Abstract
BackgroundAlthough unintentional pregnancy loss is common, national representative statistics are lacking in high-income East Asian countries undergoing rapid demographic changes. It is necessary to confirm the income inequality of pregnancy loss even in universal national health insurance.MethodUsing National Health Insurance Service data between 2008 and 2014, the annual prevalence of pregnancy loss was enumerated, and differences in pregnancy loss according to age and income levels were assessed by multivariable Poisson regression. Joint-point regression was used to examine the trend of pregnancy loss.ResultOn average, there was a 15.0% annual pregnancy loss among 3,941,020 pregnancy cases from 2008 to 2014. Pregnancy loss inequality increased stepwise with income levels except for the highest income group. After adjusting for income levels, the annual percent change of age-standardized prevalence significantly increased by 2.6% every year since 2011.ConclusionEven in high-income countries with universal national health insurance, income inequality in pregnancy loss is observed. Further appraisal is needed to explain the increasing trend of pregnancy loss between 2011 and 2014 even after adjusting income.
Highlights
Pregnancy outcomes are important issues in women’s reproductive health, including livebirths, stillbirths, spontaneous abortions, and induced abortions
After adjusting for income levels, the annual percent change of age-standardized prevalence significantly increased by 2.6% every year since 2011
Pregnancy loss rates varies in the Republic of Korea, which is inconsistent with the results of previous studies
Summary
Pregnancy outcomes are important issues in women’s reproductive health, including livebirths, stillbirths, spontaneous abortions, and induced abortions. 80% of pregnancy loss was during the first 12 gestational weeks [2]. The criterion for distinguishing a stillbirth from a miscarriage, referred to as spontaneous abortion, is fetal viability, which is generally based on 20 to 24 gestational weeks. In high-income countries, stillbirth is supposedly caused by placental dysfunction and very early preterm birth, with approximately 0.5% of pregnancies reaching 22 gestational weeks [3]. According to the Korea National Fertility and Family Health and Welfare Survey, one-fifth of pregnant women experienced pregnancy loss. This survey was only targeted at married women [4]. It is necessary to confirm the income inequality of pregnancy loss even in universal national health insurance
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