Health Aspects of
Pregnancy and Childbirth: United States, 1982-88
Infant mortality rates in the United
States have fallen dramatically, from 100 infant deaths per 1,000 live births in 1900 to
23 infant deaths per 1,000 live births in 1960 to 9 infant deaths per 1,000 live births in
1990. In 1900 most infant deaths were due to infectious causes and occurred after the
neonatal period. In recent years neonatal deaths (those within the first 28 days of life)
have accounted for the majority of infant deaths. Low birthweight is the key determinant
of neonatal deaths. The prevention of low birthweight will reduce perinatal, neonatal, and
infant morbidity and mortality as well as development deficit and health problems later in
childhood. The most effective means of reducing low birthweight rates would include
improving the access to and quality of prenatal care; reducing prenatal smoking, drinking,
and substance abuse; and narrowing disparities in nutrition and other areas of health.
To monitor the national progress toward
these goals, the National Survey of Family Growth (NSFG) is designed to provide
information on fertility, family planning, aspects of maternal, child, and reproductive
health that are closely related to childbearing. The NSFG offers several key health
measures that are useful in assessing the risk of poor pregnancy outcomes among various
racial and ethnic groups in the United States. Summary statistics are presented on the
timing of the first prenatal visits, source of prenatal care, smoking and alcohol use
during pregnancy, low birthweight, and how the delivery was paid for. Data are shown by
race and characteristics of the mother and the pregnancy.
Data Highlights:
For all women, regardless of race
or Hispanic origin, prenatal care was more likely delayed beyond the first trimester if
the mother was a teenager, never married, had considered her pregnancy unwanted or
mistimed at the time of conception, never worked, not finished high school, or had a low
income and received Medicaid for prenatal care and delivery costs.
Approximately 27 percent of
ever-pregnant women reported smoking during their most recent pregnancy. Black women were
less likely to have smoked than white women (23 versus 29 percent).