Analysis on the birth situation different fertility policy periods in monitoring area of birth defect population in Zhejiang Province
10.3760/cma.j.cn112150-20190706-0054
- VernacularTitle:浙江省出生缺陷人群监测地区不同生育政策时期生育情况分析
- Author:
Xiaohui ZHANG
1
;
Yanmin CHEN
;
Yu SUN
;
Liqian QIU
Author Information
1. 浙江大学医学院附属妇产科医院妇女保健部，杭州 310006
- Keywords:
Family planning policy;
Pregnancy outcome;
Surveillance
- From:
Chinese Journal of Preventive Medicine
2020;54(5):519-522
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impacts on birth situation associated with birth policy adaption in monitoring area of birth defect population in Zhejiang province.Methods:Data were obtained from hospital-based birth defect surveillance system in Zhejiang Province. The surveillance population was childbearing women living in Nanhu of Jiaxing and Fenghua of Ningbo no less than 1 year. We divided data into three groups as "only child" (Jan, 2012-Sep, 2013), "privileged second child" (Jan, 2015-Sep, 2016) and "universal second child" (Jan, 2017-Sep, 2018) according to birth policy adaption. The differences of maternal age distribution in different birth policy periods were compared by using Kruskal-Wallis test. The changing trend of the proportion of parturient in different birth policy periods was analyzed by using Trend χ 2 test. Unconditional logistic regression model was used to analyze the relationship between birth policy and adverse perinatal outcomes. Results:During "only child" , " privileged second child" and "universal second child" period, the number of childbearing women was 12 557, 14 097 and 15 509, respectively, with an increase of 12.3% and 10.0% over previous periods. Maternal ages [ M ( P25, P75)] were [27 (25, 30)], [28 (26, 31)] and [28 (26, 32)] years old. The proportion of multipara in each period was 19.5%, 35.7% and 45.8%, showing an increased trend ( P<0.001). The incidence of adverse perinatal outcomes was lowest in the "only child" period (8.7%) and highest in the "universal second child" period (11.1%). Unconditional logistic regression model showed that after adjusting for age, compared with the "only child" period, the risk of premature birth [ OR values (95% CI) were 1.20(1.08-1.33) and 1.08 (1.02-1.13), respectively] and birth defects [ OR values (95% CI) were 1.33(1.13-1.55) and 1.29 (1.20-1.39), respectively] increased in "privileged second child" and "universal second child" period. The risk of macro infants decreased significantly [ OR values(95% CI) were 0.87 (0.80-0.96) and 0.91 (0.87-0.95), respectively], and the risk of perinatal death changed insignificantly [ OR values (95% CI) were 0.78 (0.53-1.15) and 0.84 (0.69-1.02), respectively]. Conclusion:According to population based surveillance in two regions in Zhejiang, the proportion of women with advanced age, the proportion of multipara , the risks of birth defects increased with birth policy adaption.
