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Fay Menacker

Publications and source records attributed to Fay Menacker.

18 recordsLinked to original sources

Births: final data for 2004.

OBJECTIVES: This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. RESULTS: In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise. The twinning rate increased, but the rate of triplet and higher order multiple births was down slightly.

Adolescent↗

Maternal risk profiles and the primary cesarean rate in the United States, 1991-2002.

OBJECTIVES: We examined factors contributing to shifts in primary cesarean rates in the United States between 1991 and 2002. METHODS: US national birth certificate data were used to assess changes in primary cesarean rates stratified according to maternal age, parity, and race/ethnicity. Trends in the occurrence of medical risk factors or complications of labor or delivery listed on birth certificates and the corresponding primary cesarean rates for such conditions were examined. RESULTS: More than half (53%) of the recent increase in overall cesarean rates resulted from rising primary cesarean rates. There was a steady decrease in the primary cesarean rate from 1991 to 1996, followed by a rapid increase from 1996 to 2002. In 2002, more than one fourth of first-time mothers delivered their infants via cesarean. Changing primary cesarean rates were not related to general shifts in mothers' medical risk profiles. However, rates for virtually every condition listed on birth certificates shifted in the same pattern as with the overall rates. CONCLUSIONS: Our results showed that shifts in primary cesarean rates during the study period were not related to shifts in maternal risk profiles.

Adult↗

Method of delivery and neonatal mortality among very low birth weight infants in the United States.

OBJECTIVE: To examine the association between method of delivery (primary cesarean section vs. vaginal) and neonatal mortality risk (as well as causes of death) among very low-birth weight first-born infants in the United States. More specifically, to examine this association separately for breech/malpresenting and vertex-presenting infants, while adjusting for selected maternal characteristics, and pregnancy, labor and delivery complications. METHODS: The study population was derived from the 1995-1998 birth cohort linked birth/infant death data sets. Binary and multinomial logit regression analyses were performed to assess the relationship in four very low-birth weight categories. RESULTS: Among breech/malpresenting neonates, compared to those delivered vaginally, infants delivered by a primary cesarean section had significantly lower adjusted relative risks of death for all very low-birth weight categories and the decrease in relative risk tended to be larger with each increasing birth weight category. However, for vertex-presenting neonates, results are mixed, suggesting decreased relative mortality risks associated with primary cesarean section, which were significant for 500-749 g, not significant for 750-999 g, and barely significant for 1,000-1,249 g. In contrast, for vertex-presenting neonates weighing 1,250-1,499 g, there was a significantly increased adjusted relative risk associated with primary cesarean section. Differences in cause-specific neonatal mortality by method of delivery and presentation status were also discussed. CONCLUSIONS: Primary cesarean section appears to be associated with decreased neonatal mortality risks in each very low-birth weight category for breech/malpresenting infants, but results are mixed for vertex-presenting infants. Causal inferences should be avoided because this was an observational study by design.

Adult↗

Cesarean delivery: background, trends, and epidemiology.

OBJECTIVE: To examine trends in cesarean delivery for the overall population and for women with "no indicated risk" for cesarean section, and to summarize the available literature on "maternal request" cesarean deliveries. FINDINGS: Nearly 3 in 10 births were delivered by cesarean section in 2004 (29.1%), the highest rate ever reported in the United States. The overall rate has increased by over 40% since 1996, reflecting two concurrent trends: an increase in the primary rate (14.6% to 20.6%), and a steep decline in the rate of vaginal birth after cesarean (28.3% to 9.2%). There has been a clear increase in primary cesarean delivery without a medical or obstetrical indication, and studies using hospital discharge data or birth certificate data estimate the rate of primary cesarean deliveries with no reported medical or obstetrical indication to be between 3% and 7% of all deliveries to women who had not had a previous cesarean delivery. However, these studies contain no direct information on whether these cesareans were the result of maternal request or because of physician recommendation. There was little data to support the contention that the rise in the cesarean rate was the result of maternal request. CONCLUSION: There are no systematic data available on cesarean delivery by "maternal request." However, the rate of primary cesarean delivery is increasing rapidly for women of all ages, races, and medical conditions, as well as for births at all gestational ages. Since a first cesarean section virtually guarantees that subsequent pregnancies will be cesarean deliveries (the repeat cesarean delivery rate is now almost 91%), research is needed on physician practice patterns, maternal attitudes, clinical outcomes for mother and infant (harms, benefits), and clinical and nonclinical factors (institutional, legal, economic) that affect the decision to have a cesarean delivery.

