Considerable uncertainty exists about the potential harm that shift work during pregnancy may impose on a mom's child, yet working night shifts during pregnancy is currently an established reality in the US. We have previously linked work schedules, particularly those involving night shifts, with an increased risk of spontaneous abortion and delivering pre-tem in the Nurses' Health Study 2 (NHS2). Now, we propose to continue our work by examining how exposure of the embryo and fetus to shift work may affect their health and chronic disease risk later in life. We will make use of a worldwide unique resource, which provides critical information on both moms and their offspring, including occupational shift work exposure during pregnancy: using existing data from the ongoing NHS2 cohort and Growing Up Today Study (GUTS), i.e. children of the nurses participating in NHS2, we will investigate the following 3 major hypotheses: (1) can shift work (prior to conception as well as during pregnancy) induce growth perturbations and altered mental health in the offspring, and how may this influence disease risk across the lifespan? (2) are worsened sleep parameters including lower overnight production of melatonin and higher awakening cortisol in young adulthood associated with such early life exposures? and (3) can we define critical developmental windows (e.g., preconception, embryonic, and fetal periods) during which shift work may influence chronic disease etiology. We have complete lifetime shift work history of the NHS2 moms of all 27,795 children in GUTS, 3,740 children whose moms additionally provided shift work history during pregnancy. In alignment with Healthy People 2020, this proposal addresses all NORA Sector Programs as well as the cross- sector programs Work Organization and Stress Related Disorders, and Cancer, Reproductive and Cardiovascular Diseases. Specifically, our proposal strives to explore whether night shifts may expose offspring of workers to heightened risk for disorders. Expected immediate outputs of our proposed research are publications, presentations/posters. Intermediate outcomes will be tracked by showing new policies that cite our work. We will disseminate our findings to other scientists through the peer-reviewed literature and scientific conferences. However, our primary target audience is workers - hence, we will communicate to nurses by our Nurses' Health Study 2 staff, as well as to other workers through the staff at NIOSH, using websites, newsletters, and social media presence. Our proposed research exemplifies the translation of research into practice (r2P) in that it may lead to actual changes in work practice for pregnant women. Ultimately, this is a potentially highly effective prevention practice, which can readily be adopte by any other workplace.

Public Health Relevance

Given how frequent shift work is among pregnant women in the United States, we need a better understanding of whether and how exposure of the baby in the womb to any level or pattern of shift work may increase its risk for chronic diseases later in life. We are in the unique position to have data that simultaneously provide information on a mom's shift work history and follow their child until later in life, which allows us to study the effects of shift work, particularly during pregnancy, on the health of women's children. The results from our study have the potential to change the practice of shift work schedules for pregnant women, as this may ultimately mean that women who work night shifts should be switched to day shifts as soon as they become (or plan to become) pregnant.

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National Institute for Occupational Safety and Health (NIOSH)
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Safety and Occupational Health Study Section (SOH)
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Brigham and Women's Hospital
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Wegrzyn, Lani R; Tamimi, Rulla M; Rosner, Bernard A et al. (2017) Rotating Night-Shift Work and the Risk of Breast Cancer in the Nurses' Health Studies. Am J Epidemiol 186:532-540
Devore, Elizabeth E; Massa, Jennifer; Papantoniou, Kyriaki et al. (2017) Rotating night shift work, sleep, and colorectal adenoma in women. Int J Colorectal Dis 32:1013-1018
Heckman, Carolyn J; Kloss, Jacqueline D; Feskanich, Diane et al. (2017) Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants. Occup Environ Med 74:169-175
Devore, Elizabeth E; Warner, Erica T; Eliassen, A Heather et al. (2017) Urinary Melatonin in Relation to Postmenopausal Breast Cancer Risk According to Melatonin 1 Receptor Status. Cancer Epidemiol Biomarkers Prev 26:413-419
Schernhammer, Eva S (2017) RE: Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies. J Natl Cancer Inst 109:
Vetter, Céline; Devore, Elizabeth E; Wegrzyn, Lani R et al. (2016) Association Between Rotating Night Shift Work and Risk of Coronary Heart Disease Among Women. JAMA 315:1726-34
Hersh, Caleb; Sisti, Julia; Richiutti, Vincent et al. (2015) The effects of sleep and light at night on melatonin in adolescents. Hormones (Athens) 14:399-409
Ramin, Cody A; Massa, Jennifer; Wegrzyn, Lani R et al. (2015) The association of body size in early to mid-life with adult urinary 6-sulfatoxymelatonin levels among night shift health care workers. BMC Public Health 15:467
Ramin, Cody; Devore, Elizabeth E; Wang, Weike et al. (2015) Night shift work at specific age ranges and chronic disease risk factors. Occup Environ Med 72:100-7
Vetter, Céline; Devore, Elizabeth E; Ramin, Cody A et al. (2015) Mismatch of Sleep and Work Timing and Risk of Type 2 Diabetes. Diabetes Care 38:1707-13

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