Racial and Ethnic Differences in Mortality Rate of Infants Born to Teen Mothers: United States, 2017–2018

July 31, 2020

Questions for Ashley Woodall, Health Statistician and Lead Author of “Racial and Ethnic Differences in Mortality Rate of Infants Born to Teen Mothers: United States, 2017–2018.”

Q: Why did you decide to focus on teenagers for this report?

AW: There has not been much research on infant mortality using national data that focuses on specific maternal age groups. Teenagers are an age group of particular interest because infants born to teenagers have higher infant mortality rates compared with infants born to women in older age groups. Consequently, we wanted to explore the recent patterns in infant mortality for teenagers in the United States.


Q: Can you summarize some of the findings?

AW: In 2017–2018, infants born to teenagers aged 15–19 had the highest rate of mortality (8.77 deaths per 1,000 live births) compared with infants born to women aged 20 and over. Among teenagers, infants of non-Hispanic black females had the highest infant mortality rate (12.54) compared with non-Hispanic white (8.43) and Hispanic (6.47) females. Among the five leading causes of infant death, the largest racial and ethnic difference in mortality rates was found for preterm- and low-birthweight-related causes, where rates were two to three times higher for infants of non-Hispanic black teenagers (284.31 per 100,000 live births) than infants of non-Hispanic white (119.18) and Hispanic (94.44) teenagers.


Q: Was there a specific finding in the data that surprised you from this report?

AW: We were surprised by the large racial and ethnic disparity in deaths for preterm- and low-birthweight-related causes. This finding suggests that preterm birth and low birthweight are significant contributing factors for death among infants born to non-Hispanic black teenagers.


Q: Can you explain the difference between total infant, neonatal, and postneonatal mortality rates?

AW: Infant mortality is the death of a baby before his or her first birthday. It is calculated by dividing the number of infant deaths during a calendar year by the number of live births reported in the same year. It is expressed as the number of infant deaths per 1,000 live births. Neonatal mortality rate is the death of a baby during the first 27 days after birth, per 1,000 live births. Postneonatal mortality rate is the death of a baby between 28 days to under 1 year after birth, per 1,000 live births.


Q: What is the take home message for this report?

AW: The different mortality patterns seen among infants born to teenage mothers illustrate the racial and ethnic disparities in infant mortality and suggest that preterm birth and low birthweight are major public health concerns for infants born to non-Hispanic black teenagers.


Births: Final Data for 2018

November 27, 2019

Questions for Joyce Martin, Health Statistician and Lead Author of “Births: Final Data for 2018

Q: What is new in this report from the 2018 provisional birth report?

JM: In addition to providing final numbers and rates for numerous birth characteristics such as fertility rates, teen childbearing, cesarean delivery and preterm and low birthweight, this report presents final information on  teen childbearing by race and Hispanic origin and by state, births to unmarried women, tobacco use during pregnancy, source of payment for the delivery and twin and triplet childbearing.


Q: Was there a specific finding in the 2018 final birth data that surprised you?

JM: The continued decline in birth rates to unmarried women (down 2% for 2017-2018 to 40.1 births per 1,000 unmarried women), the fairly steep decline in tobacco smoking among pregnant women (down 6% to 6.5% of all women) and the continued declines in twin (down 2%) and triplet (down 8%) birth rates.  Also of note is the decline in the percentage of births covered by Medicaid between 2017 and 2018 (down 2% to 42.3%) and the small rise in the percentage covered by private insurance (49.6% in 2018).


Q: How did you obtain this data for this report?

JM: These data are based on information for all birth certificates registered in the United States for 2018.


Q: What is the take home message for this report?

JM: Birth certificate data provide a wealth of important current and trend information on demographic and maternal and infant health characteristics for the United States.


Q: Why do you think the birth has dropped in the U.S.?

JM: The factors associated with family formation and childbearing are numerous and complex, involving psychological, cultural, demographic, and socio-economic influences. The data on which the report is based come from all birth certificates registered in the U.S. While the data provide a wealth of information on topics such as the number of births occurring in small areas, to small population groups, and for rare health outcomes, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, the data in and of itself cannot answer the question of why births have dropped in the U.S.


Births: Provisional Data for 2018

May 15, 2019

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2018.”

Q: How does the provisional 2018 birth data compare to previous years?

BH: The  number of births, the general fertility rate, the total fertility rate, birth rates for women aged 15-34, the cesarean delivery rate and the low-risk cesarean delivery rate declined from 2017 to 2018, whereas the birth rates for women aged 35-44 and the preterm birth rate rose.


Q: When do you expect the final 2018 birth report to come out?

BH: The 2018 final birth report is scheduled for release in the fall of 2019.


Q: How did the data vary by age and race?

BH:  Birth measures shown in the report varied widely by age and race and Hispanic origin groups. Birth rates ranged from 0.2 births per 1,000 females aged 10-14 to 99.6 births per 1,000 women aged 30-34. By race and Hispanic origin, the cesarean delivery rate ranged from 28.7% of births for non-Hispanic American Indian or Alaska Native women to 36.1% for non-Hispanic black women and the preterm birth rate ranged from 8.56% for non-Hispanic Asian women to 14.12% for non-Hispanic black women.


