Profiling fertility anxiety in young Chinese women: evidence from latent class and random forest analyses

Amid China’s demographic transition and evolving fertility policies, fertility anxiety among young women has attracted increasing attention. However, the multidimensional structure of fertility anxiety remains underexplored, especially with respect to systematic examinations of heterogeneity across marital and fertility statuses and the factors related to these variations. This study collected 2000 valid samples through a questionnaire survey, employed latent profile analysis to identify types of fertility anxiety, and used a random forest model to rank the importance of key influencing factors.

The results show that multiple types exist within each marital and fertility status group, and that emotional anxiety has significantly greater discriminative power than cognitive anxiety. Parenting sense of competence, marital quality, perceived social fairness, and social support were identified as core predictive variables. The sources of moderate-to-high anxiety were manifested in actual parenting stress, decision-making uncertainty, and future identity expectations, respectively.

The classification accuracy and confusion matrix results indicate that the model demonstrates high robustness in distinguishing fertility anxiety profiles across different marital and fertility statuses. The findings indicate that fertility anxiety is a multidimensional, context-dependent psychological structure jointly shaped by cultural norms, resource adequacy, and relational support. At the policy level, China should adopt differentiated strategies: enhancing parenting competence and childcare service provision, strengthening marital stability and fertility counseling, alleviating gendered role pressures, and improving perceptions of fairness.

At the international level, low-fertility countries should tailor support measures to local gender norms and welfare systems, prioritizing the development of emotional regulation interventions and family–work-friendly policies to effectively reduce fertility anxiety and promote overall well-being. The authors would like to express our heartfelt thanks to the study participants for generously sharing their experiences and perspectives. This work was supported by grants from the start-up funding of Guangzhou University (69-622914502).

Department of Psychology, Guangzhou University, Guangzhou, China Department of Artificial Intelligence, University of Malaya, Kuala Lumpur, Malaysia Department of Anthropology and Sociology, University of Malaya, Kuala Lumpur, Malaysia Noor Eshah Tom Abdul Wahab & Haslina Muhamad Correspondence to Yiqing He, Noor Eshah Tom Abdul Wahab or Haslina Muhamad. The authors declare no competing interests. This study was conducted in China in accordance with the ethical principles of the Declaration of Helsinki and all applicable institutional and local requirements for research involving human participants.

Ethical approval was obtained before data collection from the Guangzhou University Scientific Ethics Committee in March 2024 (Guangzhou University Scientific Ethics Review [2024] No. 059). Guangzhou University is located in China, where the research and participant recruitment were conducted, and its ethics committee therefore served as the local ethics approval body for this study. Additional ethical approval was obtained from the Universiti Malaya Research Ethics Committee (UMREC) on 17 April 2024 (approval number: UM.TNC2/UMREC_3348; approval period: April 2024 to April 2027).