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Births/Maternity

Improving the well-being of mothers, infants, and children is an important public health goal for the United States. Their well-being determines the health of the next generation and can help predict future public health challenges for families, communities, and the health care system. The objectives of the Maternal, Infant, and Child Health topic area address a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life of women, children, and families.1


1. Heatlthy People 2020 Topics and Objectives, Maternal, Infant, and Child Health, accessed on 8/11/2014 from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=26.
Pregnancy can provide an opportunity to identify existing health risks in women and to prevent future health problems for women and their children. These health risks may include:
  • Hypertension and heart disease
  • Diabetes
  • Depression
  • Genetic conditions
  • Sexually transmitted diseases (STDs)
  • Tobacco use and alcohol abuse
  • Inadequate nutrition
  • Unhealthy weight

The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care.2 Moreover, healthy birth outcomes and early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential.3,4,5


2. Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR). Recommendations to improve preconception health and health care-United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Atlanta: CDC; 2006. 23 p. (MMWR Recomm Rep. 2006;55[RR-06])
3. Centers for Disease Control and Prevention (CDC). Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. Atlanta: CDC; 2004. 37 p. (MMWR Recommen Reps. 2004;53[RR-13]).
4. Centers for Disease Control and Prevention (CDC). Identifying infants with hearing loss-United States, 1999-2007. Atlanta: CDC; 2010. (MMWR. 2010;59[8]:220-3).
5. Watson MS, Mann MY, Lloyd-Puryear MA, et al.; American College of Medical Genetics, Newborn Screening Expert Group. Newborn screening: Toward a uniform screening panel and system [executive summary]. Pediatrics. 2006;117(5 Pt. 2):S296-307.
Many factors can affect pregnancy and childbirth, including:
  • Preconception health status
  • Age
  • Access to appropriate preconception and interconception health care
  • Poverty

Infant and child health are similarly influenced by sociodemographic factors, such as family income, but are also linked to the physical and mental health of parents and caregivers.

There are racial and ethnic disparities in mortality and morbidity for mothers and children, particularly for African Americans.6,7,8 These differences are likely the result of many factors.

Social Determinants of Maternal Health
These include pre-pregnancy health behaviors and health status,9 which are influenced by a variety of environmental and social factors such as access to health care and chronic stress.10

Physical Determinants of Maternal Health
Common barriers to a healthy pregnancy and birth include lack of access to appropriate health care before and during pregnancy. In addition, environmental factors can shape a woman's overall health status before, during, and after pregnancy by:
  • Affecting her health directly.
  • Affecting her ability to engage in healthy behaviors

Social Determinants of Infant and Child Health
The social determinants that influence maternal health also affect pregnancy outcomes and infant health. Racial and ethnic disparities in infant mortality exist, particularly for African American infants.11 Child health status varies by both race and ethnicity, as well as by family income12 and related factors, including educational attainment among household members and health insurance coverage.13

Physical Determinants of Infant and Child Health
The cognitive and physical development of infants and children is influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood. Breast milk is widely acknowledged to be the most complete form of nutrition for most infants, with a range of benefits for their health, growth, immunity, and development.14,15 Furthermore, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other social adversities, are more likely to have better outcomes as adults.16,17

Emerging Issues in Maternal, Infant, and Child Health
Recent efforts to address persistent disparities in maternal, infant, and child health have employed a "life course" perspective to health promotion and disease prevention. At the start of the decade, fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception health initiatives have been aimed at improving the health of a woman before she becomes pregnant through a variety of evidence-based interventions.18

The life course perspective also supports the examination of quality of life, including the challenges of male and female fertility. An estimated 7.3 million American women ages 15 to 44 have received infertility services (including counseling and diagnosis) in their lifetime.19 Infertility is an area where health disparities are large, particularly among African American women,20 and may only continue to increase as childbearing practices change over time.


