Small for gestational age and adulthood risk of disability pension: Thecontribution of childhood and adulthood conditions

J. Helgertz, D. Vågerö

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6 Scopus citations


Early exiting from the labor force and into disability pension (DP) represents a major social problem in Sweden and elsewhere. We examined how being asymmetric (A-SGA) or symmetric (S-SGA) small for gestational age predicts transitioning into DP.We analyzed a longitudinal sample of 8125 men and women from the Stockholm Birth Cohort (SBC), born in 1953 and not on DP in 1990. The SBC consists of data from various sources, including self-reported information and data from administrative registers. The follow-up period was from 1991 to 2009. Yearly information on the receipt of DP benefits from register data was operationalized as a dichotomous variable. 13 percent of the sample moved into DP during follow-up. Cox proportional hazards regression was used to examine whether disadvantageous fetal growth - A-SGA and S-SGA - predicted DP.Men and women born A-SGA had a substantially increased hazard of DP. The full model suggested a hazard ratio of 1.68 (CI: 1.11-2.54), only being affected slightly by adulthood conditions. Several childhood conditions were also associated with DP. Such factors, however, mainly affected DP risk through adulthood conditions. The effect of SGA on DP appeared particularly strong among individuals from socioeconomically disadvantaged backgrounds.The evidence presented suggests that being A-SGA influences the risk of DP, independent of childhood and adulthood conditions, and similarly for men and women. Due to A-SGA being rather infrequent, reducing the occurrence of A-SGA would, however, only have a marginal impact on the stock of DP pensioners. For the individual affected, the elevation in the risk of DP was nevertheless substantial. Other childhood conditions exercised a larger influence on the stock of DP recipients, but they mostly operated through adulthood attainment. The importance of socioeconomic resources in childhood for the long term health consequences of SGA is interesting from a policy perspective and warrants further research. © 2013 Elsevier Ltd.
Original languageEnglish
Pages (from-to)249-257
Number of pages9
JournalSocial Science and Medicine
StatePublished - 2014

Bibliographical note

Cited By :4

Export Date: 26 December 2018


Correspondence Address: Helgertz, J.; Centre for Economic Demography, Department of Economic History, Lund University, Box 7083, Sweden

Funding details: 2006:79

Funding details: Vetenskapsrådet, VR

Funding details: Forskningsrådet för Arbetsliv och Socialvetenskap, FAS, 2011:1338

Funding text 1: The authors wishes to thank the editors as well as the anonymous referees for constructive comments on the manuscript. Furthermore, we acknowledge the Swedish Research Council (Vetenskapsrådet) for co-financing the further development and maintaining of the Stockholm Birth Cohort. Valuable assistance from the administrative staff at CHESS is also gratefully acknowledged. Jonas Helgertz has received financial support from the Swedish Council for Working Life and Social Research for the post-doc project ” Early-life health conditions and adulthood socioeconomic outcomes in Sweden, 1968-2001” (FAS/FORTE, 2011:1338), as well as from the Centre for Economic Demography Linneaus Grant, financed by the Swedish Research Council (Vetenskapsrådet, 2006:79). Appendix A


  • 1991-2009
  • Childhood social conditions
  • Cox proportional hazards
  • Disability pension
  • In-utero conditions
  • Sweden
  • disability
  • growth response
  • health risk
  • pension system
  • pregnancy
  • risk assessment
  • social problem
  • socioeconomic status
  • adult
  • Article
  • birth order
  • blue collar worker
  • disability pension
  • educational status
  • family size
  • female
  • human
  • illegitimacy
  • male
  • married person
  • maternal age
  • pension
  • single (marital status)
  • small for date infant
  • socioeconomics
  • urban population
  • white collar worker
  • age distribution
  • body size
  • disabled person
  • epidemiology
  • gestational age
  • health disparity
  • middle aged
  • proportional hazards model
  • sex ratio
  • social care
  • statistics and numerical data
  • Adult
  • Age Distribution
  • Body Size
  • Disabled Persons
  • Female
  • Gestational Age
  • Health Status Disparities
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Public Assistance
  • Sex Distribution
  • Socioeconomic Factors


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