{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:50:56Z","timestamp":1791348656141,"version":"4.3.1"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    During the COVID\u201019 pandemic, studies showed a significant decrease in fertility rate among Chinese women of reproductive age. The Chinese government implemented the three\u2010child policy in an attempt to change the sustained low birth rate under the dual threat of population development and the pandemic. To separately evaluate the changes in maternal characteristics after the outbreak of the epidemic and the adjustment of fertility policies, as well as the relationship between the COVID\u201019 pandemic and adverse neonate outcomes, a retrospective study was conducted at one hospital. We collected data on birthing women from medical record databases from January 1, 2017, to December 31, 2022. Records for a total of 93,547 neonates and a corresponding 88,857 maternal medical records were analyzed using SPSS software version 26. The differences in maternal and gestational characteristics between subgroups during the two periods were analyzed using Pearson's chi\u2010square test. We used univariate and multivariate analyses to assess the relationship between the COVID\u201019 pandemic and neonatal outcomes. We found that during the epidemic, the proportion of pregnant women of advanced age (20.3% vs. 24.5%), mothers who gave birth \u2265\u20092 times (27.0% vs. 42.1%), and non\u2010IVF pregnant women (86.2% vs. 91.4%) decreased. After the implementation of the three\u2010child policy, the proportion of mothers who gave birth once (74.8% vs. 72.8%) increased significantly, while the proportion of mothers who gave birth \u2265\u20092 times (25.2% vs. 27.2%) decreased. In addition, the results of multivariate logistic regression analysis showed that the risk of cesarean birth (CB) in newborns increased (aOR 1.062, 95% CI 1.032\u20131.093,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), but the risk of premature birth (PTB) (aOR 0.809, 95% CI 0.775\u20130.844,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), low birth weight (LBW) (aOR 0.903, 95% CI 0.861\u20130.947,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), macrosomia (aOR 0.890, 95% CI 0.824\u20130.960,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003), small for gestational age (SGA) (aOR 0.921, 95% CI 0.887\u20130.956,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and large for gestational age (LGA) (aOR 0.924, 95% CI 0.887\u20130.962,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) were all reduced after the outbreak of the epidemic. In summary, during the COVID\u201019 pandemic, the proportion of pregnant women under 35\u2009years old, women without previous delivery history and women undergoing fertility therapy increased in this hospital. The incidence of adverse outcomes in newborns, including PTB, LBW, macrosomia, SGA, and LGA, was reduced. After the implementation of the three\u2010child policy, the proportion of multiparous women has decreased. This suggests that the threat of the pandemic has led to significant changes in fertility preferences in the area, but the incidence of adverse outcomes, except for cesarean birth, has decreased. However, exposure to COVID\u201019 alone cannot be assumed as a significant impact on the neonatal outcomes; we need to pay more attention to the future development of these children and the impact of public events and policies on them.\n                  <\/jats:p>","DOI":"10.1111\/birt.70126","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:25:16Z","timestamp":1791347116000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Characteristics and Adverse Neonatal Outcomes During the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic and Maternal Characteristics During the Three\u2010Child Policy: A Retrospective Analysis"],"prefix":"10.1111","author":[{"given":"Yuhua","family":"He","sequence":"first","affiliation":[{"name":"Department of Pediatrics West China Second University Hospital, Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3660-9067","authenticated-orcid":false,"given":"Fei","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics West China Second University Hospital, Sichuan University  Chengdu People's Republic of China"},{"name":"Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6857-3858","authenticated-orcid":false,"given":"Jinrong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics West China Second University Hospital, Sichuan University  Chengdu People's Republic of China"},{"name":"Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s40249-020-00678-3","article-title":"Psychological Status and Behavior Changes of the Public During the COVID\u201019 Epidemic in China","volume":"9","author":"Liu X.","year":"2020","journal-title":"Infectious Diseases of Poverty"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.14.05002","article-title":"Influence of COVID\u201019 Pandemic on Pregnancy and Fertility Preferences Among the Residents of The United Arab Emirates (UAE)","volume":"14","author":"Ganesan S.","year":"2024","journal-title":"Journal of Global Health"},{"issue":"1","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1186\/s12889-023-15907-1","article-title":"An Increase in Cesarean Section Rate During the First Wave of COVID\u201019 Pandemic in Iran","volume":"23","author":"Gharacheh M.","year":"2023","journal-title":"BMC Public Health"},{"issue":"1","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12199-020-00899-w","article-title":"The Associated Factors of Cesarean Section During COVID\u201019 Pandemic: A Cross\u2010Sectional Study in Nine Cities of China","volume":"25","author":"Zhang J.","year":"2020","journal-title":"Environmental Health and Preventive Medicine"},{"issue":"8","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.3390\/nu12082250","article-title":"Emotional Eating in Pregnant Women During the COVID\u201019 Pandemic and Its Association With Dietary Intake and Gestational Weight Gain","volume":"12","author":"Zhang J.","year":"2020","journal-title":"Nutrients"},{"issue":"6","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"e759","DOI":"10.1016\/S2214-109X(21)00079-6","article-title":"Effects of the COVID\u201019 Pandemic on Maternal and Perinatal Outcomes: