J Korean Med Sci.  2020 Oct;35(39):e341. 10.3346/jkms.2020.35.e341.

Socioeconomic Status and Successful Delivery after an Infertility Diagnosis: a Nationwide Health Insurance Cohort Study in Korea Conducted from 2005 to 2013

Affiliations
  • 1Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Policy Analysis and Management, College of Human Ecology, Cornell University, Ithaca, NY, USA
  • 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 4Institute of Health Service Research, Yonsei University, Seoul, Korea
  • 5Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
  • 6Department of Public Health Science, Graduate School, Korea University, Seoul, Korea

Abstract

Background
The global disease burden of infertility is rising and accessibility to infertility treatments and assisted reproduction is a challenging issue. Therefore, we investigated characteristics of successful delivery after an infertility diagnosis among infertile women.
Methods
We designed a retrospective cohort study with the main outcome measure of a delivery medical record after the initial diagnosis of infertility. A total of 10,108 women patients who were diagnosed with infertility between 2005 to 2013 in the National Health Insurance Cooperation Cohort Database of Korea were enrolled. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for subsequent delivery were estimated by applying a Cox proportional-hazard regression model.
Results
Approximately 55% of infertile women who reported infertility had a delivery eventually. Infertile women who are aged between 30 to 39 (HR, 0.80; 95% CI, 0.75–0.84), in low income level (HR, 0.77; 95% CI, 0.71–0.84), or diagnosed with diabetes (HR, 0.76; 95% CI, 0.60–0.96) were less likely to report a delivery.
Conclusion
These findings highlight demographic, socioeconomic, and medical characteristics of reporting a consequent delivery. Although many previous articles reported an association between socioeconomic status and receiving medical evaluation, there were few studies regarding successful delivery after an infertility diagnosis across socioeconomic status. Thus, the maintaining of support for low socioeconomic status infertile women and their family should be considered after the infertility diagnosis in aspects of financial and social approaches.

Keyword

Infertility; Delivery; Socioeconomic Status; Cohort; Inequality; Korea
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