How much can we reduce delivery-related medical costs associated with maternal mortality? A nationwide cohort study from 2003 to 2021.

Objective: This study aims to examine the association between maternal mortality and childbirth-related medical costs using both unadjusted and adjusted models and to assess the potential reduction in delivery-related medical costs associated with maternal mortality in South Korea. Methods: This retrospective cohort study used data from the National Health Insurance Service Delivery Cohort Database of South Korea. A total of 7,171,578 participants were included. The outcome measured was delivery-related medical costs associated with maternal mortality. A Generalized Estimating Equation model with a log link and gamma distribution was used to estimate delivery-related medical costs. Results: The maternal death rates were 9.7 per 100,000 births. The adjusted mean delivery-related medical costs were approximately six times higher in cases with maternal death than in those without ($2,802 vs. $480, Conclusion: This study found that maternal mortality is associated with significantly higher delivery-related medical costs, nearly six times those of non-maternal mortality cases. Therefore, policymakers should consider reducing costs and improving maternal health outcomes, expanding access to prenatal care for early risk detection and strengthen nationwide maternal health monitoring systems.