Wen Sun1,2,3, Shiliang Liu1,4, Fang He1, Lili Du1, Yanfang Guo2,3,5, Darine El-Chaar2, Shi Wu Wen2,3,6, Dunjin Chen1. 1. Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Guangzhou, China. 2. OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. 3. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. 4. Public Health Agency of Canada, Ottawa, ON, Canada. 5. BORN Ontario, Ottawa, ON, Canada. 6. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Abstract
OBJECTIVE: To assess the impact of the one-child policy in China on maternal mortality. METHODS: The present retrospective study included maternal death data from Guangdong, China, from January 1, 2006, to December 31, 2015; data from 2013 were excluded because they were not available. Maternal deaths were divided into legal and illegal pregnancies based on adherence to the one-child policy. The maternal mortality ratio (MMR) was compared between the groups, temporal trends in the MMR were examined, and comparisons were made of the causes of death and access to maternity care. RESULTS: The final analysis included 847 520 live deliveries and 383 maternal deaths. The MMR among legal pregnancies declined moderately from 18.5 deaths per 100 000 live deliveries in 2006 to 12.2 deaths per 100 000 live deliveries in 2015 (P=0.029), whereas the MMR among illegal pregnancies declined dramatically from 1268.4 deaths per 100 000 live deliveries to 177.5 deaths per 100 000 live deliveries (P<0.001). The proportion of avoidable maternal deaths decreased and access to quality maternity care improved among illegal pregnancies during the study period. CONCLUSIONS: Maternal mortality among illegal pregnancies declined with relaxation of the one-child policy in China.
OBJECTIVE: To assess the impact of the one-child policy in China on maternal mortality. METHODS: The present retrospective study included maternal death data from Guangdong, China, from January 1, 2006, to December 31, 2015; data from 2013 were excluded because they were not available. Maternal deaths were divided into legal and illegal pregnancies based on adherence to the one-child policy. The maternal mortality ratio (MMR) was compared between the groups, temporal trends in the MMR were examined, and comparisons were made of the causes of death and access to maternity care. RESULTS: The final analysis included 847 520 live deliveries and 383 maternal deaths. The MMR among legal pregnancies declined moderately from 18.5 deaths per 100 000 live deliveries in 2006 to 12.2 deaths per 100 000 live deliveries in 2015 (P=0.029), whereas the MMR among illegal pregnancies declined dramatically from 1268.4 deaths per 100 000 live deliveries to 177.5 deaths per 100 000 live deliveries (P<0.001). The proportion of avoidable maternal deaths decreased and access to quality maternity care improved among illegal pregnancies during the study period. CONCLUSIONS: Maternal mortality among illegal pregnancies declined with relaxation of the one-child policy in China.