Age Factors↗

Infant and neonatal mortality for primary cesarean and vaginal births to women with "no indicated risk," United States, 1998-2001 birth cohorts.

BACKGROUND: The percentage of United States' births delivered by cesarean section has increased rapidly in recent years, even for women considered to be at low risk for a cesarean section. The purpose of this paper is to examine infant and neonatal mortality risks associated with primary cesarean section compared with vaginal delivery for singleton full-term (37-41 weeks' gestation) women with no indicated medical risks or complications. METHODS: National linked birth and infant death data for the 1998-2001 birth cohorts (5,762,037 live births and 11,897 infant deaths) were analyzed to assess the risk of infant and neonatal mortality for women with no indicated risk by method of delivery and cause of death. Multivariable logistic regression was used to model neonatal survival probabilities as a function of delivery method, and sociodemographic and medical risk factors. RESULTS: Neonatal mortality rates were higher among infants delivered by cesarean section (1.77 per 1,000 live births) than for those delivered vaginally (0.62). The magnitude of this difference was reduced only moderately on statistical adjustment for demographic and medical factors, and when deaths due to congenital malformations and events with Apgar scores less than 4 were excluded. The cesarean/vaginal mortality differential was widespread, and not confined to a few causes of death. CONCLUSIONS: Understanding the causes of these differentials is important, given the rapid growth in the number of primary cesareans without a reported medical indication.

Cause of Death↗

Annual summary of vital statistics: 2004.

The crude birth rate in 2004 was 14.0 births per 1000 population, the second lowest ever reported for the United States. The number of births and the fertility rate (66.3) increased slightly (by <1%) from 2003 to 2004. Fertility rates were highest for Hispanic women (97.7), followed by Asian or Pacific Islander (67.2), non-Hispanic black (66.7), Native American (58.9), and non-Hispanic white (58.5) women. The birth rate for teen mothers continued to fall, dropping 1% from 2003 to 2004 to 41.2 births per 1000 women aged 15 to 19 years, which is another record low. The teen birth rate has fallen 33% since 1991; declines were more rapid for younger teens aged 15 to 17 (43%) than for older teens aged 18 to 19 (26%). The proportion of all births to unmarried women is now slightly higher than one third. Smoking during pregnancy declined slightly from 2003 to 2004. In 2004, 29.1% of births were delivered by cesarean delivery, up 6% since 2003 and 41% since 1996 (20.7%). The primary cesarean delivery rate has risen 41% since 1996, whereas the rate of vaginal birth after a previous cesarean delivery has fallen 67%. The use of timely prenatal care was 84.0% in both 2003 and 2004. The percentage of preterm births rose to 12.5% in 2004 from 10.6% in 1990 and 9.4% in 1981. The percentage of low birth weight births also increased to 8.1% in 2004, up from 6.7% in 1984. Twin birth rate and triplet/+ birth rates increased by 1% and <1%, respectively, from 2002 to 2003. Multiple births accounted for 3.3% of all births in 2003. The infant mortality rate was 7.0 per 1000 live births in 2002 compared with 6.8 in 2001. The ratio of the infant mortality rate among non-Hispanic black infants to that for non-Hispanic white infants was 2.4 in 2002, the same as in 2001. The United States continues to rank poorly in international comparisons of infant mortality. Expectation of life at birth reached a record high of 77.6 years for all gender and race groups combined. Death rates in the United States continue to decline, with death rates decreasing for 8 of the 15 leading causes. Death rates for children < or =19 years of age declined for 7 of the 10 leading causes in 2003. The death rates did not increase for any cause, and rates for heart disease, influenza, and pneumonia and septicemia did not change significantly for children as a group. A large proportion of childhood deaths, however, continue to occur as a result of preventable injuries.

Birth Rate↗

Births: preliminary data for 2004.

