Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea.
Institute of Health Services Research, Yonsei University, Seoul 03722, Korea.
Int J Environ Res Public Health. 2020 Jun 26;17(12):4606. doi: 10.3390/ijerph17124606.
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.
改善孕产妇健康是可持续发展目标 3 的 13 项目标之一；因此，预防孕产妇死亡是一个亟待解决的重要问题，而孕产妇死亡通常发生在女性的黄金生育年龄。本研究考察了社会经济地位与韩国全因孕产妇死亡之间的关系，并为孕产妇死亡的可预防风险因素提供了证据。这项基于人群的回顾性队列研究从 2003 年至 2018 年期间，从韩国国家健康保险服务数据库中提取了 3334663 名初产妇的数据。结局变量为产后 6 周和 1 年内的全因孕产妇死亡。使用对数二项式回归模型确定了孕产妇死亡率与收入水平调整后的协变量之间的关系。收入水平较低的女性在产后 6 周内（风险比（RR）=2.42，95%置信区间（CI）=1.65-3.53）和产后 1 年内（RR=1.83，95%CI=1.47-2.28）死亡的风险更高，尤其是年龄在 35-39 岁、居住在农村地区、行剖宫产分娩和有合并症的女性。该研究确定了韩国初产妇的社会经济地位与产后 6 周或 1 年内孕产妇死亡之间存在显著关系，表明需要采取干预措施来降低孕产妇死亡的风险。
