Prevalence of anxiety and its associated factors among infertile patients after ‘two-child’ policy in Chongqing, China: a cross-sectional study

Abstract

Background With the prevalence of infertility increasing every year around the world, it has seriously impacted the individual quality of family and social life. Anxiety is one of the most prevalent anxiety disorders among infertile patients. After the two-child policy, whether it affected the prevalence of anxiety is controversial. This study aimed to determine the prevalence of anxiety and its potential risk factors among Chinese infertile women after the enforcement of ‘two-child policy’. Methods This cross-sectional study included 693 infertile patients in a reproductive medical center in Chongqing, China, between February 2016 and December 2018. Data was collected by Self-filling questionnaires including basic demographic information and the Generalized Anxiety Disorder-7 (GAD-7). SPSS statistical software (IBM SPSS version 25) was used to analyse the obtained data. Descriptive analysis was used to describe basic information and anxiety scores, the chi-square test and binary logistic regression were used to analyse the relationship between anxiety and other variables. Results The prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients (FI), and 18.4% among second-child infertile patients (SI) respectively (P > 0.05). Binary logistic regression showed that patients with lower education levels were more likely to have anxiety (P < 0.01). Patients with middle salary incomes were more likely to have anxiety (OR = 1.860, 95% CI: 1.068–3.238). Oral contraception taking history (OR = 1.778, 95% CI: 1.186–2.667), and history of allergy (OR = 2.098, 95% CI: 1.219–3.612) were associated with anxiety. Conclusions Under the full liberalization of the “two-child policy”, the total prevalence of anxiety among Chinese infertile female is comparatively high. Low education levels, middle incomes, oral contraception taking and allergy history can be the related risk factors of anxiety. We promote that all infertile patients should be evaluated for the prevalence of anxiety, especially those with potential risks, and receive consultant or targeted treatment when needed.

The social determinants of mental health disorders among women with infertility: a systematic review

“…Three of these studies included women with infertility [ 41 – 43 ], while study enrolled both men and women with infertility [ 39 ]. The prevalence of anxiety disorders associated with infertility ranged from 21.8% [ 44 ] to 27.5% [ 41 ]. Notably, primary infertility had higher anxiety rates (23.5%) compared to secondary infertility (18.4%) [ 44 ].…”

“…The prevalence of anxiety disorders associated with infertility ranged from 21.8% [ 44 ] to 27.5% [ 41 ]. Notably, primary infertility had higher anxiety rates (23.5%) compared to secondary infertility (18.4%) [ 44 ].…”

“…Six studies assessed the association between income, salary levels, social class and mental health issues among women reporting infertility and reported significant associations [ 38 , 43 , 44 , 50 , 54 , 55 ]. Lower income was associated with higher anxiety [ 44 ] and women from lower social class also scored high on the state anxiety scale (STAI) compared to women of medium and higher social classes [ 43 ]. Higher individual and family incomes reduced depression risk [ 45 , 50 ], while inadequate family income was associated with higher rates of psychological distress [ 53 ].…”

“…The studies included in this systematic review reported a prevalence of 21.8% to 27.5% of anxiety and a 12.2% to 80% prevalence of depression in women with infertility [ 36 , 41 , 44 , 51 ]. Previous meta-analysis has reported a similar 25.05% to 54.24% prevalence of anxiety and 28.03% to 44.32% prevalence of depression in women with infertility [ 19 , 20 ].…”

The technical efficiency of maternal and child health hospitals in China: a case study of Hubei Province

“…In China, although MCH service provision at the national level has performed better compared with most of the other countries [5], disparities across regions still exist [6], calling for more research at regional levels. Moreover, China has implemented the universal twochild policy since 2015, and the governments at all levels encouraged each couple to raise a maximum of three children in 2021 [7]. The demand for MCH services has been increasing, which calls for optimization of health resources allocation.…”