TABLE 2—

Cesarean Rates During Different Child Policy Periods: Hubei and Gansu Provinces, China, 2013–2016

	1-Child Policy Period			Selective 2-Child Policy Period			Universal 2-Child Policy Period
	Rate	Crude RR (95% CI)	Adjusted RR (95% CI)	Rate	Crude RR (95% CI)	Adjusted RR (95% CI)	Rate	Crude RR (95% CI)	Adjusted RR (95% CI)	Pa
All	45.1 (15 020/33 271)	1 (Ref)	1 (Ref)	40.4 (18 468/45 741)	0.90 (0.87, 0.94)	0.91 (0.88, 0.94)	38.9 (5 727/14 733)	0.85 (0.81, 0.90)	0.87 (0.82, 0.91)	< .001
Province
Hubei	60.8 (6 798/11 180)	1 (Ref)	1 (Ref)	55.8 (7 656/13 718)	0.89 (0.85, 0.93)	0.88 (0.84, 0.92)	54.7 (2 023/3 702)	0.86 (0.80, 0.92)	0.83 (0.77, 0.89)	< .001
Gansu	37.2 (8 222/22 091)	1 (Ref)	1 (Ref)	33.8 (10 812/32 023)	0.92 (0.86, 0.99)	0.89 (0.83, 0.95)	33.6 (3 704/11 031)	0.95 (0.87, 1.04)	0.88 (0.81, 0.97)	< .001
Level of delivering hospital
Tertiary	41.4 (8 924/21 567)	1 (Ref)	1 (Ref)	37.0 (11 737/31 741)	0.95 (0.89, 1.01)	0.93 (0.87, 1.00)	37.0 (3 905/10 565)	0.95 (0.87, 1.03)	0.91 (0.83, 0.99)	< .001
Secondary	52.1 (6 096/11 704)	1 (Ref)	1 (Ref)	48.1 (6 731/14 000)	0.92 (0.88, 0.96)	0.90 (0.86, 0.95)	43.7 (1 822/4 168)	0.87 (0.81, 0.94)	0.84 (0.78, 0.91)	< .001
Parity
1	49.2 (2 857/5 800)	1 (Ref)	1 (Ref)	40.7 (3 706/9 099)	0.83 (0.79, 0.87)	0.86 (0.82, 0.90)	35.8 (780/2 181)	0.71 (0.65, 0.76)	0.76 (0.70, 0.82)	< .001
≥ 2	55.8 (1 576/2 823)	1 (Ref)	1 (Ref)	55.3 (3 313/5 987)	0.99 (0.93, 1.05)	1.00 (0.94, 1.06)	54.0 (1 041/1 927)	0.97 (0.90, 1.05)	1.00 (0.92, 1.08)	.24
Maternal age, y
< 35	50.4 (4 006/7 944)	1 (Ref)	1 (Ref)	45.2 (6 173/13 657)	0.89 (0.86, 0.93)	0.90 (0.87, 0.94)	42.5 (1 535/3 609)	0.84 (0.79, 0.89)	0.87 (0.82, 0.92)	< .001
≥ 35	64.3 (457/711)	1 (Ref)	1 (Ref)	61.6 (890/1 444)	0.95 (0.85, 1.07)	0.96 (0.85, 1.07)	60.0 (305/508)	0.83 (0.72, 0.96)	0.84 (0.73, 0.98)	.12

Note. CI = confidence interval; RR = relative risk.

^aP value was for the trend in cesarean rate across the 3 periods.