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China is characterized by a low fertility intention, a strong preference for sons, as well as a stringent birth control policy. In this study, we used data from a Fertility Intention and Behavior Survey of 2101 questionnaires conducted in 2013 in Shaanxi Province of northwestern China, and event history analysis methods to examine the effect of fertility intention and preference for sons on the probability of having a second child. The results not only validate the correlation of fertility intention with having a second child empirically, even in the low fertility intention and stringent birth control context of China, but also show that women with a preference for sons were less likely to have a second child. Women with son preference turn to sex-selective abortion to ensure that their first child is a son, thus reducing the likelihood of a second child and decreasing the fertility rate. Our findings also shed light on China’s potential fertility policy adjustment.

Background Nearly all countries with fertility levels of more than five children per woman are in Sub-Saharan Africa. Prestige, insurance in old age, and replacement in case of child deaths are related to preferences for large families. In this paper, we examine the association between women’s empowerment and fertility preferences of married women aged 35 years and above in four high fertility Francophone Sub-Saharan Africa (FSSA) countries, namely Burkina Faso, Mali, Niger and Chad. Method The ideal number of children among married women and their ability to have the desired number of children are used to measure fertility preferences. We used principal component analysis to construct a multidimensional empowerment index. We then estimated negative binomial and logistic regression models to examine the association between women’s empowerment and fertility preferences. Data are from the most recent Demographic and Health Surveys (DHS) conducted in the countries included in the analysis. Results Regardless of the country, more empowered women desire significantly fewer children compared with their less empowered counterparts. The first step to having fewer children is formulating programs to improve economic empowerment of women. The specific elements of women’s empowerment that were important for fertility preferences included education, skills development, decision-making power, and control over household resources. In addition, familial empowerment matters more than other dimensions of empowerment in influencing women’s ability to achieve the desired number of children in the FSSA countries included in the study. Conclusion Paid employment and access to and control over resources are factors which, if improved upon, could significantly reduce the ideal number of children. By taking necessary steps, mass media can be used much more adequately to reduce ideal number of children in FSSA countries. In addition, the desire for many children could also be due to their participation in income-generating activities to improve the household’s socio-economic status. The findings suggests that improvement of women’s ability to have the desired number of children is a big challenge to which policy makers must pay careful attention.

Objective This study used factorial survey data from five countries to assess the factors that shape young adults' attitudes toward the ideal number of children for described couples. Background Continuously low fertility rates in many Asian and European countries generate an interest in understanding the fertility attitudes of young adults—and the implications for family policies. Method The causal impact of socioeconomic and cultural factors on the ideal number of children for couples described in the vignettes was tested using a factorial survey experiment (vignette analysis). Data were collected from Germany, Japan, Russia, Ukraine, and the United Arab Emirates (UAE) to represent five different contexts each with different economies, political regimes, cultural and religious backgrounds, and population structures. Seven vignette‐level and four respondent‐level factors were assumed to affect the conditional ideal number of children. Results The strongest predictors of the higher ideal number of children for couples described in the vignettes were income, availability of childcare, and husband's full employment. The highest average ideal number of children for described couples was observed in the UAE (2.8 children), followed by Germany (1.6 children), Ukraine and Russia (1.3 children), and Japan (1.2 children). Conclusion The existing gap between public attitudes and fertility behaviors could be addressed by child‐friendly policies which allow a better reconciliation of work and family life.

Introduction Evidence on the role of medically assisted reproduction (MAR) in achieving the desired number of children is very limited. The aim of the current investigation was to assess the probability and the mode of conception of a second live birth according to the mode of conception of the first one. Material and methods This historical cohort study was based on administrative data from regional healthcare databases. Women hospitalized for childbirth in Lombardy between January 1, 2007 and December 31, 2017 were identified. The probability of a second live birth up to 2021 was estimated using the Kaplan–Meier method. We calculated this probability according to the mode of conception of the first birth, and the analysis was also performed in strata of maternal age at first birth. Cox proportional hazards models were fitted to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the association between mode of conception at first live birth and the probability of having a second live birth. Mothers were right‐censored if they moved out of the region, died, or did not have a second live birth by the end of follow‐up. Results We identified 431 333 women who had their first live birth after a natural conception and 16 837 who had their first live birth after MAR. The probability of having a second live birth was 58.6% and 32.1%, respectively in the two groups (HR = 0.68, 95% CI: 0.66–0.70). Considering solely women who naturally conceived their first live birth, the probability to have a second child with MAR was 1.1% and to have a second child naturally 59.3%. The corresponding values were 11.5% and 25.2% in the group of women with a first MAR‐mediated live birth. Conclusions In our cohort, one woman out of 10 having a first MAR‐mediated live birth underwent MAR programs again. Considering women who had a first natural live birth, this proportion was drastically reduced. In the field of MAR, more attention should be given to the capacity of a couple to achieve the number of desired children. Poor attention has been given to the contribution of medically assisted reproduction (MAR) to the desired family size. One woman out of 10 having a first live birth after MAR had a second baby by this way and only one in a hundred if one considers women with a first naturally conceived birth.

