Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study

Background: Immigrants face various problems in accessing healthcare because of lacking medical insurance. This study retrospectively evaluated the effect of insurance on the prenatal care and the obstetric outcomes of immigrants in South Korea. The main objective was to compare the obstetric compli...

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Main Authors: Yun Sung Jo, Ji Soo Um, Kyung Eun Lee, Sa Jin Kim, Jae Eun Shin
Format: Article
Language:English
Published: IMR Press 2022-05-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/49/5/10.31083/j.ceog4905107
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author Yun Sung Jo
Ji Soo Um
Kyung Eun Lee
Sa Jin Kim
Jae Eun Shin
author_facet Yun Sung Jo
Ji Soo Um
Kyung Eun Lee
Sa Jin Kim
Jae Eun Shin
author_sort Yun Sung Jo
collection DOAJ
description Background: Immigrants face various problems in accessing healthcare because of lacking medical insurance. This study retrospectively evaluated the effect of insurance on the prenatal care and the obstetric outcomes of immigrants in South Korea. The main objective was to compare the obstetric complications between uninsured and insured immigrants, and the secondary objective was to compare the prenatal care and maternal nutrition during pregnancy. Methods: Using data from the hospital records, we compared the perinatal outcomes of insured and uninsured women who delivered at Buchoen St. Mary’s Hospital between 2010 and 2020, including the sociodemographic data, prenatal care, obstetric outcomes, and maternal nutrition. The association between insurance status and the various perinatal outcomes of immigrants was assessed using multivariate logistic regression, adjusting for potential confounding variables. Results: In total, 320 immigrant women were included, and 52 (16%) were uninsured. Uninsured immigrants had fewer numbers and a later initiation of prenatal care visits (7.75 ± 4.44 vs. 12.45 ± 3.75, p < 0.001; 1st trimester: 36.5% vs. 66.8%, p < 0.001, respectively), and a lower percentage of an adequate Kessner index score (26.9% vs. 63.8%; p < 0.001, respectively) than insured immigrants. The obstetric complications and maternal nutrition did not significantly vary. After adjusting for the confounding factors, the uninsured immigrants had a higher odds ratio of less-than-adequate prenatal care (adjusted odds ratio (OR) = 5.18; 95% confidence interval: 2.54–10.53; p < 0.001). Conclusions: Uninsured immigrants had inadequate prenatal care compared to insured immigrants, but this did not result in adverse obstetric and maternal outcomes.
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spelling doaj-art-72fd3d962e3d4639b1d71a69befdc40c2025-08-20T03:48:31ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-05-0149510710.31083/j.ceog4905107S0390-6663(22)01767-5Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort studyYun Sung Jo0Ji Soo Um1Kyung Eun Lee2Sa Jin Kim3Jae Eun Shin4Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 06951 Seoul, Republic of KoreaDepartment of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 06951 Seoul, Republic of KoreaDepartment of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 06951 Seoul, Republic of KoreaDepartment of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 06951 Seoul, Republic of KoreaDepartment of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 06951 Seoul, Republic of KoreaBackground: Immigrants face various problems in accessing healthcare because of lacking medical insurance. This study retrospectively evaluated the effect of insurance on the prenatal care and the obstetric outcomes of immigrants in South Korea. The main objective was to compare the obstetric complications between uninsured and insured immigrants, and the secondary objective was to compare the prenatal care and maternal nutrition during pregnancy. Methods: Using data from the hospital records, we compared the perinatal outcomes of insured and uninsured women who delivered at Buchoen St. Mary’s Hospital between 2010 and 2020, including the sociodemographic data, prenatal care, obstetric outcomes, and maternal nutrition. The association between insurance status and the various perinatal outcomes of immigrants was assessed using multivariate logistic regression, adjusting for potential confounding variables. Results: In total, 320 immigrant women were included, and 52 (16%) were uninsured. Uninsured immigrants had fewer numbers and a later initiation of prenatal care visits (7.75 ± 4.44 vs. 12.45 ± 3.75, p < 0.001; 1st trimester: 36.5% vs. 66.8%, p < 0.001, respectively), and a lower percentage of an adequate Kessner index score (26.9% vs. 63.8%; p < 0.001, respectively) than insured immigrants. The obstetric complications and maternal nutrition did not significantly vary. After adjusting for the confounding factors, the uninsured immigrants had a higher odds ratio of less-than-adequate prenatal care (adjusted odds ratio (OR) = 5.18; 95% confidence interval: 2.54–10.53; p < 0.001). Conclusions: Uninsured immigrants had inadequate prenatal care compared to insured immigrants, but this did not result in adverse obstetric and maternal outcomes.https://www.imrpress.com/journal/CEOG/49/5/10.31083/j.ceog4905107immigrantsinsurancematernal nutritionperinatal outcomesprenatal care
spellingShingle Yun Sung Jo
Ji Soo Um
Kyung Eun Lee
Sa Jin Kim
Jae Eun Shin
Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study
Clinical and Experimental Obstetrics & Gynecology
immigrants
insurance
maternal nutrition
perinatal outcomes
prenatal care
title Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study
title_full Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study
title_fullStr Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study
title_full_unstemmed Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study
title_short Prenatal care and obstetric outcome based on the insurance status of immigrants in South Korea: a retrospective cohort study
title_sort prenatal care and obstetric outcome based on the insurance status of immigrants in south korea a retrospective cohort study
topic immigrants
insurance
maternal nutrition
perinatal outcomes
prenatal care
url https://www.imrpress.com/journal/CEOG/49/5/10.31083/j.ceog4905107
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