In China, marriage examinations are "tailor-made" examinations for newlyweds related to genetic diseases, infectious diseases, and mental illness.
If a disease is found, especially if it is contagious or affects the next generation, effective treatment and preventive measures can be taken as soon as possible to provide greater protection for the health of both parties and the next generation.
Image credit: 123RF
According to statistics, in China, a total of 8.89 million people underwent premarital medical examinations in 2011, with a disease detection rate of 9.0%, and a total of 800,000 people were detected to have diseases [1].
However, with the transition from mandatory to voluntary in 2003, the rate of premarital medical examinations across China has decreased.
Many young people are reluctant to attend a marriage exam because they feel healthy, have no time or have an avoidant mindset.
So, is the marriage examination really as everyone thinks, unnecessary?
Infection with infectious diseases
AIDS, syphilis, gonorrhea, hepatitis B, hepatitis C, etc. can all be transmitted through sexual life.
According to the China Center for Disease Control and Prevention, as of the end of September 2018, there were about 840,000 people living with HIV and AIDS in China [2].
Image source: Xinhua Newspaper Network
Syphilis and gonorrhea are not far from the general population: at present, there are 460,000 new cases of syphilis and 100,000 cases of gonorrhea in China every year [3].
Image source: Tencent Medical Code
Hepatitis B is also often screened for during marriage examinations [4,5].
Image source: Tencent Medical Code
An analysis in Mashan County, Guangxi Province, shows that from 2016 to 2019, a total of 29,742 people participated in marriage examinations, and the total detection rate of diseases was 38.10%[4].
Image source: Tencent Medical Codex She knows, according to reference 4 data mapping
Among the marriage examination population, the proportion of hepatitis B, syphilis, and HIV infection was 13.31%, 0.54%, and 0.13%, respectively[4].
Without marriage tests, it may be difficult to detect the above infectious diseases in time and block their spread.
Image source: Tencent Medical Code
Neonatal defects
Several studies have shown that after the abolition of compulsory marriage examinations, the marriage examination rate in many parts of China has long fallen to a low level, while at the same time, the detection rate of birth defects in China has increased [6-9].
Image source: References[9]
A meta-analysis by the Institute of Population Research of Peking University shows that:
After the abolition of compulsory marriage examinations in 2003, the incidence of co-birth defects in newborns increased from 2005 to 2008 to 1.32 times that of 2002-2003, indicating that the incidence of birth defects in China increased after the abolition of compulsory marriage examinations [10].
One of the defects of newborns is cleft lip
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Image source: Tencent Medical Code
Difficulty preventing unhealthy behaviors
Marriage examination also includes publicizing marriage and childbirth to newlyweds, and the prevention and treatment of birth defects.
For example, folic acid supplement distribution, contraceptive distribution, etc.
Image source: Tencent Medical Code
For example, studies have found that some childhood tumors are related to the occupations of parents, such as paints, rubber, plastic processing and other industries that are often exposed to chemicals [11].
Through the marriage test, the parents have relevant cognition, and they may stay away from these high-risk factors.
Unwanted pregnancies are sudden, occurring before pregnancy tests and pregnancy preparations, if parents do not understand these conditions and do not eliminate these high-risk factors, it may affect the health of the next generation.
Marriage check-up is done to check for infectious diseases, genetic diseases, and organic diseases (such as tumors).
For example, the marriage examination includes syphilis screening, AIDS antibody testing, etc., but the routine hematuria examination of the physical examination cannot find these, and it is necessary to purchase a separate item.
The marriage examination also checks the reproductive system, conducts semen tests, vaginal secretions tests, etc., to check fertility.
In addition, genetic testing for thalassemia for genetic disease screening, G-6-PD enzyme (the lack of which can cause hemolytic jaundice in newborns), etc., generally do not appear in the usual physical examination package.
Image source: Tencent Medical Code
▲The specific projects will have some differences in different cities, and the above table is the current free marriage inspection project in Guangzhou. Image source: Tencent Medical Codex she knows
More critically, the marriage examination also includes premarital hygiene guidance and hygiene consultation.
