Long working hours related to elevated psychological distress among United States pregnant workers: findings from the National Health Interview Survey

Long working hours and psychological distress have each been related to adverse maternal health and birth outcomes. Understanding the potential psychological health impacts of long working hours among pregnant workers may support the implementation of maternity work protections in the United States (U.S.). This cross-sectional study among a weighted sample of 3637 pregnant workers from the U.S. population-based National Health Interview Survey (NHIS) 1997-2018 aimed to examine the association of working hours with psychological distress. Multivariable linear regression models analyzed associations between categories of weekly working hours and continuous scores of psychological distress measured by the Kessler 6 (K6) scale, while accounting for demographic, socioeconomic, behavior and health characteristics. In the fully adjusted model, compared to the standard workweek of 35-40 h/week, working ≥49 h/week was associated with higher psychological distress [<i>β</i> (SE): 0.59 (0.21); <i>p</i> = .0058]. This initial evidence connecting excessive working hours with increased psychological distress among a U.S. sample of pregnant women supports clinical practices in prenatal assessments of occupational risk factors, and the provision of work-related resources and work accommodations. Future research is warranted to investigate potential occupational effects on maternal mental health throughout the course of pregnancy and postpartum using cohort studies.