Impact of pregnancy on gender differences in sickness absence

Abstract
Women in general have a higher sickness absence than men, and sickness absence is particularly high among pregnant women. Study objectives: To study the level of male sickness absence as compared to female, including and excluding pregnant women. Design: Studies of incidence and length of sickness absence exceeding 7 days using population-based sick-leave records. Setting: The community of Linköping, Sweden, 117,000 inhabitants. Participants: Subjects included in the analysis were all men and women aged 16–44 who in 1985 or 1986 had at least one sick-leave spell exceeding 7 days. Results: Pregnant women had a very high sickness absence. When pregnant women were excluded, the female sick-leave rate decreased from 0.18 (95% C.I. 0.17–0.18) to 0.15 (95% C.I. 0.15–0.16) for all women. The corresponding male sick-leave rate was 0.12 (95% c.i. 0.12–0.13). Gender differences in length of sickness absence decreased to the same extent. The results were similar when restricting the analysis to employed persons. The decrease varied a little with occupational group and was largest in the age-group 25–34. Conclusions: When pregnant women were excluded the excess female sick-leave rate was halved, but still remained 25% higher than the male. The impact of excluding pregnant women was highest in the age group 25–34, where the fertility-rate was highest. Although only 5% of all women aged 16–44 were pregnant, they had a large impact on gender differences in sickness absence.