Evidence from Finland and Sweden on the relationship between early-life diseases and lifetime childlessness in men and women

Aoxing Liu (), Evelina T. Akimova, Xuejie Ding, Sakari Jukarainen, Pekka Vartiainen, Tuomo Kiiskinen, Sara Koskelainen, Aki S. Havulinna, Mika Gissler, Stefano Lombardi, Tove Fall, Melinda C. Mills () and Andrea Ganna ()
Additional contact information
Aoxing Liu: University of Helsinki
Evelina T. Akimova: University of Oxford
Xuejie Ding: University of Oxford
Sakari Jukarainen: University of Helsinki
Pekka Vartiainen: University of Helsinki
Tuomo Kiiskinen: University of Helsinki
Sara Koskelainen: University of Helsinki
Aki S. Havulinna: University of Helsinki
Mika Gissler: Finnish Institute for Health and Welfare
Tove Fall: Uppsala University
Melinda C. Mills: University of Oxford
Andrea Ganna: University of Helsinki

Nature Human Behaviour, 2024, vol. 8, issue 2, 276-287

Abstract: Abstract The percentage of people without children over their lifetime is approximately 25% in men and 20% in women. Individual diseases have been linked to childlessness, mostly in women, yet we lack a comprehensive picture of the effect of early-life diseases on lifetime childlessness. We examined all individuals born in 1956–1968 (men) and 1956–1973 (women) in Finland (n = 1,035,928) and Sweden (n = 1,509,092) to the completion of their reproductive lifespan in 2018. Leveraging nationwide registers, we associated sociodemographic and reproductive information with 414 diseases across 16 categories, using a population and matched-pair case–control design of siblings discordant for childlessness (71,524 full sisters and 77,622 full brothers). The strongest associations were mental–behavioural disorders (particularly among men), congenital anomalies and endocrine–nutritional–metabolic disorders (strongest among women). We identified new associations for inflammatory and autoimmune diseases. Associations were dependent on age at onset and mediated by singlehood and education. This evidence can be used to understand how disease contributes to involuntary childlessness.

Date: 2024
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DOI: 10.1038/s41562-023-01763-x

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