Association of China's two-child policy with changes in number of births and birth defects rate, 2008-2017

• Published in: BMC public health Vol. 22; no. 1; p. 434
• Main Authors: Chen, Hanyi, Wei, Ting, Wang, Haiyin, Zhou, Yi, Chen, Hua, Sun, Lianghong, Xiao, Shaotan, Ma, Wuren, Zhao, Huijuan, Chen, Guanghua, Liang, Xinlei, Zhang, Donglan, Zheng, Weiwei, Zhou, Yixin, Yu, Zhangsheng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.03.2022; BioMed Central; BMC
• Subjects: Analysis; Birth defects; Birth outcomes; Birth Rate; Care and treatment; China - epidemiology; Diagnosis; Difference-in-difference model; Family Planning Policy; Female; Humans; Infant; Infant, Newborn; Male; Medical records; Number of births; Policy; Pregnancy; Premature Birth - epidemiology; Risk factors; Two-child policy; China; Birth defects; Birth outcomes; Two-child policy; Number of births; Difference-in-difference model
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-022-12839-0

In October 2015, China's one-child policy was universally replaced by a so-called two-child policy. This study investigated the association between the enactment of the new policy and changes in the number of births, and health-related birth outcomes. We used difference-in-difference model to analyse the birth record data in Pudong New Area, Shanghai.The design is descriptive before-and-after comparative study. The data covered three policy periods: the one-child policy period (January 2008 to November 2014); the partial two-child policy period (December 2014 to June 2016); the universal two-child policy period (July 2016 to December 2017). There was an estimate of 7656 additional births during the 18 months of the implementation of the universal two-child policy. The trend of monthly percentage of births to mothers aged ≥35 increased by 0.24 percentage points (95% confidence interval 0.19 to 0.28, p < 0.001) during the same period. Being a baby boy, preterm birth, low birth weight, parents with lower educational attainment, and assisted delivery were associated with a higher risk of birth defects. The universal two-child policy was associated with an increase in the number of births and maternal age. Preterm birth, low birth weight, and assisted delivery were associated with a higher risk of birth defects, which suggested that these infants needed additional attention in the future.