Two-child Policy In China Research Articles

The Effect of Family Adaptation and Cohesion on the Well-being of Married Women: A Multiple Mediation Effect

In the years since the implementation of the two-child policy in China, there has been an increase in attention to the psychological status of married women. It is necessary to increase knowledge on the association between family cohesion and the adaptation of married women and their well-being. To accomplish this goal, the mediating variables of social support and positive coping style were examined in this paper. Married women were assessed using the Family Adaptation and Cohesion Scale, the General Well-Being Schedule, the Perceived Social Support Scale, and the Positive Coping Style Scale. The 353 participants were married women across three provinces in China. The results indicated that (1) there is a significant positive correlation between family cohesion, adaptation, subjective well-being, age, and employment status; (2) there is a correlation between perceived social support, family adaptation and cohesion, and well-being; and (3) the effect of family cohesion and adaptation on subjective well-being is mediated by perceived social support and positive coping style. Therefore, married women with good family adaptation and cohesion can get adequate support from family members and have higher subjective well-being.

Study on Population Development and Carrying Capacity of Water Resources and Land Resources in China——Taking the Next 10 Years as an Example

The article takes the next 10 years as the research period to explore the challenges that water resources and land resources will face in the context of the universal two-child policy in China. By adjusting the population parameters in the policy context and using CPPS population forecasting software to predict the population size in the next 10 years, we find that the total population of China will continue growing in the next 5 years. In the next 10 years, the urban population will decrease very slightly after the increase for 7 years, reaching a peak in 2027, and the increase will cause deepening urbanization. It is necessary to take countermeasures to cope with the problem of the carrying capacity of water resources and land resources brought about by the growth of the total population and the deepening of urbanization under the influence of the universal two-child policy effect, so as to achieve the harmonious development of population growth and urbanization with ecological environment.

Sibling relationship quality and young children’s mental health in Chinese two-child families

With enactment of the universal two-child policy in China in 2016, the two-child family will replace the one-child family as the main family form. In this study we examined the contribution of sibling relationship quality in shaping the mental health of Chinese children in a two-child family. Parents (N = 280) reported the quality of their children’s sibling relationship, and their firstborn’s problematic and prosocial behavior, and temperament. Parents’ marital satisfaction and coparenting were also assessed. The results showed that after we had controlled for the child characteristics of age, gender, temperament, sibling age difference, and sibling gender difference, and for the parental characteristics of age and marital satisfaction, and coparenting, sibling negativity and positivity were both significantly related to child problematic behavior. In addition, sibling positivity was significantly related to child prosocial behavior. The results suggest that parents in a two-child family should provide guidance for their children’s sibling relationship, and, in particular, increase the children’s positive interaction to improve their mental health.

Changes in maternal age and its influences on maternal and neonatal complications under the two-child policy

