Factors Associated with Fertility Intention among Chinese Married Youth during the COVID-19 Pandemic

Prediction and unsupervised clustering of fertility intention among migrant workers based on machine learning: a cross-sectional survey from Henan, China

BACKGROUND

Although China has implemented multiple policies to encourage childbirth, the results have been underwhelming. Migrant workers account for a considerable proportion of China's population, most of whom are of childbearing age. However, few articles focus on their fertility intentions.

METHOD

From August 3 to August 29, 2023, we conducted a cross-sectional survey in Henan Province, China, which included 18,806 participants. Machine learning was used to construct a predictive model for the fertility intention of migrant workers, and unsupervised clustering was used to explore subgroup classification.

RESULT

Out of 18,806 participants, only 1057 had fertility intention. We constructed a predictive model for fertility intention based on XGBoost, with an AUC of 0.83. Age, number of children, and marital status are the most important characteristics that affect the fertility intention of migrant workers. Subsequently, unsupervised clustering was conducted on participants without fertility intentions, and it was found that they could be divided into three categories of population. The first group of people is the youngest and mostly unmarried without pregnancy, the second group has the lowest monthly income and self-perceived economic level, and the third group is the oldest and has the highest proportion of women. Regardless of the group, economic and age factors are the main reasons for participants not having a family plan in the near future.

CONCLUSION

The fertility intention of the migrant workers is at an extremely low level. Improving childcare-related benefits and family support services to reduce the economic and time costs of childcare is an effective measure to reverse fertility intentions.

The mediating role of trust in government in intergenerational transmission of fertility intentions

China's one-child policy was in effect from 1982 to 2015. However, the literature examining the association between people's trust in local government and intergenerational transmission of fertility intentions is scarce. To fill this gap, we investigated the impact of individuals' sibship size on their ideal number of children, the mediating effect of their trust in local government on the issue of fertility between two successive generations, and the moderating effect of education level on sibship size related to trust in local governments. Based on the 2019 Chinese Social Survey data, 2,340 respondents aged 18-35 participated in the analysis. The results showed that (i) individuals' number of siblings significantly positively predicted their ideal number of children; (ii) individuals' number of siblings significantly negatively predicted their trust in the local government, which in turn significantly negatively influenced fertility intentions; (iii) the mediating mechanism was significant in residents with higher levels of education, but not in people with lower degrees of education. Fertility-boosting incentives can prioritize couples who are the only child in their family. It is necessary for local governments to improve their credibility and strengthen their pregnancy-related communication with groups with higher levels of education.

Fertility policy changes, maternal and foetal characteristics and birth timing patterns at a tertiary referral centre in Beijing: a ten-year retrospective study

OBJECTIVE

This study aimed to explore the impacts of the changing national fertility policy on maternal and fetal characteristics, and birth timing patterns and provide a basis for the management of the obstetric and midwifery workforce.

DESIGN

Retrospective cohort study.

SETTING

Data from medical register of a tertiary referral centre in Beijing, China.

PARTICIPANTS

We included 20 334 births with a gestational age more than 28 weeks during January 2013-September 2023.

MAIN OUTCOMES

The main outcomes included birth numbers, maternal age, parity, birth modes, premature rates, neonatal birth weight, and birth timings.

RESULTS

The birth rates showed a general rising trend before 2016. Afterwards, the birth rates kept decreasing and reached the bottom level in 2022. The caesarean section rates showed a declining trend, while the assisted birth rates were progressively rising, especially among primiparous women. From 2013 to 2022, the proportions of multiparous women (increasing from 9.3% to 36.6%) and women with advanced maternal age (increasing from 11.4% to 34.5%) were on the rise, together with increasing rates of premature birth (increasing from 5.7% to 8.5%) and neonatal low birth weight (rising from 4.3% to 7.2%) in this population. This study found a significant peak of births between 14:00 and 15:00, which remained unchanged despite shifts in the fertility policy (p<0.001 and [Formula: see text] values close to 1, respectively).

CONCLUSION

The 'three-child' policy did not boost the birth rate further 2 years later after its enactment, and the proportion of multiparous women and women with advanced maternal age were on the rise, accompanied by an increase in rates of premature birth and low birth weight. Targeted training should be offered to healthcare professionals to empower them to deal with possible negative pregnancy outcomes and childbirth complications. Prepregnancy and antepartum education should be parity specific. Adequate midwifery staffing during this 14:00-15:00 is vital to promote a safe birth.

Factors impacting fertility anxiety among Chinese young women with marital status differences

Background

China's societal and cultural significance placed on female fertility and the changing roles of women can lead to fertility anxiety in both married and unmarried women. This anxiety is shaped by factors such as social media use, intergroup emotions, fertility risk perceptions, and national policies. This study examines the interplay of these factors in understanding fertility anxiety among Chinese women.

Methods

This study surveyed 607 young Chinese women using the Fertility Anxiety Scale developed by Zhang and Zhao. Mplus software was used for latent class analysis of respondents' fertility anxiety. A three-step approach with multinomial logistic regression was used to explore factors influencing fertility anxiety among married and unmarried women.

Results

The latent class analysis supported a two-category model: "high fertility anxiety" (65.70 % married, 53.70 % unmarried) and "low fertility anxiety" (34.30 % married, 46.30 % unmarried). Multinomial logistic regression showed that increased social media usage intensity and perception of health-family risks correlated with higher fertility anxiety in both married and unmarried women. Among unmarried women, intergroup emotions and perceptions of occupational-economic risks also influenced fertility anxiety. Attention to national policies did not significantly impact fertility anxiety among young women.

Conclusion

This study sheds light on the complex interplay of societal and individual factors in shaping fertility anxiety among young Chinese women. It underscores the enduring cultural significance placed on female fertility and the evolving roles of women in modern China. Regardless of their marital status, both married and unmarried women experience fertility anxiety, highlighting the pervasiveness of this concern.

Determinants of Fertility Intentions of the Women in Bosnia and Herzegovina-An Example from the Semberija Region

The aim of this paper was to analyze the socio-demographic determinants of fertility in Bosnia and Herzegovina that affect the number of live births in Semberija. The paper focuses on work and educational statuses, economic crisis and unemployment, and other relevant factors that affect desired family sizes and lead to negative demographic trends. The relevant data were collected through a survey questionnaire filled by a verified sample of 1000 women in their reproductive period (aged 15-49). In order to evaluate the role of each research variable in predicting fertility intentions, the arithmetic mean, frequency of responses in percentage, Pearson's coefficient, and a logistic regression model were used to explore the related factors of fertility behaviors among women in this population. The results showed that employment status, poor housing conditions, and financial support from the state statistically significantly impact future birth trends. Those socio-demographic factors affect desired family sizes and have proven essential to future fertile behavior.