This study evaluates the impacts of the COVID-19 pandemic on the reproductive behavior of men and women during the most restrictive period of the pandemic in Czechia. At the end of this period, data was collected for the Czech GGS COVID Pilot-Follow-up Study (April 2021), which included additional questions on reproductive plans and perceptions of the pandemic related to fertility. The study focuses in detail on the evaluation of the favorability of fertility during this period by considering the impact of the pandemic on the lives of individuals in various life areas. It subsequently attempts to determine to what extent this evaluation and personal experiences of the pandemic affected reproductive behavior (the intended number of children, current attempts to conceive and short-term fertility intentions). In summary, in most cases the respondents considered the most severe period of the pandemic to be unfavorable in terms of childbirth. Women provided an overall negative assessment of the favorability of childbirth in this period, which was reflected in a reduction in the planned number of children, while the men who considered this period favorable declared a higher chance of short-term fertility intentions.

• MeSH
• COVID-19 * epidemiology   MeSH
• Child MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Pandemics MeSH
• Perception MeSH
• Reproductive Behavior * MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

This study aims to enhance the understanding of how the increasing use of assisted reproductive technologies (ART) has contributed to the increase in the total fertility rate (TFR) and to further delaying childbearing. Moreover, it addresses the gap in the methodology concerning the quantification of the effect of ART on fertility postponement. Czechia is one of few countries that are able to serve for the study of the demographic impacts of ART. ART and non-ART fertility rates were calculated using unique data on all children born in Czechia. Excluding mothers who received cross-border reproductive care, the proportion of ART live births in Czechia has not exceeded 4%. However, without ART the TFR would have stood at just 1.65 instead of 1.71 in 2020. ART significantly contributed to a reduction in childlessness and to the increase in fertility rates at ages over 35. Applying the decomposition method, the contribution of the use of ART to delaying childbearing between 2013 and 2020 was 4%. The findings have important policy implications. ART has the potential to support fertility recovery in the context of delayed childbearing. The findings served to alleviate concerns about the contribution of ART to the further undesired delay of childbearing.

• MeSH
• Reproductive Techniques, Assisted MeSH
• Child MeSH
• Fertility MeSH
• Humans MeSH
• Reproduction MeSH
• Medical Tourism * MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: Fertility postponement, which has comprised the most significant reproductive trend in developed countries over the last few decades, involves a number of social, personal and health consequences. The length of stay (LOS) in hospital following childbirth varies considerably between countries. Czechia, where the fertility postponement process has been particularly dynamic, has one of the longest mean LOS of the OECD member countries. OBJECTIVE: We analyse the influence of the age of mothers on the LOS in hospital associated with childbirth. DATA AND METHODS: We employed anonymised individual data provided by the General Health Insurance Company of the Czech Republic on women who gave birth in 2014. Kaplan-Meier survival plots and binary logistic regression were employed to identify factors associated with long stays (> = 7 days for vaginal births, > = 9 days for CS births). RESULTS: The impact of the maternal age on the LOS is U-shaped. A higher risk of a longer hospitalisation period for young mothers was identified for both types of birth (OR = 1.58, 95% CI 1.33-1.87, p˂0.001 for age less than 20, OR = 1.31, 95% CI 1.20-1.44, p˂0.001 for age 20-24 compared to 30-34). The risk of a longer stay in hospital increases with the increasing age of the mother (OR = 1.23, 95% CI 1.13-1.35, p˂0.001 for age 35-39, OR = 2.05, 95% CI 1.73-2.44, p˂0.001 for age 40+ compared to 30-34), especially with concern to vaginal births. CONCLUSION: The probability of a long LOS increases significantly after the age of 35, especially in the case of vaginal births. Thus, the fertility postponement process with the significant change in the age structure of mothers contributes to the increase in health care costs associated with post-birth hospitalisation.

