Psychological job demands and preterm birth among Black women.

PURPOSE: We evaluated the role of psychological job demands on PTB among Black mothers and explored potential effect modifiers. METHODS: Within a cohort of 428 Black women employed during pregnancy, a modified version of the Karasek Job Content Questionnaire assessed the psychological demands of the prenatal work environment, comparing the top quartile vs. the lower 3 quartiles; >median vs. ≤median; and individual items (yes vs. no). Log-binomial regression models estimated associations, adjusted for confounders, and investigated effect measure modification by psychosocial factors and racism experiences, which were modeled as the top quartile vs. the bottom 3 quartiles of each scale, except for depressive symptoms (Center for Epidemiologic Studies scale, ≥16 vs. <16). RESULTS: Women who reported high psychological job demands had elevated PTB risk (adjusted risk ratio (aRR)=1.82; 95% confidence interval (CI):1.20, 2.76). Social support and depressive symptoms modified the relationships between high psychological demands and PTB, with the strongest associations seen among women with low social support (aRR: 1.92; 95% CI: 1.16, 3.17) or high depressive symptoms (aRR: 1.99; 95% CI: 1.12, 3.52). CONCLUSION: Black women whose work involves psychologically demanding activities had a higher risk of PTB, with evidence of effect measure modification by other predictors for PTB.