Investigation Of The Status Of Maternal Reproduction In Tianjin Under "Two-child" Policy

Objective:Under the "Two-Child" policy,the increase in the number of reproductive mothers and the change in the age composition ratio make comprehensive and multi-dimensional reproductive management imperative.By understanding the current state of reproduction in Tianjin,this study aims to improve women’s perinatal health and to ensure the safety and health of mothers and infants.Method:Comprehensively evaluate the hospitals in Tianjin,and six hospitals were selected.Tianjin Medical University General Hospital,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin Medical University Second Hospital,Baodi People’s Hospital,Tanggu Maternity Hospital and Permanent Hospital.The designed questionnaire was used to survey the reproductive mothers(This pregnancy was to have a second child or more.)in each hospital from 2019.7.1 to 2019.9.30.All data were imported into SPSS 22.0 software for analysis after being entered by Epidata3.1software.Results:1.Descriptive analysis:(1)General situation: This study included a total of 1691 reproductive mothers.The average age was 32.7 ± 4.2 years(20-48 years),concentrated in 30-34 years(43.5%),and 563 cases of elderly women(≥35 years)(33.3%);Company employees(36.0%)are the mainstay;university education or above is the mainstay(40.8%);household registration is dominated by local cities(57.3%);resident places are mainly urban(46.7%);they are mostly Han population(96.7%).The per capita monthly income is concentrated in 5,000 ~ 10,000(57.3%);93.1% of pregnant women have medical insurance / public medical care.(2)History of motherhood:(1)59.0% of pregnant women have 3 or more pregnancies;94.3% have a second child;14.8% have a history of spontaneous abortion,40.4% have a history of surgical abortion,10.6% have a history of medical abortion;34.9% have a history of unplanned pregnancy;92.9% have two children,and 56.7% of them are one boy and one girl.(2)The inter-pregnancy interval is 47.6% in 2 to 6 years;the last child’s exclusive breastfeeding time was 66.2% within 6 months;the last child’s menstrual recovery time was 29.7% in 3 to 6 months,and the sexual life recovery time was43.5% in 1 to 3 months.(3)The major cause of this pregnancy is 40.6% of unplanned pregnancy.Among them,contraceptive failure accounted for 17.1%.The top three methods of contraceptive failure were safety period,in vitro ejaculation,and condoms.Non-contraceptive accounted for 23.4%,and the reason "I feel like I won’t get pregnant once in a while" accounts for 59.8%.(3)Contraception history and planned contraception of this postpartum(1)Contraception history: 1255 cases(74.2%)adopted contraceptive measures between the last childbirth and this pregnancy.The time to start contraception was56.3% in 3 to 6 months.The first contraception method was mainly condoms(75.5%);The top three contraceptive methods used between two pregnancies are condoms,safety periods,and in vitro ejaculation.(2)Planned postpartum contraception: 36.9% of the postpartum contraceptive time has not been thought yet,and 67.1% chose a condom.(4)Contraceptive related knowledge level and access(1)The first three of the known contraceptive methods in turn are condoms,IUD,oral contraceptives.The correct rate of contraceptive knowledge is generally low.(2)Knowledge access: mainly publicity materials provided by hospitals and online media.2.Analysis of influencing factors(1)Fertility willingness(willing to give birth again): 178 cases had fertility willingness(10.5%).There are six influencing factors(P < 0.05).Age,household registration is urban or rural,local or foreign,the existing children’s gender combination,the type of medical insurance,and the number of existing children.(2)The choice of postpartum contraceptive methods: There are four influencing factors(P < 0.05).The availability of medical insurance,the number of unplanned pregnancies,and the first contraceptive method after the last child.(3)Pregnancy complications: There are five influencing factors(P < 0.05).Age,habitual residence,parity,number of surgical abortions,and inter--pregnancy interval.(1)Gestational diabetes: age,habitual residence,inter--pregnancy interval,hypertension during pregnancy,obesity,and history of cesarean section(P < 0.05).(2)Hypertension during pregnancy: age,inter-pregnancy interval,gestational diabetes,and obesity(P < 0.05).Conclusion:1.Under the "Two-Child" policy,it must be of great concern to the maternal and child health system that changes in the structure of reproductive population and an increase in the number of older mothers.2.Under the "Two-Child" policy,inter-pregnancy interval is self-controlling.However,too short or too long interval can cause adverse perinatal outcomes.Therefore,it is important to hold the appropriate inter-pregnancy interval.3.This survey shows that women’ s contraceptive knowledge and safe contraceptive ability are not ideal.Therefore,guidance on postpartum contraceptive education and contraceptive methods should be increased,especially for primiparas.4.The fertility willingness(willing to give birth again)is not high,and the single gender of the existing children is the biggest influencing factor.5.There are five risk factors for pregnancy complications,as habitual residence in rural areas,parity ≥ 3 times,surgical abortion ≥ 2 times,and inter-pregnancy interval > 8 years.