Sickness absence and disability pension in relation to childbirth among women with and without MS

Abstract Background Previous studies found that nulliparous women who later gave birth at least once had fewer future sickness absence (SA) and disability pension (DP) days compared to those who did not. However, this question remains unexplored among women with multiple sclerosis (MS), a population at higher risk of SA/DP. This study aimed to examine SA/DP in relation to childbirth among women with and without MS. Methods A longitudinal population-based cohort study using register microdata covering all nulliparous women in Sweden aged 18-39 in 2009 (N with MS: 1829; N without MS: 425,089). Standardized mean net days of SA/DP were calculated for each of the three years prior to (Y-3 to Y-1) and the seven years after (Y + 1 to Y + 7) the index date, defined as the first childbirth in 2010 or, for those without births, July 2, 2010 (B0). Women were categorized into the following three groups: women with (1) no childbirth during follow-up (B0), (2) a childbirth in 2010 and no subsequent births (B1), and (3) with a childbirth in 2010 and at least one subsequent birth during follow-up (B1+). Results Women with MS had about twice as many SA/DP mean net days/year during each of the studied years than those without MS, in each of the three groups (B0, B1, B1+). Women with MS with more than one birth (B1+) had 3.35 (95% CI 2.32-4.85) more SA/DP days in the last follow-up year (Y + 7) than women without MS in the B1+ group. Among women with MS, those who had more than one birth (B1+) had the lowest number of SA/DP days during the follow-up years, compared to B0, similar to the pattern seen in women without MS. The group with the highest number of SA/DP days (B0 women with MS) had about 80,3 SA/DP mean days (95% CI 74.3-86.8) in the last follow-up year (Y + 7). Conclusions Women with MS had higher number of SA/DP days in the ten studied years than those without MS and followed the same pattern as those without MS with less SA/DP days among those with more childbirths. Key messages • Women with MS who gave birth more than once had lower SA/DP days than women with MS not giving birth – thus, they showed the same overall pattern as observed in women without MS diagnosis. • Although women with MS had twice as high levels of SA/DP days compared to other women: they were not on SA or DP during the absolute majority of the days during each of the studied years.