Objective To explore the changes in gravida's age and its influences on maternal and neonatal complications under China's two-child policy. Methods This study retrospectively analyzed the clinical data such as adverse gestational complications and fetal condition of 42 771 gravidas delivering at Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University from July 2013 to December 2017. According to their age at delivery, they were divided into three groups: the younger maternal age group (1 140 cases, <20 years), the advanced maternal age group (4 307 cases, ≥35 years) and the median maternal age group (37 324 cases, ≥20 and <35 years). Chi-square test was used to compare the differences among groups. Cochran-Armitage test was used for trend analysis. The risks of various complications in younger and advanced maternal age groups were analyzed by binary logistic regression analysis. Results (1) The proportion of advanced maternal age pregnancies tended to rise gradually year by year (Z=-9.909, P<0.001). However, the figure of younger gravidas remained low and presented a downward trend (Z=10.685, P<0.001). (2) The incidence of pregnant complications in the younger, advanced and the median maternal age groups were 52.8% (602/1 140), 72.3% (3 116/4 307) and 56.5% (21 091/37 324), respectively. Compared with the median maternal age group, the advanced maternal age group was at greater risks of premature delivery [9.0% (3 343/37 324) vs 11.6% (499/4 307), χ2=124.233, P<0.001], fetal growth restriction (FGR) [0.6% (218/37 324) vs 1.2% (50/4 307), χ2=20.087, P<0.001], postpartum hemorrhage [5.7% (2 120/37 324) vs 7.8% (336/4 307), χ2=31.299, P<0.05], hypertensive disorders in pregnancy(HDP) [4.2% (1 561/37 324) vs 8.7% (376/4 307), χ2=180.013, P<0.001], gestational diabetes mellitus (GDM) [7.6% (2 845/37 324) vs 15.1% (650/4 307), χ2=280.126, P<0.001] and placenta previa [1.7% (621/37 324) vs 3.8% (165/4 307), χ2=97.904, P<0.001], and the younger maternal age group was at greater risks of HDP [4.2% (1 561/37 324) vs 5.9% (67/1 140), χ2=4.234, P=0.040], fetal distress [3.5% (1 325/37 324) vs 5.1% (58/1 140), χ2=7.546, P=0.006], premature delivery [9.0% (3 343/37 324) vs 15.0% (171/1 140), χ2=48.668, P<0.001] and FGR [0.6% (218/37 324) vs 1.1% (12/1 140), χ2=4.086, P=0.043]. (3) Gestational complications in the younger maternal age group were mainly related to the fetuses such as premature rupture of membranes (PROM) and premature delivery, while the advanced maternal age group had a higher incidence of maternal complications, especially GDM and HDP. (4) Most of the gravidas of advanced maternal age with HDP developed severe preeclampsia (47.9%, 180/376), while mild preeclampsia was dominant in the median maternal aged HDP women (45.4%, 708/1 561). (5) The advanced maternal age group had higher risk of stillbirth, premature delivery, FGR, placenta previa, GDM, HDP and postpartum hemorrhage [OR(95%CI): 1.91 (1.29-2.84), 1.33 (1.21-1.46), 1.66 (1.21-2.28), 2.56 (2.15-3.04), 2.39 (2.19-2.61), 2.36 (2.11-2.65), 1.46 (1.31-1.62); all P<0.05], but lower risks of fetal distress and PROM [OR(95%CI): 0.79 (0.65-0.95) and 0.88 (0.81-0.96); both P<0.05]. The younger maternal age group had a higher risk of premature delivery [OR(95%CI): 1.97 (1.61-2.40); P<0.001], but significant lower risks of PROM and GDM [OR(95%CI): 0.77 (0.62-0.95) and 0.05 (0.02-0.16); both P<0.05]. Conclusions Maternal age is closely related to the adverse outcomes of pregnancy. Two-child policy in China will bring about changes in maternal age and composition of pregnant complications. Key words: Pregnancy; Age factors; Pregnancy outcome

Effects of two-child policy on cesarean section rate in China: analysis under Robson Ten-Group Classification

Objective To investigate the changes in cesarean section rate(CSR) after the announcement of universal two-child policy using the Robson Ten-Group Classification. Methods A retrospective study was conducted to analyze 9 734 deliveries in the First Affiliated Hospital of Soochow University from January 2013 to August 2016. All deliveries were classified by the Robson Ten-Group Classification System and divided into three subgroups including phase 1(delivered between January 2013 and November 2013, the period before the selective two-child policy was implemented), phase 3( delivered between October 2015 and August 2016, the period after the universal two-child policy was implemented) and phase 2 (delivered between December 2013 and September 2015, the transition period from selective two-child policy to the universal two-child policy). Changes in CSR were analyzed by Chi-square test and Logistic regression. Results The cesarean section deliveries in Group 2b (singleton, cephalic presentation, primipara, ≥37 gestational weeks, cesarean section before labor) and group 5 (singleton, cephalic presentation, multipara with at least one cesarean section history, ≥37 gestational weeks) accounted for 52.78% (2 062/3 907) of the total cesarean section deliveries. The overall CSR decreased in phase 3 than in phase 1 [34.29% (654/1 907) vs 43.71% (1 112/2 544), χ2=40.376, P=0.000], and the most remarkable decline was found in group 2b [5.35% (102/1 907) vs 14.27% (363/2 544), χ2=92.700, P=0.000]. Compared with phase 1, in all deliveries, the constituent ratio of deliveries of groups 1 and 2 (singleton, cephalic presentation, primipara, ≥37 gestational weeks) was decreased in phase 3 [50.24% (958/1 907) vs 60.34% (1 535/2 544), χ2=45.145, P=0.000], while that in groups 3 and 4 (singleton, cephalic presentation, multipara, ≥37 gestational weeks, no cesarean section history) [21.66% (413/1 907) vs 16.71% (425/2 544), χ2=17.483, P=0.000] as well as in group 5 [14.47% (276/1 907) vs 9.28% (236/2 544), χ2=28.910, P=0.000] were increased. In group 5, the rate of vaginal birth after cesarean in phase 3 was higher than that in phase 1 [17.39% (48/276) vs 2.54% (6/236), χ2=29.732, P=0.000]. Conclusions The proportion of multiparae significantly increases, while the overall CSR significantly decreases after the implementation of universal two-child policy in China. Gravidas in groups 2b (singleton, cephalic presentation, primipara, ≥37 gestational weeks, cesarean section before labor) and 5 (singelon, cephalic presentation, multipara with at least one cesarean section history, ≥37 gestational weeks) are the most important target population in attempting to reduce CSR in China. Key words: Cesarean section; Logistic models; Population surveillance

