Abstract
Background: Chinese women’s reproductive patterns have changed significantly over the past several decades. However, relatively little is known about the pace and characteristics of these changes either overall or by region and socioeconomic status.Methods: We examined the cross-sectional data from the China Kadoorie Biobank cohort study that recruited 300 000 women born between 1930 and 1974 (mean age: 51 years) from 10 socially diverse urban and rural regions of China. Temporal trends in several self-reported reproductive characteristics, and effect modification of these trends by area and education (as a surrogate for socioeconomic status), were examined.Results: The overall mean age at menarche was 15.4 (standard deviation 1.9) years, but decreased steadily over the 45 birth cohorts from 16.1 to 14.3 years, except for an anomalous increase of ∼1 year for women exposed to the 1958-61 famine in early adolescence. Similarly large changes were seen for other characteristics: mean parity fell (urban: 4.9 to 1.1; rural: 5.9 to 1.4); mean age at first birth increased (urban: 19.0 to 25.9 years; rural: 18.3 to 23.8 years); and birth spacing increased after 1980 to over 5 years. Breastfeeding declined after 1950 in urban and, after 1980, in rural women; and 68% of urban and 48% of rural women experienced a terminated pregnancy. Mean age at menopause increased from 47.9 to 49.3 years.Conclusions There have been striking changes in reproductive factors over time and between areas among these Chinese women. Their effects on major chronic diseases should be investigated.
Highlights
The reproductive patterns of Chinese women have changed significantly over the past several decades, partly or wholly due to the major social and economic changes that have occurred in China
The main effect of the one-child policy seems to have been to increase the mean age at first birth, especially in urban areas, and there was a sudden increase in the spacing between first and second births after its introduction
The reproductive patterns of Chinese women have changed significantly over the past several decades, partly or wholly due to the major social and economic changes that have occurred in China.[1,2]
Summary
The reproductive patterns of Chinese women have changed significantly over the past several decades, partly or wholly due to the major social and economic changes that have occurred in China.[1,2] These changes include: the introduction of a strict family planning policy (the so-called ‘onechild’ policy); recent rapid urbanization and economic development; and periodic social upheavals (e.g. wars, famines). Relatively little is known about the pace and characteristics of these changes either overall or by region and socioeconomic status. Methods: We examined the cross-sectional data from the China Kadoorie Biobank cohort study that recruited 300 000 women born between 1930 and 1974 (mean age: 51 years) from 10 socially diverse urban and rural regions of China. Large changes were seen for other characteristics: mean parity fell (urban: 4.9 to 1.1; rural: 5.9 to 1.4); mean age at first birth increased
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