Maternal characteristics and birth outcomes under different family planning policy
LI Pengcheng, LIAO Zijun, WANG Cheng, ZHOU Yubo, LI Hongtian, CHEN Dunjin, LIU Jianmeng
Institute of Reproductive & Child Health/Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing 100191, China
Abstract：Objective To assess the potential impact of recent family planning policy adjustments on maternal characteristics and birth outcomes in China.Methods Pregnant women who delivered in six hospitals in Hubei and Gansu provinces in 2013-2016 were surveyed. The hospitals included one tertiary and two secondary hospitals in each province. Information on major maternal characteristics and birth outcomes were extracted from hospital delivery registration form. Three phases were categorized based on the implement of family planning policy:One-Child Policy period refers to January, 2013 to September, 2014; Selective Two-Child Policy period refers to October, 2014 to July, 2016 and Universal Two-Child Policy period refers to August, 2016 to December, 2016, and the secular trends in the major maternal characteristics and birth outcomes were described accordingly.Results In total, 29 895 women (30 532 neonates) were included in the analysis. The overall percentage of women with advanced age (aged ≥35 years) was 9.6%, and 39.0% were multiparous. The overall prevalence rate of preterm delivery and low birth weight was 9.0% and 7.7%, respectively. Over the three phases, the percentage of women with advanced age increased significantly from 8.6% to 9.6% and it’s 12.3% in the Universal Two-Child Policy period, and the percentage of multiparous women was 34.9%, 39.7% and 46.9% respectively. Over the study period, there were no significant increase in the prevalence of preterm delivery (9.5%, 8.4% and 9.7%), low birth weight (7.5%, 7.9% and 7.6%), and the mean 1-minter Apgar scores [(8.7±0.9),(8.8±1.0), (8.9±1.5)]. Further stratified by the institutions, compared with One-Child Policy period, there was a 24.3%~97.4% and 28.1%~75.2% increase in the percentage of women with advanced maternal age at the last period in 2 tertiary and 2 secondary hospitals respectively. While the remaining two midwifery institutions (one of them has the annual delivery of around 100 cases, the other was close to tertiary midwifery institutions) has no corresponding upward trend. In all the 6 hospitals, there were no increases in the rate of preterm delivery and low birth weight, and no decreases in the mean 1-minter Apgar scores over the study period.Conclusion Maternal characteristics have changed substantially after relaxation of the One-Child policy, especially after implementation of the universal Two-Child Policy, typically characterized by a substantial increase in the percentage of women with advanced age and that of multiparous women. However, no evidence showed the increase in the prevalence of preterm delivery and low birth weight, and decreases in the mean 1-minter Apgar scores. The safety of mothers and neonates has been effectively guaranteed in the early stage of family planning policy adjustments, although the number of high risk pregnancies increases after adjustment of family planning policy. However, follow up study was still necessary for continued monitoring the potential impacts of the Universal Two-Child Policy, in order to optimize allocation of health resources and guarantee the safety of mothers and neonates.
李鹏程,廖紫珺,王称,周玉博,李宏田,陈敦金,刘建蒙. 不同生育政策时期产妇特征及妊娠结局相关指标变化情况分析[J]. 中国生育健康杂志, 2017, 28(6): 501-505.
LI Pengcheng, LIAO Zijun, WANG Cheng, ZHOU Yubo, LI Hongtian, CHEN Dunjin, LIU Jianmeng. Maternal characteristics and birth outcomes under different family planning policy. Chinese Journal of Reproductive Health, 2017, 28(6): 501-505.
