Department of Medicine, Taixing People Hospital, Taizhou, Jiangsu, China.
Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
Sci Rep. 2022 Mar 23;12(1):5048. doi: 10.1038/s41598-022-08396-6.
The universal two-child policy (TCP; 2016) in China has affected many aspects of maternal-neonatal health. A tertiary hospital-based retrospective study (2011-2019) was used to find the association of these policy changes with maternal age and pregnancy outcomes in women with AMA (≥ 35 years) in the Hubei Province, China. The proportion of neonatal births to women with AMA increased by 68.8% from 12.5% in the one-child policy (OCP) period to 21.1% in the universal TCP period [aOR 1.76 (95% CI: 1.60, 1.93)]. In the univariate analysis, the proportion of preterm births (29.4% to 24.1%), low birth weight (LBW) (20.9% to 15.9%), and hypertensive disorders of pregnancy (HDP) (11.5% to 9.2%) significantly (p < 0.05) decreased in women with AMA from the OCP period to universal TCP period. However, the proportion of intrauterine growth restriction (IUGR) (0.2% to 0.7%) and gestational diabetes mellitus (GDM) (1.7% to 15.6%) was significantly (p < 0.05) increased over the policy changes. After adjusting for confounding factors, only the risk of GDM increased [aOR 10.91 (95% CI: 6.05, 19.67)] in women with AMA from the OCP period to the universal TCP period. In conclusion, the risk of GDM increased in women with AMA from the OCP period to the universal TCP period.
中国的普遍二孩政策（2016 年）已经影响到母婴健康的许多方面。本研究采用基于三级医院的回顾性研究（2011-2019 年），以调查这些政策变化与中国湖北省高龄产妇（≥35 岁）的母亲年龄和妊娠结局之间的关系。与一孩政策（OCP）时期相比，高龄产妇的新生儿出生率从 12.5%增加到普遍二孩政策时期的 21.1%[优势比（OR）1.76（95%置信区间（CI）：1.60，1.93)]。在单因素分析中，与 OCP 时期相比，高龄产妇的早产（29.4%降至 24.1%）、低出生体重（LBW）（20.9%降至 15.9%）和妊娠高血压疾病（HDP）（11.5%降至 9.2%）的比例显著下降（p<0.05）。然而，宫内生长受限（IUGR）（0.2%升至 0.7%）和妊娠期糖尿病（GDM）（1.7%升至 15.6%）的比例在政策变化后显著上升（p<0.05）。调整混杂因素后，仅 OCP 时期到普遍二孩政策时期，高龄产妇患 GDM 的风险增加[aOR 10.91（95%CI：6.05，19.67)]。综上所述，与 OCP 时期相比，普遍二孩政策时期，高龄产妇患 GDM 的风险增加。
