Analysis of the Characteristics of Pregnancy and Delivery before and after Implementation of the Two-child Policy

Abstract

Background:After the two-child policy is fully implemented, new challenges regarding pregnancy management and the treatment of pregnancy complications will arise. The aim of this study was to analyze the characteristics of pregnancy and delivery before and after the implementation of the two-child policy to make suggestions on the quality assurance of the new era of obstetrics.Methods:In total, 5895 cases of pregnant women who delivered from April 2016 to March 2017 in Peking University Third Hospital served as the study group and 5103 cases of pregnant women who delivered from January to December 2015 served as the control group. The characteristics of pregnancy and delivery were retrospectively analyzed.Results:In the study group, the percentage of pregnant women who were older (over 40 years) (3.6% vs. 2.2%), were multipara (30.3% vs. 17.0%), received irregular prenatal care (1.5% vs. 0.9%), were transferred for treatment from a subordinate hospital (4.4% vs. 2.8%), and were not residents of Beijing (3.8% vs. 2.2%), were significantly increased compared with the control group (P < 0.05). In the study group, the rate of a hypertensive disorder complicating pregnancy (6.4% vs. 5.0%), gestational diabetes mellitus (25.3% vs. 23.1%), dangerous placenta previa (3.0% vs. 2.3%), placental implantation (2.4% vs. 1.8%), and severe postpartum hemorrhage (2.8% vs. 1.9%) was significantly increased compared with the control group (P < 0.05). In the study group, the cesarean section rate during primipara was significantly reduced compared with the control group (42.0% vs. 44.2%). However, the rate during multipara was significantly increased compared with the control group (P < 0.05). Indications for cesarean section in the study group as well as the percentages of scared uterus and placenta previa were significantly increased compared with the control group (P < 0.05).Conclusions:According to the current situation, better methods are needed to strengthen pregnancy and delivery management, reduce the rate of cesarean section, and ensure a positive outcome for mothers and babies.

Changes in maternal age and prevalence of congenital anomalies during the enactment of China's universal two-child policy (2013–2017) in Zhejiang Province, China: An observational study

“…Some questions remain about the impacts of the birth policy changes on maternal and infant health. To date, the impact of birth policy changes on women's reproductive decisions, delivery mode, pregnancy complications, pregnancy age, and birth outcomes has been reported [6][7][8][9][10][11]. An association between certain maternal characteristics and birth defects (BDs) has also been reported, such as maternal age, maternal parity, use of assisted reproductive technology, and diabetes mellitus [12][13][14][15].…”

Efficiency of Non-invasive Prenatal Screening in Pregnant Women at Advanced Maternal Age

“…In China, all AMA pregnant women are advised to undergo prenatal diagnosis. However, with the implementation of the two-child policy, the number of AMA pregnant women has increased signi cantly [1] , which has greatly increased the demand for prenatal diagnosis [13] . However, amniotic uid sampling or umbilical cord blood collection are invasive procedures, with the risk of miscarriage which was estimated at 0.5 to 1.0% [14,15] .…”

Efficiency of Non-invasive Prenatal Screening in Pregnant Women at Advanced Maternal Age

“…In this study, we confirmed that NIPS had a high sensitivity, women are advised to undergo prenatal diagnosis. However, with the implementation of the two-child policy, the number of AMA pregnant women has increased significantly [ 1] , which has greatly increased the demand for prenatal diagnosis [ 10] . However, amniotic fluid sampling or umbilical cord blood collection are invasive procedures, with the risk of miscarriage which was estimated at 0.5 to 1.0% [ 11,12] .…”