职业紧张与胚胎停育有关吗?

Is Occupational Stress Associated with Embryonic Arrest?

[目的]探究职业紧张是否对胚胎停育的发生有影响。[方法]采用病例-对照研究。选择2014年3月14日—6月11日于济宁市第一人民医院或济宁医学院附属医院就诊的近一年内有过胚胎停育史的110例育龄妇女为病例组,同期130名在上述2所医院正常妊娠的待产孕妇或7 d内正常分娩的产妇为对照组,调查其个人基本情况和职业紧张状况。职业紧张测量采用付出-回报失衡问卷、工作内容问卷和工作-家庭冲突问卷中文版。选择其中资料完整的研究对象,对职业紧张和胚胎停育之间的关系及影响因素进行t检验、χ-2检验和logistic回归分析。[结果]付出-回报失衡问卷显示：病例组的职业紧张、外在付出评分高于对照组（t=6.139,t=5.808,均P〈0.05）,回报得分低于对照组（t=-6.248,P〈0.05）;病例组的内在投入得分≥17分者占31.8%,高于对照组的4.6%（χ-2=31.127,P〈0.05）。工作内容问卷显示：两组在工作心理要求、自主程度、上级支持和社会支持的得分差异均具有统计学意义（t=3.355,t=-3.830,t=-4.802,t=-3.708,均P〈0.05）。工作-家庭冲突问卷显示：病例组工作-家庭冲突高于对照组（t=5.697,P〈0.05）。logistic回归分析提示,职业紧张与胚胎停育的比值比为8.838,95%可信区间为2.169-36.017。[结论]职业紧张可能是胚胎停育发生的危险因素。

[ Objective ] To explore whether occupational stress has an effect on embryonic arrest. [ Methods ] With case-control study design, 110 women of child-bearing age with a history of embryonic arrest in recent one year who visited the Jining No. 1 People＇s Hospital or the Affiliated Hospital of Jining Medical University from March 14 to June 11, 2014 were selected as the case group, while 130 normal pregnant women or those who had a normal labor within 7 days in the above two hospitals were selected as the control group. Their basic information and occupational stress level were investigated. Effort-Reward Imbalance Questionnaire, Job Content Questionnaire, and Chinese Work-Family Conflict Questionnaire were used to measure occupational stress. After excluding the subjects with missing data, the associations between occupational stress and embryonic arrest as well as potential influencing factors were analyzed by t-test, χ^2 test, and logistic regression analysis. [ Results ] In the Effort-Reward Imbalance Questionnaire, the scores of occupational stress and extrinsic effort in the case group were higher than those of the control group （t=-6.139, t=-5.808, both Ps 〈0.05）, and the score of reward was lower （t=-6.248, P〈0.05）. The women with ≥ 17 scores of intrinsic effort accounted for 31.8% in the case group, higher than the control group （4.6%） （χ^2=31.127, P〈0.05）. In the Job Content Questionnaire, the scores of job demand, autonomy, superior support, and social support were different between the two groups （t=3.355, t=-3.830, t=-4.802, t=-3.708, all Ps 〈 0.05）. In the Work-Family Conflict Questionnaire, the score of work-family conflict in the case group was higher than that of the control group （t=5.697, P 〈 0.05）. The results of logistic regression analysis indicated that the odd ratio of occupational stress and embryonic arrest was 8.838 （95%CI： 2.169-36.017）. [ Conclusion ] Occupational stress might be a risk factor for embryonic arrest.