• MeSH
• Length of Stay MeSH
• Adult MeSH
• Humans MeSH
• Mothers * MeSH
• Young Adult MeSH
• Parturition MeSH
• Pregnancy MeSH
• Delivery, Obstetric * MeSH
• Maternal Age MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

OBJECTIVE: To investigate the association between a mother's age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic characteristics. METHODS: Binary logistic regression models for all women who gave birth in Czechia in 2018 (N = 111,749 mothers who gave birth to 113,234 children). RESULTS: An increase in the age of a mother significantly increases the odds of a CS birth according to all of the models; depending on the model, OR: 1.62 (95% CI 1.54-1.71) to 1.84 (95% CI 1.70-1.99) for age group 35-39 and OR: 2.83 (95% CI 2.60-3.08) to 3.71 (95% CI 3.23-4.27) for age group 40+ compared to age group 25-29. This strong association between the age of a mother and the risk of CS is further reinforced for primiparas (probability of a CS: 11% for age category ≤ 19, 23% for age category 35-39, and 38% for age category 40+). However, the increasing educational attainment of young women appears to have weakened the influence of increasing maternal age on the overall share of CS births; depending on the model, OR: 0.86 (95% CI 0.80-0.91) to 0.87 (95% CI 0.83-0.91) for tertiary-educated compared to secondary-educated women. CONCLUSIONS: The age of a mother comprises an independent risk factor for a CS birth when the influence of health, socioeconomic, and demographic characteristics is considered.

• Keywords
• Czechia, caesarean section (CS), education, fertility postponement, marital status, maternal age,
• MeSH
• Cesarean Section * MeSH
• Child MeSH
• Humans MeSH
• Mothers MeSH
• Parturition * MeSH
• Risk Factors MeSH
• Pregnancy MeSH
• Maternal Age MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: Although the percentage of cesarean sections (CS) in Czechia is below the average of that of other developed countries (23.6%), it still exceeds WHO recommendations (15%). The first aim of the study is to examine the association between a CS birth and the main health factors and sociodemographic characteristics involved, while the second aim is to examine recent trends in the CS rate in Czechia. METHODS: Anonymized data on all mothers in Czechia for 2018 taken from the National Register of Expectant Mothers was employed. The risk of cesarean delivery for the observed factors was tested via the construction of a binary logistic regression model that allowed for adjustments for all the other covariates in the model. RESULTS: Despite all the covariates being found to be statistically significant, it was determined that health factors represented a higher risk of a CS than sociodemographic characteristics. A previous CS was found to increase the risk of its recurrence by 33 times (OR = 32.96, 95% CI 30.95-35.11, p<0.001). The breech position increased the risk of CS by 31 times (OR = 31.03, 95% CI 28.14-34.29, p<0.001). A multiple pregnancy increased the odds of CS six-fold and the use of ART 1.8-fold. Mothers who suffered from diabetes before pregnancy were found to be twice as likely to give birth via CS (OR = 2.14, 95% CI 1.76-2.60, p<0.001), while mothers with gestational diabetes had just 23% higher odds of a CS birth (OR = 1.23, 95% CI 1.16-1.31, p<0.001). Mothers who suffered from hypertension gave birth via CS twice as often as did mothers without such complications (OR = 2.01, 95% CI 1.86-2.21, p<0.001). CONCLUSIONS: The increasing age of mothers, a significant risk factor for a CS, was found to be independent of other health factors. Accordingly, delayed childbearing is thought to be associated with the increase in the CS rate in Czechia. However, since other factors come into play, further research is needed to assess whether the recent slight decline in the CS rate is not merely a temporal trend.

• Keywords
• Breech delivery, Cesarean section (CS), Czechia, Fertility, Fertility postponement, Health status,
• MeSH
• Cesarean Section * adverse effects   MeSH
• Fertility * MeSH
• Humans MeSH
• Mothers MeSH
• Pregnancy, Multiple MeSH
• Pregnancy MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH