Focus Area 16: Maternal, Infant, and Child Health Progress Review October 22, 2003

Healthy People 2010 Focus Area 16 Maternal complications during labor and delivery Maternal deaths Cesarean births Ectopic pregnancies* Maternal Mortality and Morbidity Objectives * Developmental objective

Maternal Complications During Labor and Delivery by Race: Per 100 deliveries Source: NHDS, NCHS, CDC. Black White Total Note: Data by race may be under reported Target Obj. 16-5a

A condition that adversely affects a woman’s physical health during childbirth beyond what would be expected in a normal delivery Maternal Complications During Labor and Delivery Obstetric complications – 30.7% of live births Preexisting medical conditions – 4.1% of live births

White, Not Hispanic Black, Not Hispanic Hispanic* Total American Indian/ Alaska Native Percent 2010 Target Asian Native Hawaiian/ Other Pacific Islander Obj Source: NVSS, NCHS, CDC. Cesarean Births by Race: 2001 Women giving birth for the first time * Persons of Hispanic origin may be of any race.

Maternal Deaths by Race and Ethnicity: Black, Not Hispanic White, Not Hispanic Total Hispanic* Source: NVSS, NCHS, CDC. Per 100,000 live births Obj * Persons of Hispanic origin may be of any race Target

Healthy People 2010 Focus Area 16 Objectives Fetal and infant deaths Low and very low birth weight Preterm births Spina bifida and other neural tube defects Healthy Pregnancies and Healthy Infants

American Indian/ Alaska Native Infant Death Rates (Within 1 Year) by Race and Ethnicity: Per 1,000 live births Black, Not Hispanic White, Not Hispanic Asian Total Hispanic* Native Hawaiian/ Other Pacific Islander Obj. 16-1c Source: NVSS, NCHS, CDC Target * Persons of Hispanic origin may be of any race.

Per 1,000 live births N (6) (9) (15) (13) (8) 9.0 or more – – 6.9 Less than 6.0 All Infant Deaths (Within 1 Year) by State: D.C. Obj. 16-1c Source: NVSS, NCHS, CDC Target = 4.5

Leading Causes of Infant Death (Within 1 Year): 2001 Source: NVSS, NCHS, CDC. Cause of death Infant deaths per 100,000 live births Birth defects Preterm & LBW SIDS Maternal complications TotalLBW VLBW All races Black, Not Hispanic White, Not Hispanic * Persons of Hispanic origin may be of any race TotalLBW VLBW Hispanic* TotalLBW VLBW TotalLBW VLBW TotalLBW VLBW TotalLBW VLBW

Very low birth weight Low birth weight Native Hawaiian/ Other Pacific Islander American Indian/ Alaska Native LBW (<5 lbs 8 oz) and VLBW (<3 lbs 4 oz) by Race and Ethnicity: 2001 * Persons of Hispanic origin may be of any race. Obj Source: NVSS, NCHS, CDC. LBW 2010 Target VLBW 2010 Target Black, Not Hispanic Percent of live births Total AsianWhite, Not Hispanic Hispanic*

Native Hawaiian/ Other Pacific Islander American Indian/ Alaska Native LBW (<5 lbs 8 oz) and VLBW (<3 lbs 4 oz) by Race and Ethnicity: 2001 * Persons of Hispanic origin may be of any race. Obj Source: NVSS, NCHS, CDC. LBW 2010 Target VLBW 2010 Target Black, Not Hispanic Percent of live births Very low birth weight Low birth weight Total AsianWhite, Not Hispanic Hispanic* Economic and Social Impact Health care:24 – fold differential in first year medical costs between VLBW infants and all infants born in the US. Education:Children born LBW are almost 50% more likely to be enrolled in any type of special education than children who were normal weight at birth. Social services:Recent disaggregated costs are not available. Costs would include developmental services, day care programs, case management and counseling, respite care and residential care. Family expenses: Special care for LBW infants directly attributed to an infants illness account for 2 - 4% of a family's income.

Healthy People 2010 Focus Area 16 Objectives Healthy Pregnancies and Healthy Infants

Early Prenatal Care (First Trimester) by Race and Ethnicity: Percent Black, Not Hispanic American Indian/Alaska Native White, Not Hispanic Asian Total Hispanic* Native Hawaiian/Other Pacific Islander 2010 Target * Persons of Hispanic origin may be of any race. Source: NVSS, NCHS, CDC. Obj. 16-6a

Pregnant Women Abstaining from Smoking by Race and Ethnicity: American Indian/Alaska Native Asian Total Hispanic* Native Hawaiian/ Other Pacific Islander Percent Black, Not Hispanic 0 White, Not Hispanic Obj c Source: NVSS, NCHS, CDC Target * Persons of Hispanic origin may be of any race.

2010 Target Trimester SecondThird Race/Ethnicity Total Percent in month preceding survey Pregnant Women Abstaining from Alcohol by Race/Ethnicity and Trimester: 2002 FirstBlackWhiteHispanic* Obj a I 95% Confidence interval. Source: NSDUH, OAS, SAMHSA. * Persons of Hispanic origin may be of any race. 0 Not Hispanic

Breastfeeding by Race: 2002 White, Not Hispanic Asian, Not Hispanic Hispanic*Black, Not Hispanic Obj Source: Abbott Laboratories. Percent of mothers In Hospital 2010 Target In Hospital At 6 Months At 12 Months 6 Months 2010 Target 12 Months 2010 Target * Persons of Hispanic origin may be of any race.

Baseline data Median RBC Folate Level Most recent data Number (ng/ml) Spina bifida and other NTD Per 10, Target Red Blood Cell Folate Level and Neural Tube Defects Obj b & Source: NHANES, NCHS, CDC; NBDPN, NCBDDD, CDC. (in nonpregnant women 15 – 44 years)(in live births & fetal deaths >20 wks. gestation)

Sudden Infant Death Syndrome and Sleep Position: SIDS deaths Infants put to sleep on their backs Per 100,000 live births Percent Sources: NVSS, NCHS, CDC; NISPS, NICHD, NIH. Obj. 16-1h & SIDS deaths 2010 Target Sleep position 2010 Target

Healthy People 2010 Focus Area 16 Objectives * Developmental objective Children with Special Health Care Needs

Sex Male Female Total Percent Proportion of Children with Special Health Care Needs by Race/Ethnicity, Age and Sex: to 17 Black, Not Hispanic White, Not Hispanic Hispanic* 0 Age in years 0 to 56 to 11 American Indian /Alaska Native Asian Source: CSHCN, MCHB, HRSA, and NCHS, CDC.

WhiteBlack Total Autism In Children (3 to 10 years) by Race and Sex: 1996 MaleFemaleTotal Per 1,000 in Atlanta, GA MaleFemaleTotal Source: MADDSP, NCBDDD, CDC. Obj c

Progress review data and slides can be found on the web at: