Background The new Chinese fertility policy has recently received widespread public attention. However, there are few studies available on the comprehensive epidemiology of maternal and infant health with respect to the characteristic changes of childbearing women. In the study, we compared the maternal characteristics and pregnancy outcomes at different time points according to policy adjustments, accessed the possible relationship among these factors, and evaluated the impacts of these policies for medical and policy assistance. Methods This was a retrospective study. Data were collected from three representative hospitals in Zhejiang Province using stratified random sampling. The annual number of births, and maternal and child healthcare levels were the determining factors of sampling. Women who gave birth in November of 2012, 2014, and 2016 were recruited in accordance with the time of the change in the fertility policy, and we explored the differences in maternal socio-demographic characteristics, delivery mode and pregnancy outcomes. Results A total of 11,718 women were recruited, including 3480, 4044, and 4194 in November of 2012, 2014, and 2016, respectively. The proportions of multiparous women, women who aged ≥35 years, who received higher education, who had previous cesarean sections (CS), and who delivered in a high level hospital increased over time. In 2016, multipara accounted for 49.12, 14.47% were aged ≥35 years, nearly half of women had previous CS and delivered in a provincial hospital, 41.73% gave birth by CS, and 31.62% suffered pregnancy complications. The results of multiple logistic regression mode showed CS risk decreased significantly in 2014 (ORadj = 0.62; 95% CI, 0.55–0.67) relative to 2012, and risks of pregnancy complications (ORadj = 2.30; 95% CI, 1.86–2.83) and multiple births (ORadj = 3.25; 95% CI, 2.19–4.83) only increased in 2016 compared to 2012. Conclusions Some pregnancy outcomes increased as several key characteristics of childbearing women changed after China ended its “one-child” policy. This suggests that policy providers and medical staff need to strengthen healthcare in a consistent fashion regarding changes in birth policy.
Background: Recently, Chinese new fertility policy has received widespread public attention. However, there are limited studies on the comprehensive epidemiology of maternal and infant health with respect to the characteristic changes of childbearing women. In this study, we compared the changes in socio-demographic characteristics and pregnancy outcomes of childbearing women before and after ending the one-child policy in Zhejiang province of China.Methods: This was a multicenter and cross-sectional study. Data were from three representative hospitals in Zhejiang province by stratified random sampling. Women who gave birth in November 2012-2014-2016 were recruited, according to the time of the change in fertility policy. We explored the differences in maternal sociodemographic characteristics and pregnancy outcomes.Results: Totally, 11,718 women were recruited, including 3480-4044-4194 in November 2012-2014-2016 respectively. Results showed the proportion of women with advanced age, relative higher education, higher number of gravidity and parity, previous cesarean section and births in a provincial hospital increased over time. Of multipara, they were more likely to be over ≥ 35 years old, to give birth vaginally and to have pregnancy complications and multiple birth, particularly in 2016 than in 2012. Of those primipara, the proportion of women with advanced age remained stable during periods. Further, both the percentage of vaginal delivery and instrumental vaginal delivery were higher in 2014 and 2016 than in 2012. The same period, the proportions of pregnancy complications, and multiple births significantly rose, but stillbirth and birth decreased in 2014 than in 2012 among women who never delivered.Conclusions: Some adverse pregnancy outcomes increased as some key characteristics of childbearing women changed after ending the one-child policy. It suggested that policy provider and medical staff to strengthen consistent healthcare regarding to changes in birth policy.
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