Objective To examine changes in pregnancy characteristics,mode of delivery and perinatal outcomes follow-ing the three-child policy.Methods We retrospectively collected clinical data from 1 049 parturients from Shulan(Hangzhou)Hospital who gave birth between January 2020 and June 2021(control group)before the three-child policy and 725 parturients who gave birth between April 2022 and September 2023(study group)after the policy.We compared the demographics,pregnancy complications,obstetric complications,mode of delivery and perinatal outcomes of the two groups.Results The incidences of gestational diabetes mellitus(18.76％,136 cases),placenta accreta(1.93％,5 cases),fetal distress(9.79％,71 cases),and pregnancy associated with hypothyroidism(12.83％,93 cases)were significantly higher in the study group those in the control group[14.68％(154 cases),0.76％(8 cases),3.53％(37 cases),8.77％(92 cases),P＜0.05].The incidences of intrahepatic cholestasis of pregnancy(1.24％,9 cases)and pregnancy combined with hepatitis B(2.07％,15 cases)were significantly lower those in the control group[2.67％(28 cases),3.72％(39 cases),P＜0.05].The rate of vaginal assisted delivery in the study group was higher than that in the control group,whereas the rate of vaginal delivery in women with scarred uterus was lower than that in the control group(P＜0.05).The rates of caesarean section for first and second births in the study group were significantly lower than those in the control group,while the rate of caesarean section for third birth was significantly higher than that in the control group(P＜0.05).The non-medical indication cesarean section rate and the non-medical indication cesarean sec-tion rate for the second and third births in the study group were significantly higher than those in the control group,where-as the non-medical indication cesarean section rate for the first births was significantly lower those that in the control group(P＜0.05).The incidences of postpartum hemorrhage,postpartum anemia,hypoproteinemia,macrosomia and neonatal asphyxia were higher in the study group than in the control group(P＜0.05).Conclusion The main birth population af-ter the implementation of the three-child policy remains first and second births,with a higher number of older second births.Some pregnancy complications,obstetric complications and adverse perinatal outcomes have increased.
维普
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