Background Few studies have explored the relationship between the number of children and depression in older adults, especially across multiple countries. Methods In this Multi-National Cross-Sectional Analysis, we included the Health and Retirement Study (HRS, US), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the Korean Longitudinal Study of Aging (KLoSA), and the Longitudinal Aging Study in India (LASI), encompassing a total of 20 countries. The number of children was based on self-reports from the participants. The Center for Epidemiologic Studies Depression Scale (CESD) and the European Depression Scale (EURO-D) were used to assess depression. Logistic regression was used to evaluate the relationship between the number of children and depression, adjusting for potential confounders. A random-effects meta-regression model was used to examine differences in the relationship between the number of children and depression between Asian and Western countries. To explore potential non-linear relationships, restricted cubic spline (RCS) curves were utilized, and threshold effect analyses were performed to validate. Additionally, subgroup analyses were stratified by age, sex, and marital status. Results A total of 110,015 participants from six datasets were included. The prevalence of depressive symptoms ranged from 10.7% in the UK to 48.8% in Poland. Childlessness was most common in ELSA (15.8%), followed by SHARE (9.6%) and HRS (8.4%), while lower proportions were observed in CLHLS (1.5%), KLoSA (2.3%), and LASI (3.1%). In Western countries, childlessness was not significantly associated with depression (HRS: OR = 1.00, 95% CI: 0.83–1.23; ELSA: OR = 0.90, 95% CI: 0.69–1.17; SHARE: OR = 1.05, 95% CI: 0.97–1.15). However, in Asian countries, it was linked to a higher risk (CLHLS: OR = 2.00, 95% CI: 1.29–3.12; KLoSA: OR = 1.78, 95% CI: 1.24–2.55; LASI: OR = 1.33, 95% CI: 1.19–1.49). A random-effects meta-analysis confirmed this regional difference (β = 0.35, 95% CI: 0.15–0.55; P  < 0.001). A non-linear association was observed between the number of children and depression in LASI and SHARE, with risk initially decreasing and then rising beyond a threshold. Subgroup analysis found a stronger association among ≤ 75 years individuals and men in KLoSA. In HRS, childlessness was associated with a higher risk of depression only among those living alone. Conclusions The relationship between the number of children and depression varies across countries. Individuals in Asian countries may be more prone to depression than those in Western nations when they do not have children.

INTRODUCTION Few studies have concurrently examined the biological and social reproductive factors in relation to women's cognitive aging. METHODS We analyzed 8577 women and 7872 men ≥45 years of age from the China Health and Retirement Longitudinal Study. Biological reproductive factors included reproductive span, age at menarche, and age at menopause; social reproductive factors included number of children and age at first live birth. Multivariable regression models were sequentially adjusted for age, childhood cognition proxy, education, and current health and lifestyle factors. RESULTS Longer reproductive span was associated with better cognitive performance in women, whereas a higher number of children were linked to poorer cognition in both sexes, particularly in women. These associations remained robust after full adjustment, compared with age at menarche, age at menopause, and age at first birth. CONCLUSION Integrating biological and social reproductive factors provides insights into sex‐specific cognitive aging patterns and may inform tailored dementia prevention strategies. Highlights A longer reproductive span was linked to better cognition in older Chinese women. More children were linked to poorer cognition in both sexes, especially in women. Reproductive span and number of children showed robust associations with late‐life cognition, stronger than other reproductive factors.

