It’s Complicated: Impact of Work-Related Stressors on Pregnancy Outcomes of Cardiologists and Cardiovascular Team Members

BACKGROUND: Pregnancy concerns and difficulties in work-life balance may deter women from careers in cardiology; a gender-balanced workforce is needed to improve patient experience and outcomes. OBJECTIVES: The purpose of this study is to describe occupational, medical, and lifestyle factors that may contribute to pregnancy complications in physicians and cardiovascular team (CVT) members. METHODS: A survey was emailed to 6,786 randomly selected women of the American College of Cardiology inquiring about prepregnancy medical conditions and lifestyle, age and work environment during pregnancy, and pregnancy complications and outcomes. Multiple logistic regressions were conducted to examine associations between pregnancy/fetal complications (composite any maternal or fetal) and potential risk factors. RESULTS: The study included 921 pregnancies in 273 physicians and 211 CVT members, with 39% of respondents (n = 188) reporting at least one pregnancy or fetal complication. Complications (n = 401) were associated with being unpartnered during pregnancy (adjusted OR 3.439; 95% CI: 1.048-11.283), fertility treatments (1.552; 95% CI: 1.037-2.323), as well as stressful work conditions including additional duties during pregnancy (1.402; 95% CI: 1.015-1.936), and inflexible work schedules (1.495; 95% CI: 1.084-2.062). Bed rest, fetal complications, and less breast feeding were more likely to occur in complicated pregnancies. Fetal complications occurred in close to 40% of complicated pregnancies, most commonly preterm birth, low birth weight, and small-for-gestational-age. CONCLUSIONS: This study found associations between self-reported work-related stressors and pregnancy complications in physicians and CVT members. Hospitals are encouraged to improve work conditions for pregnant physicians and CVT members with the goal of improving provider, employee, and fetal outcomes.