Longitudinal Assessment of Effort–Reward Imbalance and Job Strain Across Pregnancy: A Preliminary Study

John D. Meyer, Carles Muntaner, Patricia O’Campo, Nicolas Warren

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Objectives: To assess longitudinal changes in occupational effort–reward imbalance (ERI) and demand-control (DC) scores across pregnancy and examine associations with blood pressure (BP) during pregnancy. Methods: A pilot repeated-measures survey was administered four times to a sample of working women across pregnancy using the ERI and DC instruments. Demographic data and blood pressure measurements were collected at each interval. Growth mixture modeling was used to examine trajectories of change in occupational characteristics. Associations with BP were examined using repeated-measures linear regression models. Results: ERI model components (effort, reward, and overcommitment) all declined across pregnancy while job control remained stable. Increasing ERI trajectory was associated with higher systolic BP (b = 8.8; p < 0.001) as was high overcommitment; declining ERI also showed a lesser association with higher BP. Associations between DC trajectories and BP were much smaller, and non-significant once controlled for overcommitment. Conclusions: Self-assessed efforts, rewards, and overcommitment at work decline across pregnancy in our participants, while job control remains stable. Replication in a more diverse pregnant working population is warranted to confirm these results. These preliminary data suggest that further investigation into the factors that may be linked with improved work psychosocial climate during pregnancy may be useful in order to improve pregnancy outcomes.

Original languageEnglish
Pages (from-to)1366-1374
Number of pages9
JournalMaternal and Child Health Journal
Issue number7
Publication statusPublished - 2016 Jul 1


  • Effort–reward imbalance
  • Longitudinal assessment in pregnancy
  • Occupational hazards in pregnancy
  • Occupational trajectories
  • Work organization

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology
  • Public Health, Environmental and Occupational Health


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