After rising steadily for almost two decades, birth rates for women in their thirties appear to have stabilized, recording just modest increases for the past few years. More than 100,000 babies were born in multiple deliveries in 1993, the highest number ever reported. Live births in twin delivery increased 1 percent while the number of triplet and higher-order plural births rose 7 percent. The report documents maternal medical and lifestyle risk factors during pregnancy and their impact on the health of the infant. Cigarette smoking during pregnancy declined to 15.8 percent, down from 19.5 percent in 1989, the first year that information on smoking was recorded on the birth certificate.
Smoking is a key risk factor for low birthweight and infant mortality.
The most frequently reported medical risk factors continued to be anemia, diabetes, and pregnancy-related hypertension. Prenatal care utilization improved in 1993, following more than a decade of little change, with 79 percent of mothers receiving care in the first trimester. Fewer than 5 percent of mothers had late or no care, the lowest level since 1969. The cesarean delivery rate declined again in 1993, to 21.8 percent of all births, continuing the downward trend noted in recent years following a rapid and steady increase through the late 1980's. Other measures of maternal and infant health were not so positive the annual report shows.