Abstract
Improving maternal health is one of the 13 targets of Sustainable Development Goal 3; consequently, preventing maternal death, which usually occurs in women’s prime productive years, is an important issue that needs to be addressed immediately. This study examines the association between socioeconomic status and all-cause maternal mortality in South Korea and provides evidence of preventable risk factors for maternal death. For this population-based retrospective cohort study, data on 3,334,663 nulliparous women were extracted from the Korean National Health Insurance Service database between 2003 and 2018. The outcome variables were all-cause maternal mortality within six weeks and a year after childbirth. A log-binomial regression model determined the association between maternal mortality and income-level adjusted covariates. Women with lower income levels had higher risk of maternal death within six weeks (risk ratio (RR) = 2.42, 95% confidence interval (CI) = 1.65–3.53) and within one year (RR = 1.83, 95% CI = 1.47–2.28), especially those who were aged 35–39 years, lived in rural areas, delivered via cesarean section, and had maternal comorbidities. The study identifies a significant relationship between South Korean primiparas’ socioeconomic status and maternal death within six weeks or one year after childbirth, suggesting interventions to alleviate the risk of maternal death.
Highlights
The World Health Organization (WHO) announced that to improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system [1]
We found a stronger association between low income level and risk of maternal mortality within six weeks after childbirth for those aged 35–39 years (RR = 3.40, 95% confidence intervals (CIs) = 1.59–7.29), all residential areas, C-section delivery (RR = 3.23, 95% CI = 1.97–5.27), and having maternal comorbidities (RR = 2.87, 95% CI = 1.81–4.55)
The current study identified a significant relationship between socioeconomic status and maternal death within six weeks and within one year among South Korean primiparas
Summary
The World Health Organization (WHO) announced that to improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system [1]. The maternal mortality ratio dropped by about 38% worldwide between 2000 and 2017, approximately 800 women died every day in 2017 from preventable causes related to pregnancy such as severe bleeding, infections, complications from delivery, and pre-eclampsia [1,4]. To avoid these preventable causes of maternal death, skilled health professionals and improved quality care during and after childbirth are needed [1,5]. The estimated lifetime risk of maternal mortality is substantially higher in low-income countries [3]
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