Prevalence of anxiety and its associated factors among infertile patients after 'two-child' policy in Chongqing, China: a cross-sectional study

Background With the prevalence of infertility increasing every year around the world, it has seriously impacted the individual quality of family and social life. Anxiety is one of the most prevalent anxiety disorders among infertile patients. After the two-child policy, whether it affected the prevalence of anxiety is controversial. This study aimed to determine the prevalence of anxiety and its potential risk factors among Chinese infertile women after the enforcement of 'two-child policy'. Methods This cross-sectional study included 693 infertile patients in a reproductive medical center in Chongqing, China, between February 2016 and December 2018. Data was collected by Self-filling questionnaires including basic demographic information and the Generalized Anxiety Disorder-7 (GAD-7). SPSS statistical software (IBM SPSS version 25) was used to analyse the obtained data. Descriptive analysis was used to describe basic information and anxiety scores, the chi-square test and binary logistic regression were used to analyse the relationship between anxiety and other variables. Results The prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients (FI), and 18.4% among second-child infertile patients (SI) respectively (P > 0.05). Binary logistic regression showed that patients with lower education levels were more likely to have anxiety (P < 0.01). Patients with middle salary incomes were more likely to have anxiety (OR = 1.860, 95% CI: 1.068-3.238). Oral contraception taking history (OR = 1.778, 95% CI: 1.186-2.667), and history of allergy (OR = 2.098, 95% CI: 1.219-3.612) were associated with anxiety. Conclusions Under the full liberalization of the two-child policy, the total prevalence of anxiety among Chinese infertile female is comparatively high. Low education levels, middle incomes, oral contraception taking and allergy history can be the related risk factors of anxiety. We promote that all infertile patients should be evaluated for the prevalence of anxiety, especially those with potential risks, and receive consultant or targeted treatment when needed. Plain language summary With the formulation of China's two-child policy and the increase in the incidence of infertility, anxiety is one of the most common anxiety disorders among infertility patients. This study mainly discussed the prevalence of anxiety among infertile women in China and its potential risk factors after the implementation of the two-child policy. First-child infertile patients (FI) or Second-child infertile patients (SI) were asked to self-fulfilled the 7-item Generalized Anxiety Disorder scale questionnaires to understand their anxiety. Of the 693 respondents: the prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients, and 18.4% among second-child infertile patients. The group of infertile patients with middle salary incomes, a history of oral contraceptive use, and a history of allergy were more likely to be anxious. In conclusion: under the current situation, low education levels, middle incomes, OC taking and allergy history can be the related risk factors of anxiety. It is of guiding significance for the mental health of special populations of infertility.

Automated summary

With the implementation of China's two-child policy, anxiety among infertile women in China has shown a comparatively high prevalence. Low education levels, middle incomes, oral contraception use, and allergy history may be related risk factors for anxiety.