Sick leave and disability pension following delivery in women with systemic lupus erythematosus

Figures & data

Table 1. Characteristics of 130 women with systemic lupus erythematosus (SLE) and 440 general population comparators matched by sex, age at delivery, and month of delivery with a pregnancy in the medical birth register between 2004 and 2008 in Sweden.

	Women with SLE (n = 130)	General population comparators (n = 440)
Age at delivery (years)	31 ± 4.1	31 ± 3.6
Age at delivery (years)
≤ 30	66 (51)	226 (51)
> 30	64 (49)	214 (49)
Age at SLE index date (years)	24 ± 5.7	n/a
Age at SLE index date (years)
≤ 25	76 (58)	n/a
> 25	54 (42)	n/a
Interval between SLE index date and delivery (years)	4.8 ± 4.6	n/a
Calendar period at time of delivery
2004–2006	58 (45)	221 (50)
2007–2009	72 (55)	219 (50)
Hospitalizations in the calendar year before delivery
0	23 (17)	72 (16)
1	75 (58)	329 (75)
≥ 2	32 (25)	39 (9)
Education at time of delivery (years)
≤ 12	44 (34)	176 (39)
>12	85 (65)	263 (60)
Missing	1 (1)	1 (1)
Serious maternal adverse pregnancy outcomes
Pre-eclampsia	18 (14)	24 (6)
Eclampsia	0 (0)	0 (0)
Neonatal adverse outcomes
Small for gestational age*	17 (13)	12 (3)
Preterm birth (< 37 weeks)	31 (24)	21 (4)
Admission to a neonatal intensive care unit in first year of life	0 (0)	0 (0)
Postpartum death of the baby	< 5 (n/a)	0 (0)

Data are shown as mean ± sd or n (%).

n/a, not applicable.

*There was one woman with SLE with missing information. Percentages exclude missing values.

Figure 1. Mean number of days on sick leave before and after delivery in mothers with systemic lupus erythematosus (SLE) and mothers without SLE.

Table 2. Sick leave, disability pension, and total work loss by calendar year for 130 women with systemic lupus erythematosus (SLE) matched on age at delivery and month of delivery to 440 women from the general population with a pregnancy in the medical birth register between 2004 and 2008 in Sweden.

Women with SLE
	Year before delivery	Year of delivery	Year 1 postpartum	Year 2 postpartum	Year 3 postpartum
	(N = 130)	(N = 129)	(N = 125)	(N = 108)	(N = 72)
On sick leave	45 (35)	67 (52)	25 (20)	32 (30)	23 (32)
Sick leave (days)	37 ± 83	49 ± 74	12 ± 39	25 ± 64	30 ± 71
On disability pension	17 (13)	17 (13)	17 (14)	16 (15)	16 (22)
Disability pension (days)	24 ± 76	28 ± 87	26 ± 77	32 ± 93	42 ± 96
Total work loss (days)	61 ± 112	77 ± 108	38 ± 83	57 ± 106	71 ± 114
Not included	0 (0)	1 (1)*	5 (4)†	22 (17)‡	58 (45)§
General population comparators
	Year before delivery	Year of delivery	Year 1 postpartum	Year 2 postpartum	Year 3 postpartum
	(N = 440)	(N = 440)	(N = 421)	(N = 310)	(N = 178)
On sick leave	68 (15)	134 (30)	59 (14)	49 (16)	24 (13)
Sick leave (days)	10 ± 43	15 ± 37	4 ± 28	10 ± 46	11 ± 55
On disability pension	4 (1)	5 (2)	4 (2)	4 (2)	3 (2)
Disability pension (days)	2 ± 26	2 ± 25	2 ± 25	3 ± 29	5 ± 39
Total work loss (days)	13 ± 50	16 ± 44	6 ± 38	12 ± 55	15 ± 66
Not included	0 (0)	0 (0)	19 (4)||	130 (30)¶	262 (60)**

Data are shown as mean ± sd or n (%).

