Influence of Pregnancy-Related Diagnoses on Sick-Leave Data in Women Aged 16–44

Abstract

Absence from work because of sickness often is used as an outcome measure in clinical and public health studies, reflecting morbidity and its social consequences, Whether the effects of sick leave differ in pregnant women, compared with the entire population of reproductive-age women, is not clear. The present study examined the contribution of pregnant women to the level of sickness absence in 24,481 Swedish women. Another goal was to determine to what extent sick-listed pregnant women could be identified by diagnoses on sickness certificates. The cross-sectional study enrolled sick leave-insured women aged 16 to 44 years living in Linkoping, Sweden (population 117,000), in 1985-1986. Two population-based research registers were used: one of sickness absence for the entire population and one of pregnant women in the same population and year. Pregnant women accounted for 5% of the study population and 20% of those having at least one sick leave lasting longer than 7 days. They had a significantly higher cumulative incidence of sick leave than all women. Their sick leave episodes also lasted longer than in the general population of women (45 vs. 10 days). More than 90% of all physicians' diagnoses in pregnant women were related to pregnancy (53%) or to back pain (40%). Only 46% of sick-listed pregnant women were identified from diagnoses on the sickness certificates. At any given time, pregnant women are only a fraction of all women of childbearing age, but they nevertheless make a significant contribution to registered sick leave. For this reason, the incidence of pregnancy in different groups or at different ages should be considered when analyzing data on sick leave in studies of women's work-related health.