OBJECTIVES: This report presents preliminary data for 2004 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, tobacco use, prenatal care, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. METHODS: Data in this report are based on 99.1 percent of births for 2004. The records are weighted to independent control counts of all births received in State vital statistics offices in 2004. Comparisons are made with 2003 data. RESULTS: The crude birth rate declined 1 percent to 14.0 births per 1,000 population. The fertility rate, however, rose slightly to 66.3 births per 1,000 women aged 15-44 years. Birth rates for teenagers 15-19 years declined modestly. The rate in 2004 was 41.2 births per 1,000 females aged 15-19 years, 1 percent lower than in 2003. Rates declined 1 percent each for teenagers 15-17 and 18-19 years. The rate for 10-14 year-olds increased slightly. The birth rate for women aged 20-24 years declined 1 percent to 101.8, a record low for the Nation. The rate for women aged 25-29 years remained essentially unchanged at 115.5 per 1,000. The birth rate for women aged 30-34 years rose less than 1 percent to 95.5 per 1,000, whereas the rates for women aged 35-39 and 40-44 years increased 3 to 4 percent each. The rate for women aged 45-49 years rose to 0.6 per 1,000. Childbearing by unmarried women rose to a record high of almost 1.5 million births in 2004, a 4-percent increase from 2003. The proportion of all births to unmarried women increased to 35.7 percent. Smoking during pregnancy declined slightly in 2004, to 10.2 percent of mothers in the 40-State reporting area. There was no improvement in timely receipt of prenatal care. In 2004, 83.9 percent of mothers in the 41-State reporting area began care in the first trimester. A record high cesarean delivery rate was reported in 2004, at 29.1 percent of all births, a 6-percent increase from 2003. The primary cesarean rate rose 8 percent, whereas the rate of vaginal birth after cesarean delivery declined 13 percent. Preterm and LBW rates each increased in 2004. More than 500,000 infants were born preterm, a rate of 12.5 percent. The LBW rate increased to 8.1 percent.

Adolescent↗

Trends in cesarean rates for first births and repeat cesarean rates for low-risk women: United States, 1990-2003.

OBJECTIVES: This report presents trends in cesarean rates for first births and repeat cesarean rates for low-risk women, in relation to the Healthy People 2010 (HP 2010) objectives. Data for the U.S. showing trends by maternal age and race and Hispanic origin are presented. METHODS: Cesarean rates were computed based on the information reported on birth certificates. RESULTS: With a decrease between 1990 and 1996 and an increase between 1996 and 2003, the trend in the cesarean rate for low-risk women having a first birth paralleled trends in the primary (regardless of parity) and total cesarean rates. During 1996-2003 the cesarean rate for low-risk women having a first birth has consistently been at least 13 percent lower than the rate for all women having a first birth. For 2003 the cesarean rate for all primiparous women was 27.1 percent; for low-risk women the rate was 23.6 percent. The trend in the repeat cesarean rate for low-risk women was similar to the trend in the repeat rate for all women, i.e., a decrease from 1990 to 1996 and an increase from 1996 to 2003. The repeat cesarean rate for low-risk women has consistently been slightly lower than the rate for all women. For 2003 the repeat rate for all women was 89.4; the rate for low-risk women was 88.7. These trends were found for low-risk women of all ages and racial or ethnic groups. Therefore, low-risk women giving birth for the first time who have a cesarean delivery are more likely to have a subsequent cesarean delivery.

Adult↗

Births: final data for 2003.

OBJECTIVES: This report presents 2003 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.09 million births that occurred in 2003 are presented. Denominators for population-based rates are derived from the U.S. 2000 census. RESULTS: In 2003 there were 4,089,950 live births reported in the United States, 2 percent more than the number in 2002. The crude birth rate (CBR) and general fertility rate (GFR) rose slightly. Childbearing among teenagers declined for the 12th straight year to another historic low. Birth rates for women aged 20-24 years also declined, whereas rates for women aged 25-44 years increased 2-6 percent, reaching highs not reported since the mid- to late 1960s. All measures of unmarried childbearing increased considerably in 2003, but smoking during pregnancy continued to decline. Timely initiation of prenatal care improved slightly. The cesarean delivery rate jumped another 5 percent to another all-time high, and the rate of vaginal birth after previous cesarean dropped 16 percent, an all-time low. Key measures of birth outcome-the percentages of preterm and low birthweight (LBW) births-rose. The twinning rate increased, but the rate of triplet and higher order multiple births was essentially stable.

Adolescent↗

Infant mortality statistics from the 2002 period: linked birth/infant death data set.