Repeat abortion and determinants of Chinese women: A systematic review and meta-analysis

Background Repeat abortion is a public health problem globally and has adverse impacts on women's reproductive health. Risk factors associated with repeat abortion have been well-established in many studies; however, studies documenting the prevalence of repeat abortions and associated risk factors in China are hard to access, due to the language barrier, as they are mostly published in Chinese. Meanwhile, the two-child policy in China may increase the risk of repeat abortions among women in China, hence, the need to review and document existing evidence on repeat abortions in China. Methods For this systematic review, we searched through six electronic databases, including PubMed, EMBASE, Cochrane Library, China Academic Journal Network Publishing Database, China Science Period Database, and China Biology Medicine disc. The focus of the review was on original studies, with no restrictions on language or publication date. The last search was run on May 5, 2017. The studies, which presented data on repeat abortion and related risk factors of women in mainland China were selected for the review. Two reviewers reviewed all the articles and extracted relevant data from the selected full-text studies. Meta-analyses were performed using RevMan 5.3 and the odds ratios with 95% confidence intervals were calculated in fixed or random effects models based on the results of the Q test. The publication bias was quantitatively evaluated by Egger's linear regression analysis using Stata 13.0. A narrative approach was used to analyze exposures; for which a meta-analysis was not possible. We used descriptive statistics to assess whether the percentage of repeat abortion varied significantly among women in different groups of each exposure. Results Of 3015 records initially identified, 29 studies met our inclusion criteria, representing 36,879 individuals from China. Of 36,879 individuals in 28 cross-sectional studies, 43.0% (15854) had a repeat abortion. Of 48 exposures identified, 25 were significantly associated with repeat abortions of Chinese women. Meta-analyses indicated that women who were older (≥ 20 years, OR: 2.08, 95% CI: 1.72–2.50), multiparous (≥ 1 child, 4.99, 2.18–11.43), migrant (1.62, 1.34–1.96), unemployed (2.20, 1.65–2.93), tobacco/alcohol users (2.35, 1.66–3.32), with early sexual debut ( Conclusions Chinese women with a repeat abortion account for a large percentage of the total sample of women in the included studies. Despite significant heterogeneity of some risk factors, there is evidence that repeat abortions of women are associated with individual, sexual-partner's, and parental risk factors. More targeted strategies should be developed to reduce the high-risks of repeat abortions of women.

Placenta accreta spectrum disorder trends in the context of the universal two-child policy in China and the risk of hysterectomy.

To identify both the trends in placenta accreta spectrum (PAS) disorders in the context of the universal two-child policy in China and risk factors for hysterectomy. The present retrospective analysis included confirmed PAS disorders during cesarean delivery at a tertiary hospital in Changsha, Hunan, China, from January 1, 2007, to December 31, 2016. Multivariable logistic regression was used to estimate the risk of hysterectomy. During the 10-year study period, the overall incidence of cesarean delivery was 51.6% (13530/26214) and that of PAS disorders was 1.2% (302/26214). The PAS rate increased from 0.1% (5/4617) in 2007-2008 to 2.1% (133/6351) in 2015-2016, alongside a rise in elective repeat cesarean delivery from 5.0% (106/2124) to 38.4% (1385/3603). Previous cesarean delivery greatly increased the likelihood of PAS disorders (odds ratio [OR] 97.4; P<0.001). Invasive depth (OR 92.0; P<0.001), inter-cesarean interval less than 36months (OR 7.0; P=0.002), rural residence (OR 5.3; P=0.018), and advanced maternal age (OR 3.0; P=0.045) were independent risk factors for hysterectomy among women with PAS disorders. The increasing incidence of elective repeat cesarean delivery combined with a high overall rate of cesarean delivery implies a high prevalence of PAS disorders within the context of the universal two-child policy in China. The main predictor of hysterectomy was invasive depth.

