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Early-term birth and its association with universal two-child policy: a national cross-sectional study in China
OBJECTIVE: To describe the epidemiology of early-term birth (ETB) at the national level in China, and explore the association and mediating factors between ETB and policy between universal two-child policy and ETB, so as to explain the potential reason for such a relationship and provide evidence fo...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655521/ https://www.ncbi.nlm.nih.gov/pubmed/34876437 http://dx.doi.org/10.1136/bmjopen-2021-054959 |
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author | Zhang, Jie Williams, Gareth J Wang, Guanghua Chen, Jingjing Zhang, Mengyu Du, Wenchong Zhu, Jing Zhang, Jun Hua, Jing |
author_facet | Zhang, Jie Williams, Gareth J Wang, Guanghua Chen, Jingjing Zhang, Mengyu Du, Wenchong Zhu, Jing Zhang, Jun Hua, Jing |
author_sort | Zhang, Jie |
collection | PubMed |
description | OBJECTIVE: To describe the epidemiology of early-term birth (ETB) at the national level in China, and explore the association and mediating factors between ETB and policy between universal two-child policy and ETB, so as to explain the potential reason for such a relationship and provide evidence for future ETB interventions in the era of the new birth control policy. DESIGN: Cross-sectional study. PARTICIPANTS: The cross-sectional study used data from China Labour and Delivery Survey between 2015 and 2016. A total of 75 132 survey data collected from 89 hospitals in 25 provinces were included in the analysis. We further explored the association between the universal two-child policy and ETB. RESULTS: The weighted incidence of ETB was 30.1 per 100 all births (95% CI 30.06% to 30.14%) or 29.88 per 100 live births (95% CI 29.97% to 30.05%) between 2015 and 2016 in China. There was an association between the universal two-child policy and ETB (relative risk, RR 1.19, 95% CI 1.15 to 1.23), which was not mediated by maternal age (RR 1.17, 95% CI 1.13 to 1.22), previous uterine scars (RR 1.18, 95% CI 1.14 to 1.22), parity (RR 1.19, 95% CI 1.15 to 1.24) and other measured conditions (each p<0.05). Stratified analysis showed that the association between universal two-child policy and ETB were the strongest in multiparous young women or women without previous uterine scars (each p<0.05), and disappeared in all women of advanced maternal age (each p>0.05). CONCLUSION: The incidence of ETB was high in China when compared with most of reported countries, and there might be a link between two-child policy and ETB. Obstetric practice such as selective induced labour and caesarean section should be revised with ETB risks in mind, when ETB is more likely to happen under the universal two-child policy. Preventing ETB should not be neglected in multiparous young women or those without previous uterine scars under the new policy. |
format | Online Article Text |
id | pubmed-8655521 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-86555212021-12-27 Early-term birth and its association with universal two-child policy: a national cross-sectional study in China Zhang, Jie Williams, Gareth J Wang, Guanghua Chen, Jingjing Zhang, Mengyu Du, Wenchong Zhu, Jing Zhang, Jun Hua, Jing BMJ Open Public Health OBJECTIVE: To describe the epidemiology of early-term birth (ETB) at the national level in China, and explore the association and mediating factors between ETB and policy between universal two-child policy and ETB, so as to explain the potential reason for such a relationship and provide evidence for future ETB interventions in the era of the new birth control policy. DESIGN: Cross-sectional study. PARTICIPANTS: The cross-sectional study used data from China Labour and Delivery Survey between 2015 and 2016. A total of 75 132 survey data collected from 89 hospitals in 25 provinces were included in the analysis. We further explored the association between the universal two-child policy and ETB. RESULTS: The weighted incidence of ETB was 30.1 per 100 all births (95% CI 30.06% to 30.14%) or 29.88 per 100 live births (95% CI 29.97% to 30.05%) between 2015 and 2016 in China. There was an association between the universal two-child policy and ETB (relative risk, RR 1.19, 95% CI 1.15 to 1.23), which was not mediated by maternal age (RR 1.17, 95% CI 1.13 to 1.22), previous uterine scars (RR 1.18, 95% CI 1.14 to 1.22), parity (RR 1.19, 95% CI 1.15 to 1.24) and other measured conditions (each p<0.05). Stratified analysis showed that the association between universal two-child policy and ETB were the strongest in multiparous young women or women without previous uterine scars (each p<0.05), and disappeared in all women of advanced maternal age (each p>0.05). CONCLUSION: The incidence of ETB was high in China when compared with most of reported countries, and there might be a link between two-child policy and ETB. Obstetric practice such as selective induced labour and caesarean section should be revised with ETB risks in mind, when ETB is more likely to happen under the universal two-child policy. Preventing ETB should not be neglected in multiparous young women or those without previous uterine scars under the new policy. BMJ Publishing Group 2021-12-07 /pmc/articles/PMC8655521/ /pubmed/34876437 http://dx.doi.org/10.1136/bmjopen-2021-054959 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Public Health Zhang, Jie Williams, Gareth J Wang, Guanghua Chen, Jingjing Zhang, Mengyu Du, Wenchong Zhu, Jing Zhang, Jun Hua, Jing Early-term birth and its association with universal two-child policy: a national cross-sectional study in China |
title | Early-term birth and its association with universal two-child policy: a national cross-sectional study in China |
title_full | Early-term birth and its association with universal two-child policy: a national cross-sectional study in China |
title_fullStr | Early-term birth and its association with universal two-child policy: a national cross-sectional study in China |
title_full_unstemmed | Early-term birth and its association with universal two-child policy: a national cross-sectional study in China |
title_short | Early-term birth and its association with universal two-child policy: a national cross-sectional study in China |
title_sort | early-term birth and its association with universal two-child policy: a national cross-sectional study in china |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655521/ https://www.ncbi.nlm.nih.gov/pubmed/34876437 http://dx.doi.org/10.1136/bmjopen-2021-054959 |
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