6. Centers for Disease Control and Prevention (CDC). Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. Atlanta: CDC; 2004. 37 p. (MMWR Recommen Reps. 2004;53[RR-13]).
7. Tucker MJ, Berg CJ, Callaghan WM, et al. The black-white disparity in pregnancy-related mortality from 5 conditions: Differences in prevalence and case-fatality rates. Am J Public Health. 2007 February 1;97(2):247-51.
8. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86.
9. Bryant AS, Worjoloh A, Caughey AB, et al. Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants. Am J Obstet Gynecol. 2010 Apr;202(4):335-43.
10. Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns and explanations. Ann Rev Soc. 1995;21:349-86
11. Centers for Disease Control and Prevention, Division of Vital Statistics; Martin JA, Hamilton BE, Sutton PD, et al. Births: Final data for 2006. Hyattsville, MD: National Center for Health Statistics; 2009 January 7. Report No. 57(7).
12. Larson K, Halfon N. Family income gradients in the health and health care access of US children [Internet]. Matern Child Health J. 2010 Jun 5;14(3):332-42.
13. Larson K, Russ SA, Crall JJ, et al. Influence of multiple social risks on children's health. Pediatrics. 2008 Feb 1;121(2):337-44.
14. US Department of Health and Human Services (HHS), Office on Women's Health. HHS blueprint for action on breastfeeding. Washington: HHS; 2000.
15. Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2007 Apr. (Report/Technology Assessment, No. 153. AHRQ Publication No. 07-E007).
16. National Research Council and Institute of Medicine; Board on Children, Youth, and Families,Commission on Behavioral and Social Sciences and Education. From neurons to neighborhoods: The science of early childhood development. Shonkoff J, Philips D, editors. Washington: National Academy Press; 2000. 612 p.
17. Anda RF, Felitti VJ, Walker J, et al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006 Apr;256(3):174-86.
18. Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR). Recommendations to improve preconception health and health care-United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55(RR-6).
19. Centers for Disease Control and Prevention, National Center for Health Statistics; Chandra A, Martinez GM, Mosher WD, et al. Fertility, family planning, and reproductive health of US women: Data from the 2002 National Survey of Family Growth. Vital Health Stat. 2005;23(25):1-160.
20. Wellons MF, Lewis CE, Schwartz SM, et al. Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: The CARDIA Women's Study. Fertil Steril. 2008 Nov;90(5):1640-8.
Maternal and Child Health is tracked at the national and state levels primarily through:
  • Pregnancy Risk Assessment and Monitoring System (PRAMS)
  • Birth certificates
  • Death certificates

Girls Age 10-14

Girls Age 15-17

Girls Age 18-19

Girls Age 15-19

Average Number of Prenatal Visits


2009 and Later (new birth certificate)

Prenatal Care in First Trimester

Prenatal Care in Third Trimester

No Prenatal Care

Kotelchuk Prenatal Care = Adequate

More information on the Kotelchuck Index

Kotelchuk Prenatal Care = Adequate Plus

More information on the Kotelchuck Index

2008 and Before (old birth certificate)

Prenatal Care in First Trimester

Prenatal Care in Third Trimester

No Prenatal Care

Kotelchuk Prenatal Care = Adequate

More information on the Kotelchuck Index

Kotelchuk Prenatal Care = Adequate Plus

More information on the Kotelchuck Index

Normal Birth Weight

Normal Birth Weight: Live-born infants whose birth weight was equal to or greater than 2500 grams (about 5.5 lbs.)

Low Birth Weight (<2500 grams)

Low Birth Weight: Live-born infants whose birth weight was less than 2500 grams (about 5.5 lbs.)

Very Low Birth Weight (<1500 grams)

Very Low Birth Weight: Live-born infants whose birth weight was less than 1500 grams (about 3.3 lbs.)

Extremely Low Birth Weight (<1000 grams)

Extremely Low Birth Weight: Live-born infants whose birth weight was less than 1000 grams (about 2.2 lbs.)

Extremely Low Birth Weight (<500 grams)

Extremely Low Birth Weight: Live-born infants whose birth weight was less than 1000 grams (about 2.2 lbs.)

Average Birth Weight

All Pre-term Births

Very Pre-term Births (<32 weeks)

Moderately Pre-term Births (32-33 weeks)

Late Pre-term Births (34-36 weeks)

Average Gestational Age

Gestational Age is the period of time a baby is carried in the uterus or the duration of the pregnancy, measured from the first day of the last menstrual period. Full-term gestation is between 37 and 42 weeks.
Infant Mortality and Fetal Mortality Causes

Infant Mortality - Death Data Only

Infant Mortality (Death Data Only): The number of infant deaths during the year per 1,000 live births during the same year.

Birth-Death Linked Infant Mortality - Birth Cohort

Birth-Death Linked Infant Mortality (Birth Cohort): The number of infant deaths among infants born in a given calendar year. The individual infant death records are linked to the birth records, so that characteristics of the infant and mother may be analyzed.

Birth-Death Linked Infant Mortality - Death Cohort, or Period File

Birth-Death Linked Infant Mortality (Death Cohort, or Period File): The number of infant deaths during the year per 1,000 live births during the same year. The individual infant death records are linked to the birth records, so that characteristics of the infant and mother may be analyzed.
Selecting the statewide query allows for the viewing of multiple demographic characteristics (maternal age, infant sex, and race and ethnicity) at the same time. Selecting the query by county and local health district allows for the viewing of only one demographic characteristic (maternal age, infant sex, and race and ethnicity) at a time.

New Methodology (Landline and cell phone, 2009 and later)

Old Methodology (Landline only, 2010 and before)

Vital Statistics

Pregnancy-related

Health Systems/Initiatives

Birth Outcomes

Postpartum


The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 20 October 2017 6:27:21 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 10 Oct 2017 15:41:31 MDT