Do current policies reflect current evidence on the relationship between occupational risks and preterm birth, and are they consistent? A policy content analysis.

ABSTRACT

OBJECTIVES: Preterm birth is a leading cause of neonatal mortality and the second-leading cause of death among children under five worldwide. Recent systematic reviews have demonstrated an increased risk of preterm birth in women exposed to workplace physical and psychosocial risks during pregnancy. The extent to which this evidence is reflected in policy remains unclear. This study aimed to determine the extent to which current policies reflect the current evidence regarding the association between occupational risks and preterm birth. STUDY DESIGN: Policy content analysis. METHODS: This study used a three-step search strategy searching electronic databases (Embase and Scopus), policy databases (Overton, Dimension, and Google Advanced), and websites of global and national agencies/organisations focused on occupational or women's health policies. Data were analysed through descriptive and interpretive content analyses. Eligible documents were publicly available in full text, published from 2000 onwards by credible sources, and written in English. RESULTS: Thirteen eligible policy documents were identified. Of these, eight concluded that the evidence for the relationship between occupational risks and preterm birth was inconclusive. The remaining five documents report that occupational risks may be associated with an increased risk of preterm birth. Nine documents offered recommendations to address this risk. These included four recommending job redesign, two information/education, and three a combination of job redesign, job transfer, information/education, and changes to workplace policy. Three were developed by a multidisciplinary stakeholder group, six by a multidisciplinary clinical group, and four by unidisciplinary clinicians. CONCLUSIONS: Most current policies partially reflect the current evidence on the relationship between occupational risks and preterm birth. Development of most policy documents did not use rigorous methods and did not involve multidisciplinary stakeholder groups. There is an urgent need for the development of evidence-based policies grounded in robust research methods.