Infant Mortality Statistics Show Variation

A new NCHS report presents detailed data on infant mortality rates by “race’Vethnicity, leading causes of death, infant characteristics such as birthweight, and maternal factors such as receipt of prenatal care. These data are shown for the nation, along with three-year average infant mortality rates for each state. Highlights include:
• More than 28,000 infants died in the first year of life in 1998, for an overall infant mortality rate of 7.2 deaths per 1000 births, unchanged from the 1997 rate. Infants born to black mothers had the highest mortality rate (13.8 per 1000 live births), while those born to mothers self-identified as Japanese (3.5 per 1000) and Cuban (3.6 per 1000) had the lowest rates.

• The leading causes of infant death in 1998 were congenital anomalies, disorders related to low birthweight, and SIDS, which taken together accounted for nearly one-half of all infant deaths in the United States. Maternal complications and respiratory distress syndrome rounded out the top five causes of infant death. Congenital anomalies were the leading cause of death for all racial/ethnic groups, except for infants of black mothers, whose leading cause was disorders related to low birthweight.

• Infant mortality rates for the combined years 1996-1998 varied widely by state. Rates varied from 10.5 per 1000 live births for Mississippi to 4.5 per 1000 live births for New Hampshire.

After Steady Decline, Cesarean Delivery Rates on the Rise Cesarean delivery rates were up for the third year in a row in 1999, reversing a steady decline between 1989 and 1995. The rate of cesarean delivery increased by 4% from 1998 to 1999, according to a new NCHS report, which also shows that the teen birth rate continued to drop, down 20% from the recent high point in 1991.

The birth rate for teenagers declined 3% from 1998. The 1999 rate of 49.6 per 1000 women ages 15-19 in 1999 was the lowest rate in the 60 years that data on teen births have been recorded. The drop was more pronounced for teens ages 15-17, who registered a decline of 6% between 1998 and 1999. The number of births for the youngest teenage group, ages 10-14, dropped to the lowest level in 30 years.

Teen birth rates were down for all racial and ethnic groups, with the sharpest decline between 1998 and 1999 for American Indian teenagers (6%), followed closely by a 5% drop for black teens. Hispanic teens reported the smallest decline.
Birth rates for women ages 20-24 declined slightly between 1998 and 1999, while the rate for women ages 25-29 was up slightly. Birth rates for women in their 30s and 40s continued their long pattern of increase. Rates for women in their 30s were the highest in three decades.

The report provided additional information to document the upturn in the cesarean rate. The 1999 rate of 22.0 per 100 live births is up from 21.2 per 100 in 1998, following increases first noted in 1997. The rise in the total cesarean rate was primarily fueled by the increase in the rate of primary cesarean delivery (to women who had not previously had one). This rate was up 4% from 1998 to 1999.

Another factor contributing to the rise in the total cesarean rate was the marked decline in the rate of VBAC (vaginal birth after cesarean), down 11% since 1998 and 17% since 1996. The rise in the total cesarean rate was widespread—increases were observed among woman of all ages and racial groups and in 45 of the 50 states.
Looking at other aspects of child-bearing, the report shows that use of prenatal care continued to improve, with a slight increase in the percentage of women who received early prenatal care. This measure of prenatal care showed steady progress during the 1990s, rising 10% since 1989. The increase in early prenatal care was most notable for black and Hispanic women, with about a 25% increase for each over the decade.

The proportion of infants born at low birthweight in 1999 (7.6%) was unchanged from the previous year. The US has seen a gradual upward trend in low birthweight since the mid-1980s.

Births: Preliminary Data for 19991 is based on birth records filed in state vital statistics offices and reported to NCHS through the National Vital Statistics System.