If the marriage examination finds abnormalities, the doctor can help both parties make decisions and arrangements that are beneficial to the health of both parties and the next generation, avoiding inappropriate marriage mating and the birth of children with genetic diseases.
Image source: Wenzhou.com
For example, if a man is found to have a common genital disease such as excessive foreskin length, the doctor will recommend them to treat them appropriately to reduce the risk of vaginitis in women.
01
As of 2021, 22 provinces across China will fully implement free marriage examinations.
Be sure to consult the local policy at the Marriage Registration Office of the Civil Affairs Bureau, the Health Commission or the local Maternal and Child Health Hospital to find out whether an appointment is required, the required documents, etc.
Image source: Beijing Municipal Health Commission
02
Marriage examination is generally recommended to be performed 3-6 months before marriage, so that if something abnormality is found, treatment can be carried out in time.
03
Do not drink water and eat on the day of the examination, because some tests require an empty stomach, such as blood tests for liver and kidney function.
04
Girls are advised to go 1-2 days after menstruation is clean, so as not to affect the results of the examination.
Although the promise of "whether poor or rich, sick or healthy" in the marriage vow is touching, only when both parties establish a marriage on the basis of sincerity can there be such a happy and long-term future.
I wish you all a sincere and happy love.
Reviewer
Liu Haiphong | Deputy Chief Physician of the Department of Obstetrics and Gynecology, Huashan Hospital, Fudan University
Wang Cuiling | Chief Physician of the Department of Pediatrics, Beijing Friendship Hospital affiliated to Capital Medical University
bibliography
Ministry of Health of the People's Republic of China: Report on the Prevention and Treatment of Birth Defects in China. 2012.
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[3] Key figures of the most common sexually transmitted infections (STI/STDs) in China in 2020 [https://www.statista.com/statistics/1112388/china-the-most-common-sexually-transmitted-diseases-key-figures/]
[MENG Shaojian, WEI Yingxin.Analysis of the results of premarital examination in 29742 cases[J].China Practical Medicine,2020,15(23):156-158.DOI:10.14163/j.cnki.11-5547/r.2020.23.068.
Xiao Yi. Analysis of the results of premarital medical examination in Xicheng District, Beijing in 2017[J].Chinese Journal of Reproductive Health,2019,30(01):44-46.
Fan Hui. Analysis of the current situation of premarital medical examination in the middle of the Chinese mainland of the Outline for the Development of Chinese Women and Children (2011-2020)[J].China Maternal and Child Health Care,2018,33(11):2401-2403.
[7] Wang Haochen, Guo Chao, Li Ning, et al. A meta-analysis of the change in the incidence of birth defects in mainland China before and after the abolition of compulsory marriage inspection policy[J]. Chinese Journal of Family Planning, 2013, 21 ( 2): 82-87.
Zhou Yubo, Luo Shusheng, Li Hongtian, Gao Yanqiu, Liu Jianmeng.Changes in the rate of premarital medical examinations in China from 1996 to 2013[J].Journal of Peking University (Medical Edition),2015,47(03):437-442.
[9] Liu Yanyan, Yang Yanjun, Zhang Wenling, Zhou Li, Yang Yan, Pan Li, Yupei Jiang, Ruijuan Wang, Yanbei Huo, Xiaoyu Ren, Ning Cheng. Correlation between changes in premarital examination and birth defect detection in Lanzhou[J].Chinese Journal of Eugenics and Genetics,2021,29(07):952-954.DOI:10.13404/j.cnki.cjbhh.20211102.026.
Guo Chao,Wang Haochen,Zheng Xiaoying. The importance of premarital examination for young people from the perspective of population birth health[J].China Maternal and Child Health Care,2014,29(09):1313-1315.
[11] Zachek CM, Miller MD, Hsu C, Schiffman JD, Sallan S, Metayer C, Dahl GV: Children's Cancer and Environmental Exposures: Professional Attitudes and Practices. J Pediatr Hematol Oncol 2015, 37(7):491-497.
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