Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

PLoS One. 2020 Aug 26;15(8):e0237794. doi: 10.1371/journal.pone.0237794. eCollection 2020.


Aims: This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses.

Methods: Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25-34 years old), middle-reproductive (35-44) and late-reproductive (45-54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin.

Results: Younger women show a higher incidence of overall sickness absence compared to late-reproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain.

Discussion: The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Birth Rate*
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Registries / statistics & numerical data
  • Reproductive Behavior / statistics & numerical data*
  • Sick Leave / statistics & numerical data*
  • Spain

Grants and funding

This study was financed by the State Plan for Investigation, Development, and Innovation 2013-2016, by the Health Institute Carlos III – Subdirection General of Evaluation and Promotion of Investigation (FIS PI14/00057 – EBISA), and by the European Regional Development Fund. The authors claim no conflicts of interest. This grant was awarded to the Center for Research in Occupational Health ( The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.