Distribution of demographic sociological characteristics and co-morbidities among primiparous and multiparous pregnant women: a national cross-sectional study of 24 hospitals in 16 provinces_Chinese Journal of Evidence-Based Medicine

Authors：

QI Yana ¹ , TAN Jing ¹ , SUN Xin ¹ , HE Guolin ² , YANG Hongmei ² ,  LIU Xinghui ² , GAO Yan ³ , LIU Xiuli ⁴ , ZHOU Wei ⁵ , HE Jing ⁶ , CHEN Lu ⁶ , ZHANG Xueqin ⁷ , ZHANG Hongping ⁸ , WANG Yun ⁹ , XU Xiufen ⁹ , ZOU Li ¹⁰ , XIAO Mei ¹¹ , PENG Min ¹¹ , ZHAO Xianlan ¹² , ZHOU Yan ¹² , TANG Hui ¹³ , CAO Yinli ¹⁴ , YUAN Ningxia ¹⁵ , LI Hongmei ¹⁶ , DING Guifeng ¹⁷ , PENG Yan ¹⁷ , LIU Caixia ¹⁸ , QIAO Chong ¹⁸ , ZHAN Fang ¹⁹ , YIN Chunxia ²⁰ , CAI Yan ²¹ , FAN Ling ²² , LI Jieyan ²² , CHEN Xu ²³ , ZHANG Guohua ²⁴ , ZHANG Jiewen ²⁵

1. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. West China Second University Hospital, Sichuan University/West China Women’s and Children’s Hospital, Chengdu, 610041, P.R.China;
3. Sichuan Provincial Hospital for Women and Children, Chengdu, 610045, P.R.China;
4. Panzhihua Central Hospital, Panzhihua, 617000, P.R.China;
5. Chongqing Health Center for Women and Children, Chongqing, 400010, P.R.China;
6. Women’s Hospital School of Medicine, Zhejiang University, Hangzhou, 310006, P.R.China;
7. Xiamen Medical Center for Women and Children, Xiamen, 361003, P.R.China;
8. Wenzhou People's Hospital, Wenzhou, 325000, P.R.China;
9. Suzhou Second People's Hospital/ Suzhou Municipal Hospital, Suzhou, 215002, P.R.China;
10. Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P.R.China;
11. Maternal and Child Health Hospital of Hubei Province, Wuhan, 430070, P.R.China;
12. The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, P.R.China;
13. The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, P.R.China;
14. Shanxi Provincial Hospital for Women and Children/ Northwest Women’s and Children’s Hospital, Xi'an, 710000, P.R.China;
15. The Second Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, Xianyang, 712000, P.R.China;
16. Yan'an University Affiliated Hospital, Yan’an, 716000, P.R.China;
17. Maternal and Child Health Hospital of Urumchi, Xinjiang, Urumchi, 830000, P.R.China;
18. Shengjing Hospital of China Medical University, Shenyang, 110004, P.R.China;
19. Maternal and Child Health Hospital of Dalian, Dalian, 116000, P.R.China;
20. Changchun Obstetrics-Gynecology Hospital, Changchun, 130042, P.R.China;
21. The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, P.R.China;
22. Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100006, P.R.China;
23. Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, 300100, P.R.China;
24. The Fourth Hospital of Shijiazhuang/Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang, 050011, P.R.China;
25. Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, P.R.China;

Corresponding author：

LIU Xinghui, Email: xinghuiliu@163.com

Keywords：

Primiparous; Multiparous; Parity; Pregnant co-morbidity; Multicenter survey; Cross-sectional study

DOI：

10.7507/1672-2531.201906042

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Objective To understand the distribution of demographic sociological characteristics and co-morbidities among primiparous and multiparous pregnant women under the China's universal two-child policy, to provide baseline data for clinical high-risk management and medical resources allocation.Methods We included pregnant women from 24 hospitals in 16 provinces (municipality, autonomous region) of China and collected their demographic sociological characteristics and obstetrics information by questionnaires between September 19^th, and November 20^th, 2016. Then, we used descriptive analysis to present the distribution of demographic sociological characteristics and pregnancy co-morbidities among primiparous and multiparous women and compared differences between groups by t test or Chi-square test.Results Among 12 403 investigated pregnant women, 8 268 (66.7%) were primiparous and 4 135 (33.3%) were multiparous, with highest proportion in East (931/2 008, 46.4%) and lowest in Northeast (385/2 179, 17.7%). Multiparous women, comparing to primiparous women, were more likely to be elderly than 35 years (accounting for 30.6% vs. 6.5%), lower educated with high school or below (29.7% vs. 16.9%), occupied in physical labor or unemployed (49.2% vs. 42.5%), non-local residents (12.7% vs. 10.5%), family annual income higher than 120 thousand yuan (41.3% vs. 33.3%), pre-pregnancy body mass index≥24 kg/m² (13.6% vs. 9.9%), history of artificial abortions (44.9% vs. 24.0%), or pregnancies≥4 times (23.8% vs. 3.1%) and were less likely to receive assisted reproductive technology (2.3% vs. 4.7%). The most common co-morbidities were gynecology disease (5.5%), thyroid disease (5.4% in all women), blood system disease (5.0%), digestive system disease (4.2%) and hepatitis B infection (2.5%). Multiparous women, comparing to primiparous women, had higher proportions with blood system disease (5.7% vs. 4.7%), hepatitis B infection (3.1% vs. 2.2%) and chronic hypertension (0.6% vs. 0.2%), but lower proportions with thyroid diseases, polycystic ovary syndrome, and immune system diseases, whose distribution also showed regional differences.Conclusion There existed distribution differences regarding demographic sociological characteristics and co-morbidities proportions between primiparous and multiparous women. Therefore, we should improve clinical risk management and medical resources allocation based on pregnant women’s baseline and gestational characteristics.

