Objective: To evaluate fertility intensions among couples in Shanghai under the novel coronavirus infection (COVID-19) pandemic against the backdrop of persistently low fertility. Methods: A cross-sectional study was carried out using data from studies conducted before the COVID-19 pandemic. Data were collected regarding sociodemographic characteristics, history of reproduction and gynecology, fertility intention before and after the COVID-19 pandemic, female psychological state, and the impact of the COVID-19 pandemic on daily life. Results: Under the influence of COVID-19, 296/447 (66.2%) participants did not change their original fertility intention to have children, while 151/447 (33.8%) of participants were affected by the outbreak. Participants who believed in government and hospital control policies were less likely to change their intention to become pregnant (P < 10-3 , P < 10-3). In contrast, concerns about the impact of COVID-19 on female and fetal health led participants to cancel their original pregnancy plans (P < 10 −3). Conclusion: Three in ten couples of childbearing age, who originally expressed their intention of becoming pregnant, canceled their pregnancy plans after the COVID-19 outbreak. The COVID-19 outbreak has brought new challenges to people's physical and mental health. Effective policies and measures can help to improve people's fertility intentions with respect to having children.

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Computed tomography (CT) is one of the most efficient diagnostic methods for rapid diagnosis of the widespread COVID-19. However, reading CT films brings a lot of concentration and time for doctors. Therefore, it is necessary to develop an automatic CT image diagnosis system to assist doctors in diagnosis. Previous studies devoted to COVID-19 in the past months focused mostly on discriminating COVID-19 infected patients from healthy persons and/or bacterial pneumonia patients, and have ignored typical viral pneumonia since it is hard to collect samples for viral pneumonia that is less frequent in adults. In addition, it is much more challenging to discriminate COVID-19 from typical viral pneumonia as COVID-19 is also a kind of virus. In this study, we have collected CT images of 262, 100, 219, and 78 persons for COVID-19, bacterial pneumonia, typical viral pneumonia, and healthy controls, respectively. To the best of our knowledge, this was the first study of quaternary classification to include also typical viral pneumonia. To effectively capture the subtle differences in CT images, we have constructed a new model by combining the ResNet50 backbone with SE blocks that was recently developed for fine image analysis. Our model was shown to outperform commonly used baseline models, achieving an overall accuracy of 0.94 with AUC of 0.96, recall of 0.94, precision of 0.95, and F1-score of 0.94. The model is available in https://github.com/Zhengfudan/COVID-19-Diagnosis-and-Pneumonia-Classification . Graphic Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s12539-021-00420-z.

Background With the implementation of the two-child policy in China, more couples have expressed the desire to have another child. We conducted this study to evaluate the incidence of infertility and risk factors in couples intending to have a first and second child. Methods From 2013 to 2017, a prospective cohort study was conducted at the pre-pregnancy center of the International Peace Maternal and Child Health Hospital. The participants were selected by screening and random sampling couples who came to the pre-pregnancy center. Data regarding patient sociodemographic characteristics, reproductive and gynecological history, male disease history, and laboratory and imaging examination results were collected. Couples were followed up every 3 months until pregnancy or for 12 months, whichever came first. Multi-factor logistic regression was used to analyze risk factors for infertility. Adjusted odds ratios (aORs) and corresponding 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors. Results The overall infertility incidence was 16.95% (369/2177). The infertility incidence of “first child intention” and “second child intention” was 19.30% (355/1839) and 4.14% (14/338), respectively. This study found great differences in both infertility rate (P < 0.001) and risk factors between the two groups. Risk factors for “first child intention” infertility included advanced age (> 35 years) (aOR = 1.70, 95% CI 1.27–2.28), abnormal body mass index (BMI) (aOR = 1.58, 95% CI 1.31–6.26), longer menstrual periods (aOR = 4.47, 95% CI 2.25–8.88), endometrial polyps (aOR = 2.52, 95% CI 1.28–4.97), polycystic ovarian syndrome (PCOS) (aOR = 6.72, 95% CI 1.79–7.39), salpingostomy (aOR = 3.44, 95% CI 1.68–7.07), and history of mycoplasma (aOR = 1.54, 95% CI 1.09–2.40). However, in the “second child intention” group, clinical risk factors slightly differed and included leiomyoma (aOR = 5.60, 95% CI 1.06–29.76), and higher age (> 40 years) (aOR = 7.36, 95% CI 1.01–53.84). Conclusion The overall infertility rate in Shanghai is similar to that of other large cities in China. Marriage at advanced ages has become increasingly common. As such, the government must consider subsidies to encourage childbirth at childbearing ages, which can improve fertility levels.