Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden
Objective To investigate associations of morbidity with subsequent sickness absence (SA) and disability pension (DP) among initially nulliparous women with no, one or several childbirths during follow-up.Design Longitudinal register-based cohort study.Setting Sweden.Participants Nulliparous women, a...
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
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| author | Mo Wang Kristina Alexanderson Pia Svedberg Krisztina D. László Lotta Nylén |
| author_facet | Mo Wang Kristina Alexanderson Pia Svedberg Krisztina D. László Lotta Nylén |
| author_sort | Mo Wang |
| collection | DOAJ |
| description | Objective To investigate associations of morbidity with subsequent sickness absence (SA) and disability pension (DP) among initially nulliparous women with no, one or several childbirths during follow-up.Design Longitudinal register-based cohort study.Setting Sweden.Participants Nulliparous women, aged 18 to 39 years and living in Sweden on 31 December 2004 and the three preceding years (n=492 504).Outcome measures Annual mean DP and SA days (in SA spells >14 days) in the 3 years before and after inclusion date in 2005.Methods Women were categorised into three groups: no childbirth in 2005 nor during the follow-up, first childbirth in 2005 but not during follow-up, and having first childbirth in 2005 and at least one more during follow-up. Microdata were obtained for 3 years before and 3 years after inclusion regarding SA, DP, mortality and morbidity (ie, hospitalisation and specialised outpatient healthcare, also excluding healthcare for pregnancy, childbirth and puerperium). HRs and 95% CIs for SA and DP in year 2 and 3 after childbirth were estimated by Cox regression; excluding those on DP at inclusion.Results After controlling for study participants’ prior morbidity and sociodemographic characteristics, women with one childbirth had a lower risk of SA and DP than those who remained nulliparous, while women with more than one childbirth had the lowest DP risk. Morbidity after inclusion that was not related to pregnancy, childbirth or the puerperium was associated with a higher risk of future SA and DP, regardless of childbirth group. Furthermore, morbidity both before and after childbirth showed a strong association with SA and DP (HR range: 2.54 to 13.12).Conclusion We found a strong positive association between morbidity and both SA and DP among women, regardless of childbirth status. Those who gave birth had lower future SA and DP risk than those who did not. |
| format | Article |
| id | doaj-art-efb406813b8d40ffb3efd14a484003eb |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-efb406813b8d40ffb3efd14a484003eb2024-11-27T08:50:11ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-037726Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in SwedenMo Wang0Kristina Alexanderson1Pia Svedberg2Krisztina D. László3Lotta Nylén41 Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation base of Child development and Critical Disorders; Children’s Hospital of Chongqing Medical University, Chongqing, China1 Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDivision of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenDivision of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenObjective To investigate associations of morbidity with subsequent sickness absence (SA) and disability pension (DP) among initially nulliparous women with no, one or several childbirths during follow-up.Design Longitudinal register-based cohort study.Setting Sweden.Participants Nulliparous women, aged 18 to 39 years and living in Sweden on 31 December 2004 and the three preceding years (n=492 504).Outcome measures Annual mean DP and SA days (in SA spells >14 days) in the 3 years before and after inclusion date in 2005.Methods Women were categorised into three groups: no childbirth in 2005 nor during the follow-up, first childbirth in 2005 but not during follow-up, and having first childbirth in 2005 and at least one more during follow-up. Microdata were obtained for 3 years before and 3 years after inclusion regarding SA, DP, mortality and morbidity (ie, hospitalisation and specialised outpatient healthcare, also excluding healthcare for pregnancy, childbirth and puerperium). HRs and 95% CIs for SA and DP in year 2 and 3 after childbirth were estimated by Cox regression; excluding those on DP at inclusion.Results After controlling for study participants’ prior morbidity and sociodemographic characteristics, women with one childbirth had a lower risk of SA and DP than those who remained nulliparous, while women with more than one childbirth had the lowest DP risk. Morbidity after inclusion that was not related to pregnancy, childbirth or the puerperium was associated with a higher risk of future SA and DP, regardless of childbirth group. Furthermore, morbidity both before and after childbirth showed a strong association with SA and DP (HR range: 2.54 to 13.12).Conclusion We found a strong positive association between morbidity and both SA and DP among women, regardless of childbirth status. Those who gave birth had lower future SA and DP risk than those who did not.https://bmjopen.bmj.com/content/10/11/e037726.full |
| spellingShingle | Mo Wang Kristina Alexanderson Pia Svedberg Krisztina D. László Lotta Nylén Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden BMJ Open |
| title | Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden |
| title_full | Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden |
| title_fullStr | Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden |
| title_full_unstemmed | Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden |
| title_short | Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden |
| title_sort | childbirth morbidity sickness absence and disability pension a population based longitudinal cohort study in sweden |
| url | https://bmjopen.bmj.com/content/10/11/e037726.full |
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