Citation： QI Yana, TAN Jing, SUN Xin, HE Guolin, YANG Hongmei, LIU Xinghui, GAO Yan, LIU Xiuli, ZHOU Wei, HE Jing, CHEN Lu, ZHANG Xueqin, ZHANG Hongping, WANG Yun, XU Xiufen, ZOU Li, XIAO Mei, PENG Min, ZHAO Xianlan, ZHOU Yan, TANG Hui, CAO Yinli, YUAN Ningxia, LI Hongmei, DING Guifeng, PENG Yan, LIU Caixia, QIAO Chong, ZHAN Fang, YIN Chunxia, CAI Yan, FAN Ling, LI Jieyan, CHEN Xu, ZHANG Guohua, ZHANG Jiewen. Distribution of demographic sociological characteristics and co-morbidities among primiparous and multiparous pregnant women: a national cross-sectional study of 24 hospitals in 16 provinces. Chinese Journal of Evidence-Based Medicine, 2020, 20(2): 134-143. doi: 10.7507/1672-2531.201906042 Copy

1.	Li HT, Xue M, Hellerstein S, et al. Association of China's universal two child policy with changes in births and birth related health factors: national, descriptive comparative study. BMJ, 2019, 366: l4680.
2.	Zeng Y, Hesketh T. The effects of China's universal two-child policy. Lancet, 2016, 388(10054): 1930-1938.
3.	康楚云, 高燕秋, 宋莉, 等. 生育政策调整对助产医院分娩量及产妇构成的影响. 人口研究, 2015, 39(6): 85-93.
4.	李鹏程, 廖紫珺, 王称, 等. 不同生育政策时期产妇特征及妊娠结局相关指标变化情况分析. 中国生育健康杂志, 2017, 28(6): 501-505.
5.	胡美娜, 邹晓璇, 赵银珠, 等. 生育政策调整后医院经产妇生育特征及妊娠结局分析. 中国计划生育学杂志, 2018, 26(7): 555-558.
6.	劳力, 何小文, 叶宁. 佛山市禅城区4545例经产妇妊娠及分娩情况分析. 中国妇幼卫生杂志, 2017, 8(1): 71-74.
7.	Kurabayashi T, Mizunuma H, Kubota T, et al. Pregnancy-induced hypertension is associated with maternal history and a risk of cardiovascular disease in later life: Japanese cross-sectional study. Maturitas, 2013, 75(3): 227-231.
8.	徐志芳, 杨昱, 陈丽莉, 等. 妊娠期糖尿病发病机制及其对母婴的影响. 中国临床医生杂志, 2015, 43(8): 26-29.
9.	范晓东, 王如, 常闻艳. 妊娠晚期缺铁性贫血对妊娠结局的影响. 国际妇产科学杂志, 2014, 41(3): 274-276.
10.	何国琳, 孙鑫, 谭婧, 等. 中国部分城市妊娠期铁缺乏和缺铁性贫血患病率的调查. 中华妇产科杂志, 2018, 53(11): 761-767.
11.	Tan J, Qi YN, He GL, et al. Association between maternal weight indicators and iron deficiency anemia during pregnancy: a cohort study. Chin Med J (Engl), 2018, 131(21): 2566-2574.
12.	Barrows SP. China's one-child policy. JAMA, 2016, 315(21): 2349-2350.
13.	Hesketh T, Lu L, Xing ZW. The effect of China's one-child family policy after 25 years. N Engl J Med, 2005, 353(11): 1171-1176.
14.	李传松, 梁粟. 济南市部分地区已育女性二孩生育意愿影响因素调查. 中国计划生育学杂志, 2019, 27(4): 422-427.
15.	卢纯玲, 邓东, 周健美. 某三级甲等医院适龄女职工二胎生育意愿及其影响因素分析. 中国社会医学杂志, 2018, 35(6): 593-595.
16.	倪骎骎. 经产妇孕期保健意识及需求的调查. 中华全科医学, 2017, 15(3): 466-467, 544.
17.	Demétrio F, Teles-Santos CAS, Santos DBD. Food insecurity, prenatal care and other anemia determinants in pregnant women from the NISAMI cohort, Brazil: hierarchical model concept. Rev Bras Ginecol Obstet, 2017, 39(8): 384-396.
18.	Looker AC, Dallman PR, Carroll MD, et al. Prevalence of iron deficiency in the United States. JAMA, 1997, 277(12): 973-976.
19.	邓润泽. 成渝两地社区居民乙肝、丙肝知信行的流行病学调查. 重庆: 重庆医科大学, 2017.
20.	徐文华, 刘晋, 陆艳, 等. 江苏省高血压患病率、知晓率、治疗率和控制率现状调查. 实用心电学杂志, 2018, 27(5): 310-316.
21.	刘秀秀. 产次与高血压、糖尿病之间的相关性研究. 苏州: 苏州大学, 2017.
22.	阳剑, 李攀. 女性不孕不育与自身免疫性甲状腺疾病的相关性研究. 中国继续医学教育, 2017, 9(26): 76-78.
23.	Lua ACY, How CH, King TFJ. Managing polycystic ovary syndrome in primary care. Singapore Med J, 2018, 59(11): 567-571.