New medical risks affecting obstetrics after implementation of the two-child policy in China.

China recently instituted a two-child policy in response to its aging population, declining workforce and demographic dividend, and the need to develop asocial economy. Additionally, women generally delay having a second child because of the overwhelming pressure in their lives. With the improvements in assisted fertility technologies in recent years, the number of elderly women attempting to bear children has increased. The quality of woman's eggs and a man's sperm declined dramatically with increasing age, leading to an increased risk of pregnancy-related complications among older women. Therefore, the types of fertility problems experienced by elderly females must be provided with considerable attention by obstetricians. This commentary article focuses on the medical problems faced by older second-child pregnant women. This work discusses their increased rates of infertility, spontaneous abortion, fetal malformation, gestational diabetes, cesarean section, placenta previa, postpartum hemorrhage, postpartum depression, and hypertensive disorders, which complicate pregnancy.

Cumulative live-birth rate with repeat in vitro fertilization treatment cycles of chinese advanced age women

With introduction of the universal two-child policy in China, increasing number of advanced age women seek helps from reproductive medical centers.However,most of them have to receive repeat treatments to achieve pregnancy because of low live-birth rate(LBR) in single cycle. The aim of the study is to determine the extent to which repeat cycles continue to increase the likelihood of a live-birth in advanced age women. China needs their own data to estimate the effectiveness of ART treatment and guide clinical decision-making. Prospective study. We linked data from the database of Reproductive Centre of the First Affiliated Hospital of Sun Yet-sen University. Female aged≥35 years old and had their first IVF/ICSI cycle between 2009 to 2015 were included and followed until Dec 2016. A cycle is defined as an episode of ovarian stimulation and all subsequent fresh and frozen embryo transfers. LBR per cycle and cumulative live-birth rates(CLBR) across all cycles in each age subgroup were analyzed. Opitmal and conservative CLBR were estimated assuming that women who discontinued IVF treatments would have live-birth rate similar to those continuing treatments(opitmal) or would have a live-birth rate of zero(conservative). A total of 3486 patients who received 5050 ovarian stimulation cycles were enrolled. In all women the LBR for the first cycle was 32.1% (95%CI:30.6, 33.7). The CLBR continued to increase up to the fourth, with 48.5%(47.2,49.9)of women achieving a live birth by the fourth cycle. For women aged 35-37, the LBR for the first cycle was41.0% ((95%CI:38.8, 43.2), which continued to increase up to the fourth achieving an optimal and conservative estimated CLBR of 71.1% (68.1, 74.2) and 52.1%(50.1,54.1).For women age 38-39,the first cycle LBR dropped to 29.6(95%CI:26.4,32.8), with four cycles achieving an optimal and conservative estimated CLBR of 54.6% (51.6,57.6) and 39.0%(36.1, 41.9).LBR in age 40-42 subgroup further declined to 16.0% (95%CI:13.1, 19.0) in the first cycle. Four cycles achieved CLBR of 34.7% (32.1, 37.2) and 23.8% (21.1, 26.5) respectively. For women older than 42 years old, all rates within each cycle were less than 4% and there was no upward trend in consecutive cycles. The CLBR after four cycles were 48.5% in advanced age women, with significant variations by age. Women younger than 42 years old would achieve increasing LBR after repeated treatments beyond three to four cycles. However,the prognosis for women older than 42 is disappointing despite of repeated attempts. Data of our research can be used as reference for ART counseling of Chinese advanced age women.

Web Topic Analysis of the Two-child Policy in China

Since the Two-child Policy was enacted by The Chinese government in October 2015, two children in a family have become an important question related to people's livelihood and have triggered a wide discussion. As an important platform to discuss and monitor public opinion changes, Sina Weibo plays an important role in public opinion analysis. This paper chooses two-child policy as search topic to crawl 19751 related microblogs in Sina Weibo, uses topic over time (TOT) model of the microblogs to make topic analysis, to extract what people focus on the Internet. The results of analysis show that most people cause extensive concern of the country's follow-up policy, including economy, education and other aspects of the follow-up policy.

중국 단독 두 자녀 정책의 출범 배경과그에 따른 법률문제에 관한 연구

In 2013, selective two-child policy was finally concerned in China. The selective two-child policy in China fundamentally changed the orientation and trend of the one-child and “one child”family planning policy, it is the turning point of China's Family Planning Policy. One-child policy has been i...