# Presentation: 261759

## Focus Area 16:Maternal, Infant, and Child HealthProgress Review 

**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: 1998 - 2001

**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.

**Obj. 16-5a**

## Maternal Complications

**Maternal Complications**
**During Labor and Delivery**

**Obstetric complications – 30.7% of live births**
**Preexisting medical conditions – 4.1% of live births**

## Slide 5

## Cesarean Births by Race: 2001

**White,**
**Not Hispanic**

**Black,**
**Not Hispanic**

**Hispanic* **

**Total**

**American Indian/**
**Alaska Native**

**Percent**

**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.

## Maternal Deaths by Race and Ethnicity:

**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**

## 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**

## Infant Death Rates (Within 1 Year)

**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.

## All Infant Deaths (Within 1 Year)

**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**

## 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**

**Total**

**LBW**

**VLBW**

**137.6**

**1011.8**

**2247.8**

**109.5**

**1361.8**

**7105.0**

**55.5**

**139.4**

**159.4**

**37.3**

**459.1**

**2353.6**

**All races**

**Black, Not**
**Hispanic**

**White, Not**
**Hispanic**

- * Persons of Hispanic origin may be of any race.

**293.5**

**2159.3**

**8961.4**

**77.5**

**1081.6**

**6157.1**

## LBW (<5 lbs 8 oz) and VLBW (<3 lbs 4 oz)

**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**

**Asian**

**White, Not**
**Hispanic**

** ****Hispanic* **

## LBW (<5 lbs 8 oz) and VLBW (<3 lbs 4 oz)

**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**

**Asian**

**White, 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)

**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**

- * 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: 1998 - 2001

**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**

**White, Not Hispanic**

**Obj. 16-17c**

- Source: NVSS, NCHS, CDC.

**2010 Target**

- * Persons of Hispanic origin may be of any race.

## Pregnant Women Abstaining from Alcohol by Race/Ethnicity and Trimester: 2002

**2010 Target**

**Trimester**

**Second**

**Third**

**Race/Ethnicity**

**Total**

**Percent in month preceding survey**

**Pregnant Women Abstaining from Alcohol by Race/Ethnicity and Trimester: 2002**

**First**

**Hispanic***

**Obj. 16-17a**

- I 95% Confidence interval.
- Source: NSDUH, OAS, SAMHSA.

- * Persons of Hispanic origin may be of any race.

**Not Hispanic**

**Notes:**
(Describe slide)

## Breastfeeding by Race: 2002

**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.

## Red Blood Cell Folate Level and

**Baseline data**

**Median RBC Folate Level**

**Most recent data**

**Number (ng/ml)**

**Spina bifida and other NTD**

**Per 10,000**

**Red Blood Cell Folate Level and**
**Neural Tube Defects**

- 1991-94

- 1999-2000

- 1996

- 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)

## Sudden Infant Death Syndrome and Sleep Position: 1996 - 2001

**1996**

**1997**

**1998**

**1999**

**2000**

**2001**

**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**

## Healthy People 2010 Focus Area 16 Objectives

- * Developmental objective

**Children with Special Health Care Needs**

## Proportion of Children with Special Health Care Needs by Race/Ethnicity, Age and Sex: 2001

**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*

**Age in years**

**0 to 5**

**6 to 11**

- American Indian
- /Alaska Native

- Asian

- Source: CSHCN, MCHB, HRSA, and NCHS, CDC.

**Notes:**
(Describe slide)

## Autism In Children (3 to 10 years)

**White**

**Black**

**Total**

**Autism In Children (3 to 10 years)**
**by Race and Sex: 1996**

**Male**

**Female**

**Total**

**Per 1,000 in Atlanta, GA**

**Male**

**Female**

**Total**

- Source: MADDSP, NCBDDD, CDC.

**Obj. 16-14c**

**Notes:**
(Describe slide)

## http://www.cdc.gov/nchs/hphome.htm

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

**http://www.cdc.gov/nchs/hphome.htm**