The income-based disparities in preeclampsia and postpartum hemorrhage: a study of the Korean National Health Insurance cohort data from 2002 to 2013

Abstract

There is limited evidence on the effects of relatively low socioeconomic status on maternal health. Additionally, the global economic recession that began in 2008 could have worsened disparities in maternal complications. To explore disparities in maternal health, we analyzed the occurrence of preeclampsia and postpartum hemorrhage according to level of household income. A population-based cohort data set from the Korean National Health Insurance was used to calculate the age-adjusted incidence, slope index of inequality, and Kunst and Mackenbach relative index of inequality (RIIKM) for preeclampsia and postpartum hemorrhage from 2002 to 2013. In the aggregated data of 65,479 live births, women with lower household income showed a higher risk of developing preeclampsia and postpartum hemorrhage than those with higherhigher incomes after adjusting for conventional risk factors. The absolute and relative inequalities for both complications showed no significant change over the period from 2002 to 2013. Considering the difference in the trends and risks of major obstetric complications according to level of household income, policies to monitor and reduce disparities in maternal health across different economic levels need to be implemented.