Prospective cohort study of PoMS and population-based references, using Swedish nationwide microdata from 1990-2016. PoMS (onset < 18 years) were identified in the Swedish MS Registry. The non-MS (no ICD-code for a demyelinating disorder) general population reference cohort was randomly selected from the Total Population Register, matched 10:1 on age, sex, country of birth, and year of socioeconomic data. Highest educational level (elementary, high school, or university) was compared using logistic regression. Income, measured as the mean annual earnings from work in Swedish kronor (SEK), was compared using Tobit models, and net annual sickness absence (SA) and disability pension days were compared using zero-inflated negative binomial regression. Income and days on disability benefits were compared within five age periods (19-24; 25-34; 35-44; 45-54; 55-64).

699 PoMS and 6983 matched references were included.  There was no difference in the odds of attending university for PoMS versus the matched references (odds ratio: 0.89; 95%CI: 0.75-1.05). Still, the PoMS cohort had significantly lower annual earnings than the reference cohort, ranging from -19,558 SEK (95%CI: -26,677 to -12,439) in the youngest age period to -230,502 SEK (95%CI: -267,202 to -193,802) in the eldest. PoMS received higher rates of disability benefits, as sickness absence days in the youngest age period (rate ratio (RR): 3.12 (95%CI: 2.19–4.43), and disability pension days in the later age period (RR: 1.31; 95%CI:1.15–1.50).

While having PoMS did not influence educational achievement, it was associated with reduced earnings and increased use of disability benefits throughout the working lifespan. As adults, persons with PoMS never earned as much as their non-MS counterparts.