1. Li HT, Xue M, Hellerstein S, et al. Association of China's universal two child policy with changes in births and birth related health factors: national, descriptive comparative study. BMJ, 2019, 366: l4680.
2. Zeng Y, Hesketh T. The effects of China's universal two-child policy. Lancet, 2016, 388(10054): 1930-1938.
3. 康楚云, 高燕秋, 宋莉, 等. 生育政策调整对助产医院分娩量及产妇构成的影响. 人口研究, 2015, 39(6): 85-93.
4. 李鹏程, 廖紫珺, 王称, 等. 不同生育政策时期产妇特征及妊娠结局相关指标变化情况分析. 中国生育健康杂志, 2017, 28(6): 501-505.
5. 胡美娜, 邹晓璇, 赵银珠, 等. 生育政策调整后医院经产妇生育特征及妊娠结局分析. 中国计划生育学杂志, 2018, 26(7): 555-558.
6. 劳力, 何小文, 叶宁. 佛山市禅城区4545例经产妇妊娠及分娩情况分析. 中国妇幼卫生杂志, 2017, 8(1): 71-74.
7. Kurabayashi T, Mizunuma H, Kubota T, et al. Pregnancy-induced hypertension is associated with maternal history and a risk of cardiovascular disease in later life: Japanese cross-sectional study. Maturitas, 2013, 75(3): 227-231.
8. 徐志芳, 杨昱, 陈丽莉, 等. 妊娠期糖尿病发病机制及其对母婴的影响. 中国临床医生杂志, 2015, 43(8): 26-29.
9. 范晓东, 王如, 常闻艳. 妊娠晚期缺铁性贫血对妊娠结局的影响. 国际妇产科学杂志, 2014, 41(3): 274-276.
10. 何国琳, 孙鑫, 谭婧, 等. 中国部分城市妊娠期铁缺乏和缺铁性贫血患病率的调查. 中华妇产科杂志, 2018, 53(11): 761-767.
11. Tan J, Qi YN, He GL, et al. Association between maternal weight indicators and iron deficiency anemia during pregnancy: a cohort study. Chin Med J (Engl), 2018, 131(21): 2566-2574.
12. Barrows SP. China's one-child policy. JAMA, 2016, 315(21): 2349-2350.
13. Hesketh T, Lu L, Xing ZW. The effect of China's one-child family policy after 25 years. N Engl J Med, 2005, 353(11): 1171-1176.
14. 李传松, 梁粟. 济南市部分地区已育女性二孩生育意愿影响因素调查. 中国计划生育学杂志, 2019, 27(4): 422-427.
15. 卢纯玲, 邓东, 周健美. 某三级甲等医院适龄女职工二胎生育意愿及其影响因素分析. 中国社会医学杂志, 2018, 35(6): 593-595.
16. 倪骎骎. 经产妇孕期保健意识及需求的调查. 中华全科医学, 2017, 15(3): 466-467, 544.
17. Demétrio F, Teles-Santos CAS, Santos DBD. Food insecurity, prenatal care and other anemia determinants in pregnant women from the NISAMI cohort, Brazil: hierarchical model concept. Rev Bras Ginecol Obstet, 2017, 39(8): 384-396.
18. Looker AC, Dallman PR, Carroll MD, et al. Prevalence of iron deficiency in the United States. JAMA, 1997, 277(12): 973-976.
19. 邓润泽. 成渝两地社区居民乙肝、丙肝知信行的流行病学调查. 重庆: 重庆医科大学, 2017.
20. 徐文华, 刘晋, 陆艳, 等. 江苏省高血压患病率、知晓率、治疗率和控制率现状调查. 实用心电学杂志, 2018, 27(5): 310-316.
21. 刘秀秀. 产次与高血压、糖尿病之间的相关性研究. 苏州: 苏州大学, 2017.
22. 阳剑, 李攀. 女性不孕不育与自身免疫性甲状腺疾病的相关性研究. 中国继续医学教育, 2017, 9(26): 76-78.
23. Lua ACY, How CH, King TFJ. Managing polycystic ovary syndrome in primary care. Singapore Med J, 2018, 59(11): 567-571.

Chinese Journal of Evidence-Based Medicine

Distribution of demographic sociological characteristics and co-morbidities among primiparous and multiparous pregnant women: a national cross-sectional study of 24 hospitals in 16 provinces

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