reduce sickness leave during pregnancy. The overall strength is the study design with easy access to study participants within a large hospital. The main limitation of the study is the high complexity of the study. The trial is registered in ClinicalTrials.gov with ID number 29-2019-03. [ABSTRACT FROM AUTHOR]