title: Determinants of second pregnancy among pregnant women: a hospital-based cross-sectional survey in China.
abstract: This study aimed to explore determinants of second pregnancy and underlying reasons among pregnant Chinese women.
  
  
  
  The study was a population-based cross-sectional survey.
  
  
  
  16 hospitals in 5 provinces of Mainland China were included.
  
  
  
  A total of 2345 pregnant women aged 18 years or above were surveyed face to face by investigators between June and August 2015.
  
  
  
  The pregnancy statuses (first or second pregnancy) and reasons for entering second pregnancy.
  
  
  
  A total of 1755 (74.8%) and 590 (25.2%) women in their respective first and second pregnancies were enrolled in this study. The most common self-reported reasons for entering second pregnancy among participants included the benefits to the first child (26.1%), love of children (25.8%), adoption of the 2-child policy (11.5%), concerns about losing the first child (7.5%) and suggestions from parents (7.5%). Pregnant women with low (prevalence ratio (PR) 1.96; 95% CI 1.62 to 2.36) and moderate education level (PR 1.97; 95% CI 1.65 to 2.36) were more likely to have a second pregnancy than their higher educated counterparts. Income was inversely associated with second pregnancy. However, unemployed participants (PR 0.79; 95% CI 0.66 to 0.95) were less likely to enter a second pregnancy than those employed. Women with moderate education were 3 times more likely to have a second child following the '2-child policy' than the low education level subgroup.
  
  
  
  1 in every 4 pregnant women is undergoing a second pregnancy. The benefits of the firstborn or the love of children were the key drivers of a second pregnancy. Low socioeconomic status was positively associated with a second pregnancy as well. The new 2-child policy will have an influence on China's demographics.
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing, China.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
authors.forename: Xianglong
authors.initials: X
authors.lastname: Xu
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing, China.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
authors.forename: Hanxiao
authors.initials: H
authors.lastname: Zuo
authors.affiliation: Faculty of Health Sciences, School of Medicine, The University of Adelaide, North Terrace Adelaide, South Australia, Australia.
authors.forename: Zumin
authors.identifier: 0000-0002-3099-3299
authors.initials: Z
authors.lastname: Shi
authors.affiliation: School of Nursing, Chongqing Medical University, Chongqing, China.
authors.forename: Yunshuang
authors.initials: Y
authors.lastname: Rao
authors.affiliation: The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.|Department of Reproduction Health and Infertility, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.|Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China.
authors.forename: LianLian
authors.initials: L
authors.lastname: Wang
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing, China.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Zeng
authors.affiliation: Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.|Faculty of Medicine, Central Clinical School, Nursing and Health Sciences, Monash University, Melbourne, Australia.|Faculty of Medicine, School of Public Health and Preventive Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.|Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Behavioral and Environmental Health, Jackson State University, Jackson, UK.|Walden University, USA.
authors.forename: Manoj
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Preventive Medicine, Loma Linda University Medical Center, Loma Linda, California, USA.
authors.forename: Cesar
authors.initials: C
authors.lastname: Reis
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing, China.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000328:Adult; D001723:Birth Rate; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057217:Economic Development; D005190:Family / Q000523:psychology*; D005191:Family Characteristics; D016656:Family Planning Policy / Q000331:legislation & jurisprudence* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D011155:Population Control / Q000379:methods*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D012959:Socioeconomic Factors
keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH; REPRODUCTIVE MEDICINE; SOCIAL MEDICINE