"Maternal and Child Health Statistics: Russian Federation and United States, Selected Years 1985-95," covers prenatal and obstetrical care, natality data, breastfeeding practices, mortality data including leading causes of death, immunization rates, communicable diseases, and other morbidity measures.

For most of these indicators, the U.S. contrasts favorably with the Russian Federation. For example, despite a recent decline in the infant mortality rate in Russia, the rate is still more than twice that in the U.S. The Russian maternal mortality rate is about 7 times the U.S. rate. Russia exceeds the U.S. in most of the leading causes of death for children 1-19 years of age, with the notable exceptions of motor vehicle accident deaths and homicides among adolescents. However, immunization levels have improved in both countries and are now similar in the Russian Federation and the U.S., and for many of the sexually transmitted diseases, rates are lower in Russia.

Other highlights in the report:

In 1995 the rate of abortions was 67.6 abortions per 1,000 women ages 15-49 in the Russian Federation; 17.7 in the United States. Although the abortion rate is declining, Russian women were almost twice as likely to have an abortion as a live birth, while in the U.S. there were 31.1 abortions per 100 live births.

Cesarean delivery rates in the U.S. are double those in Russia (20.8 compared with 10.1 percent in 1995).

The prevalence of medical risk factors during pregnancy is much higher in the Russian Federation than in the United States. For example, more than 20 percent of pregnant women in Russia were diagnosed with anemia at the time of delivery compared with 2 percent in the United States. However, the prevalence of diabetes during pregnancy in Russia was substantially lower than in the U.S.

In 1995 about a third of the births in the United States were to unmarried mothers, compared with about a fifth of the infants in the Russian Federation.

Mortality rates for children and teenagers are higher in Russia than in the U.S., with rates particularly high for accidental deaths. The accidental death rate for children ages 1-14 in Russia is comparable to the death rate for all causes of death combined in the United States. The exceptionally high death rate for drowning in Russia contributes to this striking difference. In Russia, the rate of drowning was twice as high for children ages 1-4 than in the United States; almost 4 times higher for those ages 10-14; 5 times higher for teenagers 15-19; and for children 5-9, the drowning rate in Russia was more than 10 times higher than in the U.S.

For adolescents, homicide rates were slightly higher in the United States, while suicide rates were twice as high in Russia.

The incidence of diphtheria among children 0-14 years of age rose rapidly after 1990 in the Russian Federation but declined 11 percent in 1995 from the peak reached in 1994. Cases of diphtheria are rare in the United States. Hepatitis rates declined by more than 50 percent from 1990 to 1995 but remain far higher in Russia than in the U.S. In contrast, gonorrhea rates in the U.S. were almost 3 times the Russian rate for adolescents 15-17 in 1995, despite the significant decline in the U.S. rate from 1990 to 1995. However, Russian syphilis rates for those 15-17 are 30 times higher than the U.S. rate.

This report was produced under the framework of the Gore-Primakov Commission which fosters collaborative research and scientific endeavors between the two countries. The comprehensive report is intended to enhance the understanding of maternal and child health in the Russian Federation and the United States by presenting data in a comparative format, using tables, figures, and commentary. It includes a discussion of data quality issues to assist in understanding limitations in the accuracy, coverage or comparability of the information presented. A background section provides a brief description of the organization of each country's health care system, as well as an outline of national guidelines for maternal and child health care.