Q: Was there a specific finding in the provisional data that surprised you?

BH: The report includes a number of interesting findings. The record lows reached for the general fertility rate, the total fertility rate and birth rates for females aged 15-19, 15-17, 18-19, and 20-24 are noteworthy. In addition, the magnitude of the continued decline in the birth rate for teens aged 15-19, down 7% from 2017 to 2018, is also historic.


Q: What is the take home message for this report?

BH:  The number of births for the United States was down 2% from 2017 to 2018, as were the general fertility rate and the total fertility rate, with both at record lows in 2018. Birth rates declined for nearly all age groups of women under 35, but rose for women in their late 30s and early 40s. The birth rate for teenagers aged 15–19 was down 7% from 2017 to 2018. The cesarean delivery rate and low-risk cesarean delivery rate were down in 2018. The preterm birth rate rose for the fourth year in a row in 2018.


Q: Do you anticipate this drop will continue?

BH: The factors associated with family formation and childbearing are numerous and complex. The data on which the report are based come from all birth certificates registered in the U.S. While the scope of these data is wide, with detailed demographic and health   information on rare events, small areas, or small population groups, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, these data do not answer the question of why the number of births dropped in 2018 or if the decline will continue.


Fact or Fiction: Do women who live in rural counties in the U.S. give birth at an earlier age than women in large metropolitan counties?

October 17, 2018

Source: National Vital Statistics System, 2017

https://www.cdc.gov/nchs/data/databriefs/db323-h.pdf


Births: Provisional Data for 2017

May 17, 2018

Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2017

Q: What did you think was the most interesting finding in your new analysis?

BH: The report includes a number of very interesting findings. The general fertility rate, 60.2 births per 1,000 women aged 15–44, declining 3% in 2017 and reaching a record low is certainly noteworthy. In addition, the continued decline in the birth rate for teens, down 7% from 2016 to in 2017, and reaching another record low, is very significant. The increase in the cesarean delivery rate following several years of decline is noteworthy as are the recent increase in rates of preterm and low birthweight births.


Q: Why does fertility keep going down in the U.S.?

BH: In general, there are a number of factors associated with fertility. The data on which the report is based comes from the birth certificates registered for births in the U.S. While the scope of this data is essentially all births in the country, and provides detailed information about rare events, small areas, or small population groups, the data does not provide information about the parent’s decision to have (or not have) a child. And so, accordingly, we cannot examine the “why” of the changes and trends in births.


Q: Does the decline in the Total Fertility Rate essentially mean fertility is down below “replacement” levels?  Could you explain this in general terms?

BH: “Replacement” refers to a minimum rate of reproduction necessary for generation to exactly replace itself, that is, enough children born to replace a group of 1,000 women and their partners. For the total fertility rate, this rate is generally considered to be 2,100 births per 1,000 women. In 2017, the total fertility rate, 1,764.5 births per 1,000 women, was below replacement.


Q: Do the increases among women over 40 suggest a “new norm” in people waiting till much later to have children?

BH: Birth rates for women aged 40-44 and 45-49 years have increased generally over the last 3 decades. Given this, it reasonable to expect this trend to continue.


Q: Are the annual declines in teen pregnancy something that we are in danger of taking for granted?

BH: The birth rate for females aged 15-19 has decreased 8% per year from 2007 through 2017. For comparison, the decline in the birth rates for women aged 20-24 and 25-29 was 4% and 2% from 2007 through 2017. The decline in teen births is very noteworthy.


Q: Can you explain how the increases in preterm births and low birthweight are connected?

BH: Infants born preterm are also often, but not exclusively, born low birthweight and vice-versa.  The causes of the recent upward shift in these rates are not well understood.


Stat of the Day – June 21, 2017

June 21, 2017


Births: Final Data for 2015

January 5, 2017

Questions for Joyce A. Martin, M.P.H., Demographer, Statistician, and Lead Author on “Births: Final Data for 2015

Q: Was there a result in your study’s analysis of births in the United States that you hadn’t expected and that really surprised you?

JM: Although small, (from 9.57% to 9.63%) the rise in the preterm birth rate (births of less than 37 completed weeks of gestation) was unexpected. This rate had been declining steadily since 2007.

Also of note is the decline in the triplet and higher-order multiple birth rate, down 9% from 2014 to 2015, and a decrease of 46% since 1998. The year 2015 also is the third straight year of declines in the rate of cesarean delivery (rate of 32.0% in 2015).

The continued, large decline in the teen birth rate (down 8% from 2014 to 2015) was also somewhat surprising, although not unprecedented. From 2007 through 2014, the teen birth rates had declined 7% annually.


Q: What is the difference between this new births report and the other reports your office produced on 2015 birth data, like the preliminary data report on 2015 births and the Data Brief on teen births?