OBJECTIVES: This report presents 2002 period infant mortality statistics from the linked birth/infant death data file by a variety of maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. METHODS: Descriptive tabulations of data are presented and interpreted. RESULTS: The U.S. infant mortality rate increased from 6.8 infant deaths per 1000 live births in 2001 to 7.0 in 2002. The rate for infants of non-Hispanic white mothers was 5.7 in 2001 compared with 5.8 in 2002. The rate for infants of non-Hispanic black mothers was 13.5 in 2001 compared with 13.9 in 2002. Neither of the changes for non-Hispanic white nor non-Hispanic black was significant. Between 2001 and 2002, overall cause-specific rates increased 5 percent for low birthweight and 14 percent for maternal complications. The rate rose significantly for infants of mothers who smoked, 10.5 to 11.1. It also increased significantly from 10.7 to 11.5 for infants of mothers aged 15-17 years. The rate dropped significantly for triplet births, 71.4 to 60.1. Infant mortality rates ranged from 3.0 per 1000 live births for Chinese mothers to 13.9 for non-Hispanic black mothers. Among Hispanics, rates ranged from 3.7 for Cuban mothers to 8.2 for Puerto Rican mothers. Infant mortality rates were higher for those infants whose mothers were born in the 50 States and the District of Columbia, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. The three leading causes of infant death-Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)-taken together accounted for 45 percent of all infant deaths. For infants of non-Hispanic black mothers, the cause-specific infant mortality rate for low birthweight was nearly four times that for infants of non-Hispanic white mothers. For infants of non-Hispanic black and American Indian mothers, the SIDS rates were at least double the rate for non-Hispanic white mothers. A more intensive analysis of the rise in the infant mortality rate utilizing information on maternal and infant health risk factors available in the linked birth/infant death and fetal death data files is forthcoming.

Adult↗

Births to 10-14 year-old mothers, 1990-2002: trends and health outcomes.

OBJECTIVES: This report presents the number and rate of U.S. births for 10-14 year olds, for 1990-2002 by race and Hispanic origin and by State. Pregnancy risk factors and outcomes by selected maternal and infant characteristics are shown. METHODS: Tabular and graphical descriptions of births and infant deaths to 10-14 year olds are presented based on information reported on birth and death certificates for the United States and each State. RESULTS: 7,315 females aged 10-14 years delivered a live birth in 2002. The rate of births to 10-14 year olds was 0.7 per 1,000 in 2002, half of the rate during 1989-94. This rate peaked in 1989 (1.4 per 1,000). For 1990-94 the rate remained at 1.4, and then began a steady decline to 0.7 per 1,000 in 2002. Large declines in young teenage childbearing were seen among all racial and ethnic subgroups, as well as almost all States. These young mothers were least likely to receive timely prenatal care compared with mothers of older age groups. Compared with infants of mothers aged 20-39 years, infants of the youngest mothers experienced almost twice the rates of preterm delivery (21.3 percent) and low birthweight (12.6 percent). The infant mortality rate (15.4 per 1,000) was two to three times higher than that for infants of mothers aged 20-44 years.

Adolescent↗

Births: final data for 2002.

OBJECTIVES: This report presents 2002 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.022 million births that occurred in 2002 are presented. Denominators for population-based rates are derived from the 2000 U.S. census. Rates for 1991-2001 may differ from those published previously based on the 1990 U.S. census. RESULTS: There were 4,021,726 live births in 2002, essentially unchanged from 2001. The birth rate, fertility rate, and total fertility rates all declined 1 percent in 2002. The teenage birth rate dropped 5 percent, reaching another record low. The birth rates for women 20-24 years declined, whereas the rate for women 25-29 years was stable. The birth rate for women 30-34 years declined, but the rate for women 35-44 years continued to rise. Births to unmarried women changed very little. Smoking during pregnancy was down again. The timeliness of prenatal care continued to improve. The cesarean delivery rate climbed to the highest level ever reported in the United States (26.1 percent) and the rate of vaginal birth after previous cesarean plummeted 23 percent to 12.6 percent. Preterm and low birthweight levels both rose for 2002. The twin birth rate continued to climb, but the rate of triplet/+ births was down slightly.

Adolescent↗

Infant mortality statistics from the 2001 period linked birth/infant death data set.

OBJECTIVES: This report presents 2001 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics. METHODS: Descriptive tabulations of data are presented and interpreted. RESULTS: Infant mortality rates ranged from 3.2 per 1,000 live births for Chinese mothers to 13.3 for black mothers. Among Hispanics, rates ranged from 4.2 for Cuban mothers to 8.5 for Puerto Rican mothers. Infant mortality rates were higher for those infants whose mothers were born in the 50 States and the District of Columbia, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. The three leading causes of infant death--Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)--taken together accounted for 44 percent of all infant deaths. Cause-specific mortality rates varied considerably by race and Hispanic origin. For infants of black mothers, the cause-specific infant mortality rate for low birthweight was nearly four times that for infants of white mothers. Between 1995 and 2001, the overall infant mortality rate declined by 10.5 percent; significant declines ranged from 8.2 percent for infants of non-Hispanic black mothers to 14.3 percent for infants of Hispanic mothers. The SIDS rate declined by 11 percent from 2000 to 2001. For infants of black and American Indian mothers, the SIDS rates were 2.2 and 2.8 times that for non-Hispanic white mothers.

