Work-Related Factors and Pregnancy Outcomes in Female Surgeons

OBJECTIVE: To describe work-related factors, pregnancy, and pregnancy outcomes in female surgeons is the objective of this study. BACKGROUND: Some data suggest surgeon workload may deter pregnancy and adversely affect pregnancy outcomes in female surgeons. METHODS: A cross-sectional, web-based survey was distributed via e-mail to members of the Society of Obstetrics and Gynaecologists of Canada and to surgical departments of 6 Canadian universities from October 2019 to January 2020. RESULTS: A total of 223 surgeons with 451 pregnancies participated. Work hours were reduced in 33.3% of pregnancies, and 28.0% had a policy for pregnancy in their workplace. A total of 57% of surgeons intentionally delayed pregnancy due to heavy workload and 39% to career concerns, and 31% reported work adversely affected their pregnancy. Adverse maternal outcomes included miscarriage (14.9%), preterm labor (6.2%), hypertension (5.5%), pre-eclampsia (2.9%), and placenta praevia (1.3%). Adverse infant outcomes included preterm birth (6.9%), small for gestational age at birth (6.9%), and neonatal intensive care unit admission (4%). Congenital anomalies occurred in 4.2% of pregnancies. Surgeons who reported a policy for working while pregnant were more likely to have reduced their work hours than those without a policy (48.4% vs 28.5% respectively, P < 0.0001). In unadjusted models, those who reduced their work hours while pregnant were less likely to have a miscarriage than those who did not (odds ratio = 0.2, 95% confidence interval, 0.1–0.4). CONCLUSIONS: Female surgeons reported delays in pregnancy due to work, adverse effects of work on pregnancy, and some elevated rates of adverse outcomes. These data support policies for pregnancy in surgeons and surgical trainees.