ORs Harbor Reproductive Hazards for Female Surgeons

A new study suggests that reproductive hazards in the operating room (OR) may contribute to pregnancy complications and infertility in female surgeons.

Researchers at Harvard Medical School (HMS; Boston, MA, USA) and Western Health (St Albans, Australia) reviewed studies that show increased rates of infertility and pregnancy complications among surgeons, including conditions affecting both mother and fetus, such as spontaneous abortion, preterm delivery, growth restriction, and congenital abnormalities. While attention has been focused on the older age and the demanding working conditions of pregnant surgeons, they also found reproductive hazards in the OR that might also be contributing factors.

Relevant hazards include radiation, surgical smoke, working conditions, sharps injury, anesthetic gases, and intraoperative use of toxic agents. As published evidence is limited to retrospective studies, robust data are often unavailable to guide specific dose-response relationships, making it difficult to quantify relative risk and create occupational safety guidelines. But regulatory agencies have set exposure limits for some agents, relying on limited evidence, and various workplace interventions have shown success in reducing exposure levels for many reproductive hazards. The study was published on January 2, 2020, in JAMA Surgery.

“Female surgeons perceive stigma regarding pregnancy, especially during training. Most surgical training centers do not have programs or policies in place to protect pregnant surgeons, despite calls for implementation,” concluded study authors Matilda Anderson, MBBS, MPH, and Rose Goldman, MD, MPH. “Given the limited data regarding operating room hazards and reproductive outcomes, as well as introduction of new operating room environmental exposures, more research is needed to define their reproductive effects, as well as effective and practical interventions to reduce exposure.”

Female surgeons have been found to have high rates of adverse pregnancy outcomes and infertility. In a survey of 1,021 US female surgeons across different specialties, an overall pregnancy complication rate of 35.3% was measured, as compared with 14.5% in the general population. Other studies support this finding, with a complication rate of 25.3% identified in a survey of 163 female urologists. High infertility rates have also been described, with 32% of respondents in a 2012 survey reporting difficulty with fertility, compared with 10.9% of the general population.

Related Links:
Harvard Medical School
Western Health