Clinical characteristics of puerperae having the second child after implementation of the Universal Two-Child Policy in China

Abstract

Objective To explore possible reproductive risks by analyzing the clinical characteristics of puerperae having the second child after the implementation of the Universal Two-Child Policy in China. Methods A total of 4 000 puerperae who delivered in Chengdu Women′s & Children′s Central Hospital and other 9 hospitals were recruited. And 2 000 puerperae who consistent with the Universal Two-Child Policy and having the second child were allocated to the study group. The other 2 000 puerperae who were except for the inclusion criteria of study group and delivered in the same period and in the same hospital were allocated to the control group. The data of all subjects and their spouses′ basic situation, the pregnancy and childbirth conditions were collected through enquiring puerperae and transcribing medical records. These general clinical data were statistically compared between two groups by chi-square test. This study was consistent with the World Medical Association Declaration of Helsinki revised in 2013. All subjects in this study signed the informed consents of clinical research. Results ①There were significant differences between two groups in constituent ratios of maternal age ( 10 000-50 000 yuan, >50 000-100 000 yuan, >100 000 yuan) (χ2=53.325, 89.160, 21.948; all P 0.05). ②The proportions of maternal age≥35 years old and the cesarean section history (23.7%, 56.0%), and the incidence rates of hypertension disorders complicating pregnancy, gestational diabetes mellitus, placenta previa and postpartum hemorrhage in study group (2.3%, 16.7%, 3.4%, 3.9%) were all higher than those in control group (20.7%, 5.4%, 0.6%, 14.4%, 2.1%, 2.0%), and the differences were statistically significant (χ2=5.221, P=0.022; χ2=1 351.204, P 0.05). Conclusions Maternal age≥35 years old and cesarean section history, as well as hypertension disorders complicating pregnancy, gestational diabetes mellitus, placenta previa and postpartum hemorrhage, may be the reproductive risk factors of women who consistent with the Universal Two-Child Policy and having the second child. Key words: Family planning policy; Universal Two-Child Policy; Give birth to second child; Case-control studies; Income; Occupational groups; Puerpera