PREGNANCY-RELATED SICKNESS ABSENCE IN A SWEDISH COUNTY, 1985-87

Sickness absence during pregnancy has increased in Sweden as well as i n other countries. Study objective - The study aimed to describe pregn ancy related sickness absence and its increase from 1985-87; to consid er if the increase were parallel to an increase in sickness absence fo r all diagnoses or could be explained by a higher birth rate; and to c ompare different ways of presenting sickness absence data. Design - Th e data from a prospective incidence study of all new sick leave spells exceeding seven days in 1985-87 were related to the population at ris k through relevant data from different registers. Setting - The county of Ostergotland, Sweden (about 400 000 inhabitants). Participants - S ubjects were approximately 70 000 sick leave-insured women aged 16-44 years, of whom some 15 000 had sickness absences > seven days. Some 46 00 women gave birth in 1985, approximately 1300 of whom were listed as having pregnancy related diagnoses. Main results - The number of wome n with sick leave associated with pregnancy related diagnoses increase d by 24% (95% confidence interval (CI) 15, 33%) during the period. Thi s diagnosis group was one of the very few with an increasing number of people listed as sick. The corresponding increase for all diagnoses i n women aged 16-44 years was < 1% (95% CI 1, 3%). The increase in the number of women who gave birth was 9% (95% CI 5, 13%). The sick leave rate associated with pregnancy related disorders increased by 14% (95% CI 7, 21%) in 1985-87, while that in all women aged 16-44 years incre ased by 3% (95% 1, 5%). (p < 0.0001). The number of sick leave days as sociated with pregnancy related disorders increased by 49% (p < 0.0001 ) in the period - twice the equivalent increase (p < 0.0001) in the to tal number of sick leave days for all diagnoses taken together. The si ck leave rate and duration, like the increase in these variables, vari ed with age. Different ways of presenting the length of absence proved complementary to each other. Conclusions - After correcting for chang es in the overall sick leave rate and in the birth rate, there is stil l an 11% increase in the sick leave rate associated with pregnancy rel ated disorders that needs to be explained. Medical factors cannot-expl ain this increase but changes in attitudes and practice in relation to sickness insurance among pregnant women and their doctors merit furth er study.