JM: The annual report “Births: Final Data for 2015” offers substantially more detail (e.g., age, race and Hispanic origin of mother, state) on key topics, than does the report on preliminary birth statistics (“Births: Preliminary Data for 2015”). The final report also includes information on topics not included in the preliminary reports such as multiple births, attendant and place of birth, birth order and birth rates for fathers.


Q: How has the number of births in the United States changed in 2015 from previous years?

JM: The number of births in the United States declined slightly in 2015 (by 9,579 births to 3,978,497) from 2014. The decline for 2015 followed an increase in births for 2014, which was the first increase since 2007.


Q: What differences, if any, did you see among race and ethnic groups, and among various ages?

JM: Of continued concern are the higher risks of poor birth outcomes as measured by levels of preterm birth and low birthweight among non-Hispanic black mothers compared with total births and other race and Hispanic origin groups. For example, in 2015 the preterm birth rate for births to non-Hispanic black mothers was more than 50% higher at 13.41% than for non-Hispanic white women (8.88%) and nearly 50% higher than the rate for births to Hispanic mothers (9.14%).


Q: Did you observe any regional or state differences in this study on births?

JM: Differences by state were observed for many of the demographic and medical/health items included in the 2015 final birth report. For example, from 2014 to 2015, the general fertility rate–which is the number of births per 1,000 women aged 15–44–declined in eight states and was essentially unchanged in the 42 states and the District of Columbia (DC). In 2015, the general fertility rate ranged among states from 51.1 births per 1,000 women aged 15–44 in Vermont to 78.2 in South Dakota.

Also, increases in preterm birth rates were limited to four states from 2014 to 2015: Arkansas, California, Nebraska, and North Carolina. Rates declined in four states: Montana, New York, Texas and Wyoming. Nonsignificant differences were reported for the remaining states and DC.


Confidentiality Concerns and Sexual and Reproductive Health Care Among Adolescents and Young Adults Aged 15–25

December 16, 2016

Confidentiality concerns can impact adolescent and young adults’ access to sexual and reproductive health services. Young people who are covered by their parents’ private health insurance may be deterred from obtaining these services due to concerns that their parents might find out about it.  Similarly, confidentiality concerns may arise because youth seeking such services may not have time alone during a visit with a health care provider.

A new NCHS report describes two measures related to confidentiality concerns and sexual and reproductive health care.

Findings:

  • About 7% of persons aged 15–25 would not seek sexual or reproductive health care because of concerns that their parents might find out about it.
  • For females aged 15–17 and 18–25, those who had confidentiality concerns were less likely to receive sexual and reproductive health services in the past year compared with those without these concerns.
  • Less than one-half of teenagers aged 15–17 (38.1%) spent some time alone in the past year during a visit with a doctor or other health care provider without a parent, relative, or guardian in the room.
  • Teenagers aged 15–17 who spent some time alone during a visit with a health care provider were more likely to have received sexual or reproductive health services in the past year compared with those who had not.

 

 


Provisional Estimates of Birth Data for 2014 through the Second Quarter of 2016

November 22, 2016

NCHS has released provisional estimates of selected reproductive indicators from birth data for 2014 through the second quarter of 2016. Estimates for 2014 and 2015 are based on final data.

The estimates for the first and second quarter of 2016 are based on all birth records received and processed by NCHS as of August 28, 2016.

Estimates are presented for: general fertility rates, age-specific birth rates, total and low risk cesarean delivery rates, preterm birth rates and other gestational age categories. These indicators were selected based on their importance for public health surveillance as well as the feasibility of producing reliable estimates using available provisional data. Future quarterly releases will include additional birth indicators from natality data.

Quarterly estimates are compared with estimates for the same quarter of the preceding year; for example, the second quarter of 2016 is compared with the second quarter of 2015. For comparability with rates for 12-month periods, the quarterly (3-month) rates have been annualized to present births per year per 1,000 population that would be expected if the quarter-specific rate prevailed for 12 months.

In addition, the rates and percentages for a 12-month period ending with each quarter (i.e., 12-month moving average) are presented to account for seasonality. Estimates for the 12-month period ending with the fourth quarter in each year can be interpreted as an annual provisional estimate for that year.

natality_infographic

 

 


QuickStats: Gestational Weight Gain Among Women with Full-Term, Singleton Births, Compared with Recommendations — 48 States and the District of Columbia, 2015

October 14, 2016

Gestational weight gain was within the recommended range for 32% of women giving birth to full-term, singleton infants in 2015, with 48% gaining more weight and 21% less weight than recommended.

Approximately 44% of women who were underweight before pregnancy gained within the recommendations, compared with 39% of women who were normal weight, 26% of women who were overweight, and 24% of women with obesity before pregnancy.

Weight gain above the recommendations was highest among women who were overweight (61%) or had obesity (55%) before pregnancy.

SOURCE: https://www.cdc.gov/mmwr/volumes/65/wr/mm6540a10.htm