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

2. 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

3. Maternal Complications During Labor and Delivery by Race: 1998 - 2001 Per 100 deliveries Source: NHDS, NCHS, CDC. Black White Total Note: Data by race may be under reported. 2010 Target Obj. 16-5a

4. 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

6. White, Not Hispanic Black, Not Hispanic Hispanic* Total American Indian/ Alaska Native Percent 2010 Target Asian Native Hawaiian/ Other Pacific Islander Obj. 16-9 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.

7. Maternal Deaths by Race and Ethnicity: 1999 - 2001 Black, Not Hispanic White, Not Hispanic Total Hispanic* Source: NVSS, NCHS, CDC. Per 100,000 live births Obj. 16-4 * Persons of Hispanic origin may be of any race. 2010 Target

8. 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

9. American Indian/ Alaska Native Infant Death Rates (Within 1 Year) by Race and Ethnicity: 1998 - 2001 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. 2010 Target * Persons of Hispanic origin may be of any race.

10. Per 1,000 live births N (6) (9) (15) (13) (8) 9.0 or more 8.0 - 8.9 7.0 – 7.9 6.0 – 6.9 Less than 6.0 All Infant Deaths (Within 1 Year) by State: 1998-2000 D.C. Obj. 16-1c Source: NVSS, NCHS, CDC. 2010 Target = 4.5

11. 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 137.61011.82247.8 109.51361.87105.0 55.5139.4159.4 37.3459.12353.6 All races Black, Not Hispanic White, Not Hispanic * Persons of Hispanic origin may be of any race. 293.52159.38961.477.51081.66157.1 TotalLBW VLBW 146.31271.52635.3 76.41130.56261.0 27.178.4102.5 21.0303.21655.5 Hispanic* TotalLBW VLBW 162.0721.71291.4 113.5230.3262.3 85.3630.12608.5 TotalLBW VLBW 134.11071.82723.9 45.6122.5124.5 29.3443.32438.8 TotalLBW VLBW TotalLBW VLBW

12. 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. 16-10 Source: NVSS, NCHS, CDC. LBW 2010 Target VLBW 2010 Target Black, Not Hispanic Percent of live births Total AsianWhite, Not Hispanic Hispanic*

13. 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. 16-10 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.

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

15. Early Prenatal Care (First Trimester) by Race and Ethnicity: 1998 - 2001 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

16. Pregnant Women Abstaining from Smoking by Race and Ethnicity: 1998 - 2001 American Indian/Alaska Native Asian Total Hispanic* Native Hawaiian/ Other Pacific Islander Percent Black, Not Hispanic 0 White, Not Hispanic Obj. 16-17c Source: NVSS, NCHS, CDC. 2010 Target * Persons of Hispanic origin may be of any race.

17. 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. 16-17a I 95% Confidence interval. Source: NSDUH, OAS, SAMHSA. * Persons of Hispanic origin may be of any race. 0 Not Hispanic

18. Breastfeeding by Race: 2002 White, Not Hispanic Asian, Not Hispanic Hispanic*Black, Not Hispanic Obj. 16-19 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.

19. Baseline data Median RBC Folate Level Most recent data Number (ng/ml) Spina bifida and other NTD Per 10,000 2010 Target Red Blood Cell Folate Level and Neural Tube Defects 1991-94 1999-20001996 2000 Obj. 16-16b & 16.15 Source: NHANES, NCHS, CDC; NBDPN, NCBDDD, CDC. (in nonpregnant women 15 – 44 years)(in live births & fetal deaths >20 wks. gestation)

20. 1996 1997 1998199920002001 Sudden Infant Death Syndrome and Sleep Position: 1996 - 2001 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 & 16.13 SIDS deaths 2010 Target Sleep position 2010 Target

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

22. Sex Male Female Total Percent Proportion of Children with Special Health Care Needs by Race/Ethnicity, Age and Sex: 2001 12 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.

23. 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. 16-14c

24. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm