The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis
Abstract Background Although years have passed since the implementation of China’s universal two-child policy, the effectiveness of this policy remains unclear. To address this knowledge gap, we, here, assessed the impact of the two-child policy on total live births, preterm births, and multiple liv...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17620-5 |
| _version_ | 1827377095818346496 |
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| author | Yuehang Geng Lin Zhuo Rui Zhang Houyu Zhao Xinlin Hou Hu Chen Lili Liu |
| author_facet | Yuehang Geng Lin Zhuo Rui Zhang Houyu Zhao Xinlin Hou Hu Chen Lili Liu |
| author_sort | Yuehang Geng |
| collection | DOAJ |
| description | Abstract Background Although years have passed since the implementation of China’s universal two-child policy, the effectiveness of this policy remains unclear. To address this knowledge gap, we, here, assessed the impact of the two-child policy on total live births, preterm births, and multiple live births. Methods Data identifying pregnancies resulting in at least one live birth between April 1 2013 and December 31 2018 were collected from the Hospital Quality Monitoring System database. Using an interrupted time-series analysis, we estimated immediate level changes and long-term trends in total, preterm (birth before 37 weeks’ gestation), and multiple live births that had occurred after July 2016, when the universal two-child policy had taken effect. Results A total of 8,273,622 live births were reported during the study time frame. The number of live births (p = 0.277), preterm births (p = 0.052), and multiple births (p = 0.856) per month slightly increased immediately after July 2016, but these increases did not meet statistical significance. Further, all three outcomes showed a significant downward trend that lasted until the end of 2018 (p < 0.0001 for all). Among all live births, the percentage of preterm births remained stable (p = 0.101), while the percentage of multiple live births that were preterm significantly increased (trend change = 0.21% per month, 95% CI 0.14 to 0.28, p < 0.0001). The percentage of live multiple births among all live births significantly decreased (p for trend = 0.0039). Conclusions Overall, our data reveal a transient baby boom, as well as an increase in the proportion of live multiple births that were preterm, after China’s two-child policy took effect. The latter should be noted by healthcare professionals due to the high risk of complications and special medical care required by preterm babies. |
| first_indexed | 2024-03-08T12:33:57Z |
| format | Article |
| id | doaj.art-eafbb6a9fc1741d19a4421a6631553e5 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T12:33:57Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-eafbb6a9fc1741d19a4421a6631553e52024-01-21T12:38:37ZengBMCBMC Public Health1471-24582024-01-012411710.1186/s12889-023-17620-5The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysisYuehang Geng0Lin Zhuo1Rui Zhang2Houyu Zhao3Xinlin Hou4Hu Chen5Lili Liu6Department of Pediatrics, Peking University First HospitalResearch Center of Clinical Epidemiology, Peking University Third HospitalDepartment of Pediatrics, Peking University First HospitalDepartment of Epidemiology and Biostatistics, School of Public Health, Peking UniversityDepartment of Pediatrics, Peking University First HospitalCenter for Medical Administration, National Health Commission of the People’s Republic of ChinaDepartment of Pediatrics, Peking University First HospitalAbstract Background Although years have passed since the implementation of China’s universal two-child policy, the effectiveness of this policy remains unclear. To address this knowledge gap, we, here, assessed the impact of the two-child policy on total live births, preterm births, and multiple live births. Methods Data identifying pregnancies resulting in at least one live birth between April 1 2013 and December 31 2018 were collected from the Hospital Quality Monitoring System database. Using an interrupted time-series analysis, we estimated immediate level changes and long-term trends in total, preterm (birth before 37 weeks’ gestation), and multiple live births that had occurred after July 2016, when the universal two-child policy had taken effect. Results A total of 8,273,622 live births were reported during the study time frame. The number of live births (p = 0.277), preterm births (p = 0.052), and multiple births (p = 0.856) per month slightly increased immediately after July 2016, but these increases did not meet statistical significance. Further, all three outcomes showed a significant downward trend that lasted until the end of 2018 (p < 0.0001 for all). Among all live births, the percentage of preterm births remained stable (p = 0.101), while the percentage of multiple live births that were preterm significantly increased (trend change = 0.21% per month, 95% CI 0.14 to 0.28, p < 0.0001). The percentage of live multiple births among all live births significantly decreased (p for trend = 0.0039). Conclusions Overall, our data reveal a transient baby boom, as well as an increase in the proportion of live multiple births that were preterm, after China’s two-child policy took effect. The latter should be noted by healthcare professionals due to the high risk of complications and special medical care required by preterm babies.https://doi.org/10.1186/s12889-023-17620-5China’s two-child policyPreterm birthMultiple birthsInterrupted time-series analysis |
| spellingShingle | Yuehang Geng Lin Zhuo Rui Zhang Houyu Zhao Xinlin Hou Hu Chen Lili Liu The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis BMC Public Health China’s two-child policy Preterm birth Multiple births Interrupted time-series analysis |
| title | The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis |
| title_full | The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis |
| title_fullStr | The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis |
| title_full_unstemmed | The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis |
| title_short | The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis |
| title_sort | impact of china s universal two child policy on total preterm and multiple births a nationwide interrupted time series analysis |
| topic | China’s two-child policy Preterm birth Multiple births Interrupted time-series analysis |
| url | https://doi.org/10.1186/s12889-023-17620-5 |
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