{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:23:52Z","timestamp":1770488632994,"version":"3.49.0"},"reference-count":29,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,2,20]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to explore determinants of second pregnancy and underlying reasons among pregnant Chinese women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The study was a population-based cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>16 hospitals in 5 provinces of Mainland China were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2345 pregnant women aged 18\u2005years or above were surveyed face to face by investigators between June and August 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The pregnancy statuses (first or second pregnancy) and reasons for entering second pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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 \u20182-child policy\u2019 than the low education level subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-014544","type":"journal-article","created":{"date-parts":[[2017,3,27]],"date-time":"2017-03-27T20:23:18Z","timestamp":1490646198000},"page":"e014544","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Determinants of second pregnancy among pregnant women: a hospital-based cross-sectional survey in China"],"prefix":"10.1136","volume":"7","author":[{"given":"Xianglong","family":"Xu","sequence":"first","affiliation":[{"name":"School of Public Health and Management, Chongqing Medical University, Chongqing, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China"},{"name":"The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanxiao","family":"Zuo","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Chongqing Medical University, Chongqing, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China"},{"name":"The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3099-3299","authenticated-orcid":false,"given":"Zumin","family":"Shi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, School of Medicine, The University of Adelaide, North Terrace Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunshuang","family":"Rao","sequence":"additional","affiliation":[{"name":"School of Nursing, Chongqing Medical University, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LianLian","family":"Wang","sequence":"additional","affiliation":[{"name":"The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Department of Reproduction Health and Infertility, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huan","family":"Zeng","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Chongqing Medical University, Chongqing, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China"},{"name":"The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China"},{"name":"Faculty of Medicine, Central Clinical School, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Faculty of Medicine, School of Public Health and Preventive Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoj","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Environmental Health, Jackson State University, Jackson, UK"},{"name":"Walden University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Loma Linda University Medical Center, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Chongqing Medical University, Chongqing, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China"},{"name":"The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,3,27]]},"reference":[{"key":"2025120523580424000_7.3.e014544.1","unstructured":"National Health and Family Planning Commission of the People's Republic of China. 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