Socio-Demographic Characteristics and Outcomes of Pregnant Women Who Delivered Before and After Ending the One-Child Policy in China: A Comparative Study

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.