A Systematic Review and Meta\u2010Analysis","volume":"9","author":"Chmielewska B.","year":"2021","journal-title":"Lancet Global Health"},{"issue":"13","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"3820","DOI":"10.1111\/jocn.16486","article-title":"Examining the Relationship Between Perinatal Anxiety, COVID\u201019 Phobia and Birth Type Preferences: A Cross\u2010Sectional Study","volume":"32","author":"Akg\u00fcn M.","year":"2023","journal-title":"Journal of Clinical Nursing"},{"issue":"10","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/1471-0528.16381","article-title":"Prenatal Anxiety and Obstetric Decisions Among Pregnant Women in Wuhan and Chongqing During the COVID\u201019 Outbreak: A Cross\u2010Sectional Study","volume":"127","author":"Liu X.","year":"2020","journal-title":"BJOG: An International Journal of Obstetrics and Gynaecology"},{"issue":"8","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-006359","article-title":"Are COVID\u201019 Mitigation Measures Reducing Preterm Birth Rate in China?","volume":"6","author":"Bian Z.","year":"2021","journal-title":"BMJ Global Health"},{"issue":"3","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/AOG.0000000000004236","article-title":"Prematurity Rates During the Coronavirus Disease 2019 (COVID\u201019) Pandemic Lockdown in Melbourne, Australia","volume":"137","author":"Matheson A.","year":"2021","journal-title":"Obstetrics and Gynecology"},{"issue":"11","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"e604","DOI":"10.1016\/S2468-2667(20)30223-1","article-title":"Impact of COVID\u201019 Mitigation Measures on the Incidence of Preterm Birth: A National Quasi\u2010Experimental Study","volume":"5","author":"Been J. V.","year":"2020","journal-title":"Lancet Public Health"},{"issue":"5","key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/uog.23743","article-title":"Impact of COVID\u201019 Pandemic Restrictions on Pregnancy Duration and Outcome in Melbourne, Australia","volume":"58","author":"Rolnik D. L.","year":"2021","journal-title":"Ultrasound in Obstetrics & Gynecology"},{"issue":"4","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"550.e1","DOI":"10.1016\/j.ajog.2021.11.034","article-title":"Preterm Birth After the Introduction of COVID\u201019 Mitigation Measures in Norway, Sweden, and Denmark: A Registry\u2010Based Difference\u2010In\u2010Differences Study","volume":"226","author":"Oakley L. L.","year":"2022","journal-title":"American Journal of Obstetrics and Gynecology"},{"issue":"1","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1136\/archdischild-2020-319990","article-title":"Danish Premature Birth Rates During the COVID\u201019 Lockdown","volume":"106","author":"Hedermann G.","year":"2021","journal-title":"Archives of Disease in Childhood. Fetal and Neonatal Edition"},{"issue":"4","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajogmf.2020.100258","article-title":"Decreased Incidence of Preterm Birth During Coronavirus Disease 2019 Pandemic","volume":"2","author":"Berghella V.","year":"2020","journal-title":"American Journal of Obstetrics & Gynecology MFM"},{"issue":"3","key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/aogs.14318","article-title":"COVID\u201019 Pandemic and Population\u2010Level Pregnancy and Neonatal Outcomes in General Population: A Living Systematic Review and Meta\u2010Analysis (Update#2: November 20, 2021)","volume":"101","author":"Yang J.","year":"2022","journal-title":"Acta Obstetricia et Gynecologica Scandinavica"},{"issue":"1","key":"e_1_2_13_18_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003884","article-title":"Obstetric Interventions and Pregnancy Outcomes During the COVID\u201019 Pandemic in England: A Nationwide Cohort Study","volume":"19","author":"Gurol\u2010Urganci I.","year":"2022","journal-title":"PLoS Medicine"},{"key":"e_1_2_13_19_1","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.923324","article-title":"Impact of COVID\u201019 Pandemic on Birth Outcomes: A Retrospective Cohort Study in Nanjing, China","volume":"10","author":"Wen J.","year":"2022","journal-title":"Frontiers in Public Health"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2024.1336108","article-title":"Associations of COVID\u201019 Lockdown With Birth Weight in China","volume":"12","author":"Chen Y.","year":"2024","journal-title":"Frontiers in Pediatrics"},{"issue":"2","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.wombi.2020.09.022","article-title":"The Experiences of Pregnant Women During the COVID\u201019 Pandemic in Turkey: A Qualitative Study","volume":"34","author":"Mizrak Sahin B.","year":"2021","journal-title":"Women and Birth"},{"issue":"9","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-003075","article-title":"Unprecedented Reduction in Births of Very Low Birthweight (VLBW) and Extremely Low Birthweight (ELBW) Infants During the COVID\u201019 Lockdown in Ireland: A'natural Experiment'Allowing Analysis of Data From the Prior Two Decades","volume":"5","author":"Philip R. K.","year":"2020","journal-title":"BMJ Global Health"},{"issue":"1","key":"e_1_2_13_23_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-20049-2","article-title":"Changes in Preterm Birth and Birthweight During the SARS\u2010CoV\u20102 Pandemic: A Nationwide Study in South Korea","volume":"12","author":"Hwang J.","year":"2022","journal-title":"Scientific Reports"},{"issue":"4","key":"e_1_2_13_24_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0283909","article-title":"The Impact of the COVID\u201019 Lockdown on Birthweight Among Singleton Term Birth in Denmark","volume":"18","author":"Knegt V. E.","year":"2023","journal-title":"PLoS One"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvacx.2024.100536"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2434"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70126","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.70126","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:25:19Z","timestamp":1791347119000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.70126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":25,"alternative-id":["10.1111\/birt.70126"],"URL":"https:\/\/doi.org\/10.1111\/birt.70126","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2024-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"birt.70126"}}