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Association of China’s universal two child policy with changes in births and birth related health factors: national, descriptive comparative study

BMJ (Online), 2019-08, Vol.366, p.l4680-l4680 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2019 BMJ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to 2019 BMJ ;ISSN: 0959-8138 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.l4680 ;PMID: 31434652

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  • Title:
    Association of China’s universal two child policy with changes in births and birth related health factors: national, descriptive comparative study
  • Author: Li, Hong-tian ; Xue, Ming ; Hellerstein, Susan ; Cai, Yue ; Gao, Yanqiu ; Zhang, Yali ; Qiao, Jie ; Blustein, Jan ; Liu, Jian-meng
  • Subjects: Adult ; Age ; Birth ; Birth Rate - trends ; Childrens health ; China - epidemiology ; Families & family life ; Family Characteristics ; Family planning ; Family Planning Policy - trends ; Female ; Health care policy ; Humans ; Infant, Newborn ; Male ; Maternal & child health ; Maternal Age ; Parity ; Population ; Pregnancy ; Premature birth ; Premature Birth - epidemiology ; Provinces ; Time series ; Trends ; Womens health
  • Is Part Of: BMJ (Online), 2019-08, Vol.366, p.l4680-l4680
  • Description: AbstractObjectiveTo measure the association of China’s universal two child policy, announced in October 2015, with changes in births and health related birth characteristics.DesignNational, descriptive before-and-after comparative study.SettingEvery county in 28 of 31 provinces of mainland China.ParticipantsBirths included in two national databases: 67 786 749 births from county level monthly aggregated data between January 2014 and December 2017; and 31 786 279 deliveries from individual level delivery information records between January 2015 and December 2017.Main outcome measuresMonthly mean number of births and mean proportion of multiparous mothers and mothers aged 35 and over, preterm deliveries, and caesarean deliveries.ResultsThe study had two phases: the baseline period (up to and including June 2016, nine months after the policy announcement) and the effective period (from July 2016 to December 2017). The estimated number of additional births attributable to the new policy between July 2016 and December 2017 was 5.40 million (95% confidence interval 4.34 to 6.46). The monthly mean percentage of multiparous mothers and mothers aged 35 and over increased by 9.1 percentage points (95% confidence interval 6.4 to 11.7) and 5.8 percentage points (5.2 to 6.4), respectively. This increase in older mothers, however, was not associated with a concurrent increase in the overall rate of preterm birth. The monthly mean caesarean delivery rate among multiparous mothers increased by 1.2 percentage points (0.8 to 1.6) from 39.7% to 40.9%, and decreased by 3.0 percentage points (−3.5 to −2.5) among nulliparous mothers from 39.6% to 36.6%.ConclusionsSince its announcement in October 2015, the universal two child policy has been associated with a rise in births in China and with changes in health related birth characteristics: women giving birth have been more likely to be multiparous, and more likely to be aged 35 and over. No evidence of concurrent worsening outcomes (that is, premature births) was seen.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0959-8138
    EISSN: 1756-1833
    DOI: 10.1136/bmj.l4680
    PMID: 31434652
  • Source: BMJ Open Access Journals
    MEDLINE
    ProQuest Central
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