title: Early life origins of all-cause and cause-specific disability pension: findings from the Helsinki Birth Cohort Study.
abstract: BACKGROUND
  There is some evidence linking sub-optimal prenatal development to an increased risk of disability pension (DP). Our aim was to investigate whether body size at birth was associated with transitioning into all-cause and cause-specific DP during the adult work career.
  
  
  METHODS
  10 682 people born in 1934-44 belonging to the Helsinki Birth Cohort Study had data on birth weight extracted from birth records, and on time, type and reason of retirement between 1971 and 2011 extracted from the Finnish Centre for Pensions.
  
  
  RESULTS
  Altogether 21.3% transitioned into DP during the 40-year follow-up, mainly due to mental disorders, musculoskeletal disorders and cardiovascular disease. Average age of transitioning into DP was 51.3 (SD 8.4) for men and 52.2 (SD 7.6) for women. Cohort members who did not transition into DP retired 10 years later on average. Among men, higher birth weight was associated with a lower hazard of transitioning into DP, adjusted hazard ratio (HR) being 0.94 (95% confidence interval [CI] 0.88-0.99 for 1 SD increase in birth weight). For DP due to mental disorders the adjusted HR was 0.90, 95% CI 0.81, 0.99. A similar but non-significant trend was found for DP due to cardiovascular disease. Among women there were no associations between body size at birth and all-cause DP (p for interaction gender*birth weight on DP p = 0.007).
  
  
  CONCLUSIONS
  Among men disability pension, particularly due to mental disorders, may have its origins in prenatal development. Given that those who retire due to mental health problems are relatively young, the loss to the workforce is substantial.
authors: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyväskylä, Finland.
authors: Mikaela B
authors: MB
authors: von Bondorff
authors: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyväskylä, Finland.
authors: Timo
authors: T
authors: Törmäkangas
authors: Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland.
authors: Minna
authors: M
authors: Salonen
authors: Gerontology Research Center and Department of Health Sciences, University of Jyvaskyla, Jyväskylä, Finland.
authors: Monika E
authors: ME
authors: von Bonsdorff
authors: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.
authors: Clive
authors: C
authors: Osmond
authors: Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynaecology, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors: Eero
authors: E
authors: Kajantie
authors: Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland; Vasa Central Hospital, Vasa, Finland.
authors: Johan G
authors: JG
authors: Eriksson
mesh_terms: D000368:Aged; D001724:Birth Weight; D049628:Body Size; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology; D015331:Cohort Studies; D003710:Demography; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000209:etiology; D016016:Proportional Hazards Models; D012179:Retirement; D012306:Risk