High fertility preferences and strong socio-cultural norms around gender and family slow fertility transitions in sub-Saharan Africa (SSA). We examine how gender attitudes shape fertility preferences among youth aged 15–24 using Demographic and Health Survey data from 10 high-fertility SSA countries (total fertility rate ≥5 in 2015–20). We conduct pooled and country-specific negative binomial regressions separately for men and women, relating attitudes towards wife beating and gender preferences for children to the ideal number of children. Tolerance of wife beating is associated with 7% higher desired fertility for both men and women (IRR=1.07, p<0.001), with substantial cross-country variation in magnitude and direction, particularly among women. Gender preferences (son, daughter, or none versus balanced) show clear differences between men and women; these associations are generally positive for men and mixed for women, although modest in magnitude. This study finds marked variation across and within countries, highlighting context- and gender-specific patterns in how gender attitudes relate to young people's fertility preferences in high-fertility SSA. Cette étude analyse l'association entre des attitudes de genre et les préférences de fécondité des jeunes de 15–24 ans en Afrique subsaharienne (ASS). À partir des EDS de 10 pays à forte fécondité, nous estimons, pour les hommes et les femmes, des régressions binomiales négatives, groupées et par pays, reliant la justification des violences conjugales et les préférences de sexe des enfants au nombre idéal d'enfants (NIE). La justification des violences conjugales est associée à un NIE supérieur de 7% chez les hommes et les femmes (IRR=1.07; p<0.001), avec une forte hétérogénéité entre pays, particulièrement chez les femmes. Les préférences de sexe (garçons, filles ou aucune; réf. équilibrée) montrent des contrastes, généralement positifs chez les hommes et mixtes chez les femmes, mais leurs effets sur le NIE restent modestes. L'étude met en évidence de fortes variations entre et au sein des pays et montre que la relation entre les attitudes de genre et les préférences de fécondité des jeunes est à la fois contextuelle et spécifique au genre dans les pays d'ASS à forte fécondité.

Background In former studies, parity was associated with adverse cardiovascular outcomes in parents. This study aims to extend the limited existing data regarding the association between the number of children and heart disease and/or stroke in a large longitudinal study in different European countries in both men and women. Methods For 42 075 subjects (18 080 men, 23 995 women; median age 58 years (interquartile range: 53 to 65)) from 19 European countries and Israel in the Survey of Health, Ageing and Retirement in Europe (SHARE), odds ratios (OR) for the association between number of children and incident self-reported heart disease and/or stroke (HDS) were estimated using logistic regression analyses. Persons with one or two children were used as reference. The final model was adjusted for baseline age, sex, education, region, and marital status. All analyses were stratified by sex. Results Women with seven or more children had the highest OR for the association between the number of children and incident HDS (OR = 2.12 [95% CI: 1.51 to 2.98]), while men with six children showed the highest OR (OR = 1.62 [1.13 to 2.33]). Stratified by education, across all education levels, men and women with five or more children had the highest ORs for this association. The highest OR was observed in both women and men in the group with primary education (OR = 1.66 [1.29 to 2.15] and OR = 1.60 [1.19 to 2.14], respectively). Stratified by region, both men and women with five or more children showed the highest ORs in Southern Europe (OR = 2.07 [1.52 to 2.82] and OR = 1.75 [1.25 to 2.44], respectively). Conclusion In this long-term follow-up study in various countries in Europe and Israel we found a positive association between number of children and incident HDS. This association was more pronounced in lower educated subjects and showed regional variations.

Fertility punishment is a powerful interpretation of the low birth rate in contemporary China, but it is not consistent with the fact that the proportion of second children has been increasing year by year for some time. From the perspective of Bandura’s “Self-efficacy”, based on the post-80 s and post-90 s youth samples in the Psychology and Behavior Investigation of Chinese Residents 2021 , this paper explores the quantitative relationship between the number of children and individual self-efficacy. The data indicates that: (1) Fertility is closely linked to self-efficacy, with young people who have two children exhibiting higher self-efficacy; (2) The quantitative relationship between the number of children and self-efficacy varies based on parental roles—men/fathers show almost no change in self-efficacy when moving from having no children to one child, but demonstrate a significant increase in self-efficacy when they have two children. In contrast, women/mothers experience the lowest self-efficacy when having one child, which only shows a significant improvement when they have two children. These findings provide a new perspective for theoretically explaining the current fertility situation and expand the application of self-efficacy. In terms of policy efforts, it is necessary to provide support for women’s one-child fertility, and to increase the publicity of the view of more children and more efficacy to resist the potential energy of low fertility that arises from the view of more children and more burdens.

The continuous decrease in the number of women of childbearing age and the consequent decrease in reproductive willingness have contributed to the continuous decrease in labor participation among Chinese women, which has negatively affected the stable socioeconomic development in terms of health. This paper deeply explores the intrinsic relationship between the number of children and women’s labor participation based on 2016 data from China Labor-force Dynamic Survey (CLDS). Our results show that there is an “inverted U-shaped” relationship between the number of children and the rate of women’s labor involvement; in other words, women’s labor participation shows a trend with the increase in the number of children, first rising and then falling; meanwhile, the relationship is more pronounced among women in eastern and central regions and towns. To this end, this study provides a theoretical research basis to effectively alleviate women’s selective pressure at home and work, and has a certain reference value for the Chinese government to improve women’s employment environment.