Night shift work among pregnant healthcare workers

The National Institutes of Health National Heart Lung and Blood Institute awarded Mainehealth $187,235 on August 15, 2026, under the Cardiovascular Diseases Research program (CFDA 93.837) to support Dr. Isha Agarwal's mentored patient-oriented research career development award focused on night shift work, sleep, and women's perinatal and cardiometabolic health.

Dr. Agarwal, an Assistant Professor of Emergency Medicine at Mainehealth with a dual appointment at Tufts University School of Medicine, will conduct a five-year integrated training and research program. The research plan aims to identify socioeconomic predictors of night shift work during pregnancy, determine the impact of night shift work pre-pregnancy and during pregnancy on cardiometabolic adverse pregnancy outcomes independent of socioeconomic factors, and characterize barriers and facilitators for requesting and granting night shift work accommodations among pregnant night shift workers and employers. The work employs a mixed quantitative and qualitative approach leveraging detailed shift work and pregnancy outcome data from the Nurses' Health Study II occupational cohort, supplemented by new qualitative research.

Dr. Agarwal's training will emphasize perinatal and reproductive epidemiology, sleep and circadian disruption, qualitative research methods, and translating scientific evidence to occupational health practice. Performance occurs in Portland, Maine. The award period runs through July 31, 2031.

Abstract

Isha agarwal, MD SCD is an assistant professor of emergency medicine at mainehealth, with a dual appointment at tufts university school of medicine (mainehealth's academic affiliate). She seeks a mentored patient-oriented research career development award to develop fundamental scientific knowledge and skills in key areas that will prepare her to launch an independent research career focused on understanding the role of night shift work, and more generally sleep, on women's perinatal and long-term cardiometabolic health. DR. Agarwal's proposed five-year training, career development, and research plan builds upon her outstanding academic background, including doctoral thesis work in cardiovascular epidemiology, more recent work on the cardiometabolic impacts of night shift work and other occupational exposures, and clinical experience as an emergency physician who works night shifts. DR. Agarwal has identified key focus areas in which she requires additional in-depth training including perinatal/reproductive epidemiology, sleep, and circadian disruption, qualitative research, and translating scientific evidence to practical change in occupational health. Her training goals are highly-integrated with her proposed research plan, which aims to: 1) identify key social-economic predictors of night shift work during pregnancy, 2) determine the impact of night shift work pre-pregnancy and during pregnancy on cardiometabolic adverse pregnancy outcomes independent of social-economic factors, and 3) characterize the barriers and facilitators of requesting and granting night shift work accommodations among pregnant night shift workers and their employers. DR. Agarwal proposes a mixed quantitative and qualitative approach, leveraging detailed data on shift work and pregnancy outcomes from a large, occupational cohort of US nurses (nurses' health study II), and supplementing this with a new qualitative evaluation of pregnant healthcare workers and their employers at three US hospitals. DR. Agarwal's mentors, DR. Abby fleisch (perinatal epidemiology), DR. Deirdre tobias (cardiometabolic disease epidemiology), and DR. Charles reynolds (sleep and circadian disruption), have related and complementary expertise relevant to DR. Agarwal's training goals and research aims, and prior experience mentoring k-awardees. DR. Agarwal's unique dual affiliation with both mainehealth and tufts will enable her to benefit from the exceptional scientific environment and robust institutional support provided by both institutions, and will facilitate her interactions with her proposed team of mentors and advisors in maine and boston. DR. Agarwal will emerge from the K23 period with critical knowledge and skills to launch an independent research career focused on understanding the role of night shift work, and more generally sleep, on women's perinatal and long-term cardiometabolic health.