title: [Secular trends of premarital medical examination in China during 1996 and 2013].
abstract: OBJECTIVE
  To describe the secular trends of premarital medical examination (PME) in China during 1996 and 2013 and to assess the impacts of national health policies on the PME rate.
  
  
  METHODS
  The information on marriage and PME for districts and counties in 31 provinces of China was annually collected by the Office for National Maternal & Child Health Statistics of China, and the information on the health policies was from official governmental websites. According to the main health policies, the calendar years were categorized into 3 periods: 1996 to 2003 was mandatory PME period; 2004 to 2008 was encouraged voluntary PME period; and 2009 to 2013 was free-paid voluntary PME period.
  
  
  RESULTS
  During the 18-year period, 284 242 719 people were registered for a marriage in which 107 198 795 were examined, giving the PME rate of 37.7%. During the mandatory PME period, the rate ranged 52.7%-67.7% with an average of 60.9% (urban 71.5%, and rural 51.7%). In 2004, the first year when the PME became voluntary, the rate was abruptly dropped to 2.6%, and thereafter gradually increased to 11.5% in 2008. As the policies of the free-paid voluntary PME were subsequently issued, the rate was quickly increased to 52.3% (urban 49.8%, and rural 54.6%) in 2013. The increasing trend was consistently observed both in urban and rural areas, and across East, Middle, West, and Northeast economical regions. However, the rates differed greatly among provinces. In 2013, 5 provinces had rates of >90% (Guangxi 97.5%, Fujian 96.0%, Ningxia 95.4%, Zhejiang 93.4% and Anhui 90.1%), whereas some provinces were stuck at a low rate, including developed and underdeveloped provinces/cities. The PME rate in 2013 was 27.4% for Shanghai, 25.5% for Guangdong, 12.4% for Chongqing, 5.8% for Beijing and 4.6% for Tianjin. Underdeveloped provinces were Guizhou (6.4%) and Qinghai (1.8%).
  
  
  CONCLUSIONS
  As various national policies to promote voluntary PME were issued, the PME rate was significantly increased after a sharp decline, though it varied greatly by provinces. For provinces with high PME rate, PME-related health benefits need to be evaluated; for provinces with low rate, it is of important practical significance to explore a cost-effective health service model that is likely incorporated with pre-pregnancy examination.
authors.affiliation: Office for National Maternal & Child Health Statistics of China, Peking University School of Public Health, Beijing 100191, China; Institute of Reproductive & Child Health, Ministry of Health Key Laboratory of Reproductive Health, Beijing 100191, China; Department of Epidemiology & Biostatistics, Peking University School of Public Health, Beijing 100191, China.
authors.forename: Yu-bo
authors.initials: YB
authors.lastname: Zhou
authors.affiliation: Office for National Maternal & Child Health Statistics of China, Peking University School of Public Health, Beijing 100191, China; Department of Child, Adolescent and Women's Health, Peking University School of Public Health, Beijing 100191, China.
authors.forename: Shu-sheng
authors.initials: SS
authors.lastname: Luo
authors.affiliation: Office for National Maternal & Child Health Statistics of China, Peking University School of Public Health, Beijing 100191, China; Institute of Reproductive & Child Health, Ministry of Health Key Laboratory of Reproductive Health, Beijing 100191, China; Department of Epidemiology & Biostatistics, Peking University School of Public Health, Beijing 100191, China.
authors.forename: Hong-tian
authors.initials: HT
authors.lastname: Li
authors.affiliation: Office for National Maternal & Child Health Statistics of China, Peking University School of Public Health, Beijing 100191, China; Department of Child, Adolescent and Women's Health, Peking University School of Public Health, Beijing 100191, China.
authors.forename: Yan-qiu
authors.initials: YQ
authors.lastname: Gao
authors.affiliation: Office for National Maternal & Child Health Statistics of China, Peking University School of Public Health, Beijing 100191, China; Institute of Reproductive & Child Health, Ministry of Health Key Laboratory of Reproductive Health, Beijing 100191, China; Department of Epidemiology & Biostatistics, Peking University School of Public Health, Beijing 100191, China.
authors.forename: Jian-meng
authors.initials: JM
authors.lastname: Liu
mesh_terms: D002681:China; D006291:Health Policy; D006801:Humans; D008393:Marriage; D011291:Premarital Examinations / Q000639:trends*