Effects of ultrasound, shortwaves, and physical exertion on pregnancy outcome in physiotherapists.

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Abstract
STUDY OBJECTIVE--The aim of the study was to investigate whether occupational exposure among physiotherapists is associated with spontaneous abortion or congenital malformation in the offspring. DESIGN--The study was a retrospective nested case-control study, where the pregnancy outcome data were based on the medical registers. SETTING--All registered physiotherapists in Finland who had become pregnant during the study period were included in the study. SUBJECTS--Cases were defined as women who had been treated for spontaneous abortion during 1973-1983 or had delivered a malformed child during 1973-1982. One pregnancy per woman was randomly selected for the study. Three age matched (+/- 18 months) controls were selected for each abortion case and five for each malformation case. The final study population was 204 cases and 483 controls in the spontaneous abortion study, and 46 cases and 187 controls in the congenital malformation study. MEASUREMENTS AND MAIN RESULTS--Exposure information was collected by mailed questionnaires from 1329 women. The response rate was 92% in the spontaneous abortion study, and 89% in the congenital malformation study. Heavy lifting (including patient transfers) was associated significantly with spontaneous abortion. Exposure to ultrasound and shortwaves showed about threefold odds ratios for spontaneous abortions occurring after the 10th week of gestation but in analysis where potential confounding variables were controlled, neither reached statistical significance. Deep heat therapies together, and shortwaves alone, were associated significantly with congenital malformations, but the increase was found in the lower exposure category only. From the potential confounding variables, previous abortion (spontaneous or induced) was associated significantly with spontaneous abortion, and febrile disease in early pregnancy was associated with congenital malformation. CONCLUSION--Physical exertion during early pregnancy seems to be a risk factor for spontaneous abortion. The findings raise suspicion of the potential harmful effect of shortwaves and ultrasound on the pregnancy, but no firm conclusion can be drawn on the bases of these results alone.