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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
0
10
20
30
40
1998 1999 2000 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.
2010 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 ComplicationsDuring Labor and Delivery
Obstetric complications – 30.7% of live births
Preexisting medical conditions – 4.1% of live births
10
12
14
16
18
20
1989 1991 1993 1995 1997 1999 2001
0
5
10
15
20
25
White,Not Hispanic
Black,Not Hispanic
Hispanic*
Total
American Indian/Alaska Native
Percent2010 Target
Asian
Native Hawaiian/Other Pacific Islander
Obj. 16-9Source: NVSS, NCHS, CDC.
Cesarean Births by Race: 2001
Women giving birth for the first time
* Persons of Hispanic origin may be of any race.
0
20
40
60
80
100
1950 1960 1970 1980 1990 2000
0
5
10
15
20
25
30
1999 2000 2001
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
0
5
10
15
1998 1999 2000 2001
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. 16-1cSource: NVSS, NCHS, CDC.
2010 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 8.0 - 8.97.0 – 7.96.0 – 6.9Less than 6.0
All Infant Deaths (Within 1 Year)by State: 1998-2000
D.C.
Obj. 16-1cSource: 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 racesBlack, NotHispanic
White, NotHispanic
* Persons of Hispanic origin may be of any race.
293.5 2159.3 8961.4 77.5 1081.6 6157.1
Total LBW VLBW
146.3 1271.5 2635.3
76.4 1130.5 6261.0
27.1 78.4 102.5
21.0 303.2 1655.5
Hispanic*
Total LBW VLBW
162.0 721.7 1291.4
113.5 230.3 262.3
85.3 630.1 2608.5
Total LBW VLBW
134.1 1071.8 2723.9
45.6 122.5 124.5
29.3 443.3 2438.8
Total LBW VLBW Total LBW VLBW
Very low birth weight
Low birth weight
0
5
10
15
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. 16-10Source: NVSS, NCHS, CDC.
LBW2010 Target
VLBW2010 Target
Black, NotHispanic
Percent of live births
Total Asian White, NotHispanic
Hispanic*
0
2
4
6
8
10
1981 86 91 96 2001
0
5
10
15
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. 16-10Source: NVSS, NCHS, CDC.
LBW2010 Target
VLBW2010 Target
Black, NotHispanic
Percent of live birthsVery low birth weight
Low birth weight
Total Asian White, NotHispanic
Hispanic*
0
2
4
6
8
10
1981 86 91 96 2001
Economic and Social ImpactHealth 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
Prenatal care Very low birth weight infants born at level III hospitals
Prenatal substance exposure Breastfeeding
Optimum folic acid levels Infants put to sleep on their backs
60
70
80
90
1998 1999 2000 2001
Early Prenatal Care (First Trimester)by Race and Ethnicity: 1998 - 2001
Percent
Black, Not Hispanic
American Indian/Alaska Native
White,NotHispanic
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
75
80
85
90
95
100
1998 1999 2000 2001
Pregnant Women Abstaining from Smoking by Race and Ethnicity:
1998 - 2001
American Indian/Alaska Native
Asian
Total
Hispanic*
Native Hawaiian/Other PacificIslander
Percent
Black, Not Hispanic
0
White, Not Hispanic
Obj. 16-17cSource: NVSS, NCHS, CDC.
2010 Target
* Persons of Hispanic origin may be of any race.
0
20
40
60
80
100 2010 Target
Trimester
Second Third
Race/Ethnicity
Total
Percent in month preceding survey
Pregnant Women Abstaining from Alcohol by Race/Ethnicity and
Trimester: 2002
FirstBlack WhiteHispanic*
Obj. 16-17aI 95% Confidence interval.Source: NSDUH, OAS, SAMHSA. * Persons of Hispanic origin may be of any race.
0
Not Hispanic
0
20
40
60
80
100
Breastfeeding by Race: 2002
White,Not Hispanic
Asian,Not Hispanic
Hispanic* Black,Not Hispanic
Obj. 16-19Source: Abbott Laboratories.
Percent of mothers
In Hospital2010 Target
In Hospital
At 6 Months
At 12 Months
6 Months2010 Target
12 Months2010 Target
* Persons of Hispanic origin may be of any race.
0
50
100
150
200
250
300Baseline data
0
2
4
6
8
Median RBC Folate Level
Most recent data
Nu
mb
er (
ng
/ml)
Spina bifida and other NTD
Per
10,
000
2010 Target
Red Blood Cell Folate Level andNeural Tube Defects
1991-94 1999-2000 1996 2000
Obj. 16-16b & 16.15Source: NHANES, NCHS, CDC; NBDPN, NCBDDD, CDC.
(in nonpregnant women 15 – 44 years) (in live births & fetal deaths >20 wks. gestation)
77 72 67 62 5679
35
53 56
6664
0
20
40
60
80
1996 1997 1998 1999 2000 2001
Sudden Infant Death Syndrome and Sleep Position: 1996 - 2001
SIDS deathsInfants put to sleep on their
backsPer 100,000 live births Percent
Sources: NVSS, NCHS, CDC; NISPS, NICHD, NIH. Obj. 16-1h & 16.13
SIDS deaths2010 Target
Sleep position2010 Target
Healthy People 2010 Focus Area 16 Objectives
* Developmental objective
Children with Special Health Care Needs
Developmental disabilities Medical homes for children with special health care needs*
Sepsis among children with special health care needs*
Service systems for children with special health care needs*
Newborn bloodspot screening*
0
5
10
15
20
Sex
Male FemaleTotal
Percent
Proportion of Children with Special Health Care Needs by Race/Ethnicity,
Age and Sex: 2001
12 to 17Bla
ck,
Not H
ispan
icW
hite
,
Not H
ispan
ic
Hispan
ic*0
Age in years
0 to 5 6 to 11
Amer
ican
Indi
an
/Alask
a Nat
ive
Asian
Source: CSHCN, MCHB, HRSA, and NCHS, CDC.
0
1
2
3
4
5
6
7
WhiteBlack
Total
Autism In Children (3 to 10 years)by Race and Sex: 1996
Male FemaleTotal
Per 1,000 in Atlanta, GA
Male FemaleTotal
Source: MADDSP, NCBDDD, CDC. Obj. 16-14c
Progress review data and slidescan be found on the web at:
http://www.cdc.gov/nchs/hphome.htmhttp://www.cdc.gov/nchs/hphome.htm