Women with polycystic ovary syndrome have poorer work ability and higher disability retirement rate at midlife: a Northern Finland Birth Cohort 1966 study

Abstract

Objective: Polycystic ovary syndrome (PCOS) presents with multiple comorbidities potentially affecting function. This was the first general population-based study to evaluate work ability, participation in working life, and disability retirement in middle-aged women with and without PCOS.

Design: This is a cohort study.

Methods: Women with PCOS (n = 280) and women without PCOS symptoms or diagnosis (n = 1573) were identified in the Northern Finland Birth Cohort in 1966 and were evaluated for self-rated work ability and potential confounders at age 46. Next, incidence rate ratios (IRRs) for disability and unemployment days were extracted from national registers during a prospective 2-year follow-up. Lastly, we assessed hazard ratios (HRs) for disability retirement between 16 and 52 years of age from national registers.

Results: The women with PCOS reported poorer ability to work at age 46, especially due to poorer health. During the 2-year follow-up period, the affected women gained on average an additional month of disability and unemployment days, corresponding to an approximately 25% higher risk for both disability (IRR (95% CI): 1.25 (1.22-1.27)) and unemployment days (IRR (95% CI): 1.26 (1.23-1.28)) in models adjusted for health and socioeconomic factors. Lastly, we found a two-fold higher cumulative risk for disability retirement by age 52 compared to non-PCOS women (HR (95% CI): 1.98 (1.40-2.80)), which remained after adjusting for confounding factors (aHR (95% CI): 1.55 (1.01-2.38)).

Conclusions: PCOS is associated with lower participation in working life already in midlife. Acknowledging PCOS-related multimorbidity, concerted efforts are needed to support sustainable careers for women with PCOS.

Figure 1

Flowchart of the study design.

Figure 2

Cumulative hazard functions of age at first-ever disability pension decision in women with PCOS and in non-PCOS controls. Women with PCOS: n  = 43, 15.4% vs non-PCOS control women: n  = 126, 8.0%, P-value <0.001. The symbols ‘+’ indicate individuals censored from follow-up due to death, and the final time point of follow-up at age 52 years. The figure includes the unadjusted hazard ratio (HR) and the fully adjusted HR (aHR, adjusted for self-rated health, BMI, alcohol consumption, smoking, physical activity, parity, marital status, type of residential area, education, employment history) with their 95% CIs from Kaplan–Meier and Cox regression analyses for disability retirement.