Percentages for sick leave and disability pension variables exclude those women who are not included per year. Percentages for the variable ‘not included’ are calculated from the total group of women with SLE (N = 130) and general population comparators (N = 440). Sick leave exceeding 14 days was registered in the Swedish Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA), so the numbers on sick leave do not include the first 14 days.

Number of women with missing data on sick leave and disability pension: *†n = 1, ‡§n = 2, ||¶n = 3, **n = 5.

Number of women for whom follow-up was ended because they had their second child in that year: †n = 4, ‡n = 20, §n = 56, ||n = 16, ¶n = 127, **n = 257.

Figure 2. Mean number of days of disability pension before and after delivery in mothers with systemic lupus erythematosus (SLE) and mothers without SLE.

Table 3. Work loss (> 30 days) in the first and second calendar years postpartum among 130 women with systemic lupus erythematosus (SLE) by patient characteristics with risk estimates.

	First year postpartum		Second year postpartum
Variable and category	Work loss n/N (%)	Adjusted OR* (95% CI)	Work loss n/N (%)	Adjusted OR† (95% CI)
Age at delivery (years)
≤ 30	21/66 (31.8)	1.1 (0.5–2.3)	18/66 (27.3)	1.4 (0.6–3.4)
> 30	19/64 (29.7)	1 (reference)	13/64 (20.3)	1 (reference)
Age at SLE onset (years)
≤ 25	26/76 (34.2)	1.6 (0.7–3.6)	21/76 (27.6)	1.9 (0.8–4.9)
> 25	14/54 (25.9)	1 (reference)	10/54 (18.5)	1 (reference)
Interval between SLE onset and delivery (years)
≤ 2	13/50 (26.0)	0.5 (0.2–1.2)	9/50 (18.0)	0.3 (0.1–0.9)
> 2	27/80 (33.8)	1 (reference)	22/80 (27.5)	1 (reference)
Number of hospitalizations during pregnancy
0	5/23 (21.7)	1 (reference)	2/23 (21.7)	1 (reference)
1	21/75 (28.0)	1.5 (0.3–6.4)	15/75 (20.0)	2.7 (0.5–14.3)
≥ 2	14/32 (43.8)	0.8 (0.2–4.4)	11/32 (34.4)	1.6 (0.3–9.6)
Education at time of delivery (years)
≤ 12	21/44 (47.7)	2.6 (1.1–6.0)	17/44 (38.6)	2.3 (0.9–5.9)
> 12	19/85 (22.4)	1 (reference)	14/85 (16.5)	1 (reference)
Number of neonatal adverse outcomes‡
0	25/92 (27.2)	1 (reference)	18/92 (19.6)	1 (reference)
≥ 1	15/38 (39.5)	1.4 (0.6–3.3)	13/38 (34.2)	1.8 (0.7–4.6)
Sick leave in the year of delivery (days)
≤ 30	15/76 (19.7)	1 (reference)	12/76 (15.8)	1 (reference)
> 30	25/53 (47.2)	4.4 (1.5–12.9)	19/53 (35.9)	2.9 (0.9–9.5)
Sick leave in the first year postpartum (days)
≤ 30	n/a	n/a	24/116 (20.7)	1 (reference)
> 30	n/a	n/a	7/13 (53.9)	2.1 (0.5–8.5)

CI, confidence interval; OR, odds ratio; n/a, not applicable.

There is one missing value each for education at time of delivery, sick leave in the year of delivery, and sick leave in the first year postpartum.

*Models are adjusted for age at delivery, sick leave in the year before delivery, and calendar year of delivery, all as continuous variables, except if it was the variable of interest.

†Models are adjusted for age at delivery, sick leave in the year before delivery, sick leave in the first year postpartum, and calendar year of delivery, all as continuous variables, except if it was the variable of interest.

‡Consists of small for gestational age, preterm birth, and admission to a neonatal intensive care unit in the first year of life.