Adult↗

Births: final data for 2001.

OBJECTIVES: This report presents 2001 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.026 million births that occurred in 2001 are presented. Denominators for population-based rates are derived from the 1990 U.S. census. As a result, rates are generally larger than would be the case if 2000-based estimates were used. The magnitude of the overestimate will vary by population subgroup; overestimates are likely greatest for those of Hispanic origin. RESULTS: The number of births, the birth rate, fertility rate, and total fertility rates all declined 1 percent in 2001. The teenage birth rate reached another historic low. Birth rates for women in their twenties declined slightly, whereas rates for women aged 30 to 44 years continued to rise. Births to unmarried women changed very little. Smoking by pregnant women was down again. Women were more likely to begin care in the first trimester of pregnancy (83.4 percent). The cesarean delivery rate rose for the fifth consecutive year to 24.4 percent; the primary cesarean rate was up 5 percent and the rate of vaginal births after a previous cesarean fell 20 percent. Preterm and low birthweight levels both rose for 2001. The twin birth rate continued to climb, and following 2 years of decline, the rate of triplet/+ births also increased.

Adolescent↗

Infant mortality statistics from the 2000 period linked birth/infant death data set.

OBJECTIVES: This report presents the 2000 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics. METHODS: Descriptive tabulations of data are presented and interpreted. RESULTS: Infant mortality rates ranged from 3.5 per 1,000 live births for Chinese mothers to 13.5 for black mothers. Among Hispanics, rates ranged from 4.5 for Cuban mothers to 8.2 for Puerto Rican mothers. Infant mortality rates were higher for those infants whose mothers had no prenatal care, were teenagers, had 9-11 years of education, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. The three leading causes of infant death--Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)--taken together accounted for 45 percent of all infant deaths in the United States in 2000. Cause-specific mortality rates varied considerably by race and Hispanic origin. For infants of black mothers, the infant mortality rate for low birthweight was nearly four times that for white mothers. For infants of black and American Indian mothers, the SIDS rates were 2.4 and 2.3 times that for non-Hispanic white mothers.

Birth Weight↗

Births: final data for 2000.

OBJECTIVES: This report presents 2000 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.059 million births that occurred in 2000 are presented. RESULTS: The number of births rose 3 percent in 2000; birth and fertility rates rose 1 to 2 percent. The total fertility rate was above "replacement" for the first time in almost 30 years. Teenage birth rates continued to fall while birth rates for women aged 20-24 years rose slightly, and rates for women in their late twenties and thirties rose 3 to 5 percent. Births to women in their forties and early fifties were also up for 2000. The number of births to unmarried women, the birth rate, and the percent of births that were to unmarried women rose 1 to 3 percent, but birth rates for unmarried teenagers declined. Smoking by pregnant women was down again. The cesarean delivery rate rose 4 percent to 22.9, the fourth consecutive increase; the primary cesarean rate was up and the rate of vaginal births after a previous cesarean was down. The number and rate of twin births continued to rise, but the triplet/+ birth rate declined for the second year in a row. For the first year in almost a decade the preterm birth rate declined (to 11.6 percent); the low birthweight rate, however, was unchanged at 7.6 percent.

Adolescent↗

Infant mortality statistics from the 1999 period linked birth/infant death data set.

OBJECTIVES: This report presents 1999 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics. METHODS: Descriptive tabulations of data are presented. RESULTS: In general, mortality rates were lowest for infants born to Chinese and Japanese mothers (2.9 and 3.4 per 1,000, respectively). Infants of Cuban, Central and South American, Mexican, and non-Hispanic white mothers had low rates, while rates were higher for infants of Puerto Rican and highest for non-Hispanic black mothers (13.9). Filipino mothers also had low rates. Rates were high for infants of Hawaiian and American Indian mothers. Infant mortality rates were higher for those infants whose mothers had no prenatal care, were teenagers, had 9-11 years of education, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. The three leading causes of infant death--Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)--taken together accounted for 45 percent all infant deaths in the United States in 1999. Cause-specific mortality rates varied considerably by race and Hispanic origin. For infants of black mothers, the infant mortality rate for low birthweight was four times that for white mothers. For infants of American Indian mothers, the SIDS rate was 2.4 times that for non-Hispanic white mothers. SIDS rates for infants of Hispanic and Asian or Pacific Islander mothers, were 40-50 percent lower than those for non-Hispanic white mothers.

Birth Certificates↗