Does Postponement of First Pregnancy Increase Gender Differences in Sickness Absence? A Register Based Analysis of Norwegian Employees in 1993–2007

Anja M S Ariansen,Arnstein Mykletun,Hamid Reza Baradaran

doi:10.1371/journal.pone.0093006

Anja M S Ariansen, Arnstein Mykletun + Show 1 more

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https://doi.org/10.1371/journal.pone.0093006

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Abstract

BackgroundFrom 1970–2012, the average age at first delivery increased from 23.2–28.5 in Norway. Postponement of first pregnancy increases risks of medical complications both during and after pregnancy. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and thus contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women.MethodsWe employed registry-data to analyse sickness absence among all Norwegian employees with income equivalent to full-time work in the period 1993–2007.ResultsAfter control for age, education, and income, pregnant women's sickness absence (age 20–44) increased on average 0.94 percentage points each year, compared to 0.29 in non-pregnant women and 0.14 in men. In pregnant women aged 20–24, sickness absence during pregnancy increased by 0.96 percent points per calendar year, compared to 0.60 in age-group 30–34. Sickness absence during pregnancy accounted for 25% of the increased gender gap in sickness absence, accounting for changes in education, income and age.ConclusionsPostponement of first pregnancy does not explain the increase in pregnant women's sickness absence during the period 1993–2007 as both the highest level and increase in sickness absence is seen in the younger women. Reasons are poorly understood, but still important as it accounts for 25% of the increased gender gap in sickness absence.

Highlights

Norway’s high levels of fertility and female employment is often cited in support of the success story of the Nordic model [1]
The second aim of the paper is to examine if the increased gender differences in sickness absence is accounted for by increased sickness absence during pregnancy
Statistical analyses In each of the analyses presented sickness absence was measured as a rate; the number of number of sick days covered by the National Insurance insurance the current year is divided on maximum possible sick leave days covered by the national insurance over the same time span

Summary

Introduction

Norway’s high levels of fertility and female employment is often cited in support of the success story of the Nordic model [1]. High and growing levels of sickness absence is part of this picture, and entails public costs [4]. To what extent increased sickness absence over the last two decades primarily applied to women in general is currently being debated [5], [6], while the recent increase in sickness absence among pregnant women is less controversial [7], [8]. In order to facilitate fertility as well as female employment, it is imperative to better understand causes of the increase in pregnancy related sickness absence, and causes for sickness absence in general. Sick listed employees get their wage fully compensated for a year, and high and growing levels of sickness absence entail substantial public expenses. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women

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