N C H S - Publications and Information Products - 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.

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).

Among women of all races, low birthweight rates were lower for mothers who were older, were ever married, wanted their pregnancies, and had more education.