Socio-economic factors and mortality in Turner syndrome: a registry study
Kirstine Stochholm & Claus Gravholt
In Turner persons questionnaire surveys have identified quality of life, perception of health and education to be at a similar or higher level compared to the background population. To shed further light on these seemingly paradoxical findings in Turner persons we aimed to analyze various socio-economic parameters in Turner persons compared to an age-matched female background population.
All diagnosed Turner syndrome women nationwide (n=977) were identified and compared with an age-matched cohort of the female background population (n=94 883). The socio-economic parameters were marital status, education, retirement, income, unemployment, children, and convictions. All were related to age, study period, and time of diagnosis. Furthermore, we analyzed mortality adjusted for marital status and education.
Our major finding was significantly different socio-economic parameters in Turner persons, only convictions and unemployment were comparable to controls. In Turner persons, the educational level was significantly higher, whereas income and the number of children were significantly reduced; however the latter was surprisingly high. Being diagnosed with Turner syndrome had a clear association with marital status and retirement. All-cause mortality adjusted for gender and age and calendar time was significantly increased with a hazard ratio (HR) of 3.2 (95% confidence interval: 2.63.9). Further adjusted for socio-economic parameters, the HR only changed little.
A divergent socio-economic profile in Turner persons is apparent, with similar educational level, but lower chance of cohabiting and higher risk of early retirement. As previously reported, the mortality among Turner persons was increased; it did not change when adjusted for socio-economic parameters.