Embed Size (px)
DESCRIPTION
S. Lee Woods, M.D., Ph.D. Medical Director, Center for Maternal and Child Health March 23, 2010. Infant Mortality in Maryland. Infant Mortality in Maryland & U.S. Timing of Infant Deaths. Data Source: MD DHMH, Vital Statistics Administration. Leading Causes of Infant Mortality. - PowerPoint PPT Presentation
Citation preview
Infant Mortality in Maryland
S. Lee Woods, M.D., Ph.D.
Medical Director, Center for Maternal and Child Health
March 23, 2010
Infant Mortality in Maryland & U.S.
Infant Mortality Rate, Maryland and U.S., 1982-2008
6
7
8
9
10
11
12
13
Year
Rat
e p
er 1
,000
live
bir
ths
Maryland 11.7 11.7 11.7 11.9 11.7 11.4 11.2 10.4 9.6 9.1 9.8 9.8 8.8 8.7 8.4 8.6 8.6 8.3 7.4 8.0 7.6 8.1 8.5 7.3 7.9 8.0 8.0
United States 11.5 11.2 10.8 10.6 10.4 10.1 10.0 9.8 9.2 8.9 8.5 8.3 8.0 7.6 7.3 7.2 7.2 7.1 6.9 6.8 7.0 6.8 6.8 6.9 6.7 6.6 6.5
1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 20062007
*2008
*
Data Source: MD DHMH:Vital Statistics Administration, CDC:NCHS* U.S. data for 2007 are preliminary, data for 2008 are provisional
Timing of Infant Deaths
Percent of Total Infant Deaths by Age at Death, Maryland, 2008
Neonatal Mortality
73%
Postneonatal Mortality
27%
Data Source: MD DHMH, Vital Statistics Administration
Leading Causes of Infant Mortality
Causes of Infant Death, Maryland, 2008
Preterm / Low Birth Weight, 26.1%
Congenital Abnormalities, 15.6%
SIDS, 12.0%Maternal Complications, 7.6%
All Other Causes, 26.6%
Respiratory Distress, 2.1%
Sepsis, 3.2%
Necrotizing Enterocolitis, 3.2%
Complications of Placenta/Cord, 3.6%
Data Source: MD DHMH, Vital Statistics Administrationn=617 deaths
Preterm Births – Maryland & U.S.
Percentage of Preterm Births (gestation* <37 weeks), Maryland, U.S., 2000-2007
0
5
10
15
Pe
rce
nt
U.S. 11.6 11.9 12.1 12.3 12.5 12.7 12.8 12.7
Maryland 12.7 12.9 12.9 13.1 13.3 13.3 13.5 13.4
2000 2001 2002 2003 2004 2005 2006 2007*
Data Source: NCHS, National Vital Statistics* Gestation based on LMP, Data for 2007 are preliminary
Low Birth Weight – Maryland & U.S.
Percentage of Low Birth Weight (<2500g) Infants, Maryland, U.S., 1999-2008
0
2
4
6
8
10
12
Pe
rce
nt
Maryland 9.1 8.7 9.0 9.0 9.1 9.4 9.2 9.4 9.1 9.3
United States 7.6 7.6 7.7 7.8 7.9 8.1 8.2 8.3 8.2
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Data Sources: MD DHMH, Vital Statistics Administration, NCHS National Vital Statistics SystemU.S. data for 2007 are preliminary, U.S. data for 2008 not yet available
Maryland Rankings
• Infant Mortality 39th
• Preterm Birth 34th
• Low Birth Weight 43rd
• SIDS / SUID 35th
Racial Disparity in Infant Mortality
Infant Mortality Rates, Maryland, 1999-2008
0
5
10
15
20
Year
Rat
e p
er 1
,000
live
bir
ths
All Races 8.3 7.4 8.0 7.6 8.1 8.5 7.3 7.9 8.0 8.0
White 5.1 4.7 5.5 5.4 5.4 5.6 4.7 5.7 4.6 5.2
Black 14.7 13.0 13.6 12.7 14.7 14.9 12.7 12.7 14.0 13.4
Hispanic 5.1 6.2 5.3 6.0 5.3 4.6 3.0 3.8 3.2
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Data Source: MD DHMH, Vital Statistics Administration
Racial Disparity in Preterm Births
Percentage of Births that are Preterm (<37 weeks gestation), Maryland, 2000-2008
0.02.04.06.08.0
10.012.014.016.0
Calendar Year
% P
rete
rm B
irth
s
All Races 10.8 10.8 10.9 11.0 11.3 11.3 11.4 10.9 11.0
White Non-Hisp 9.1 9.5 9.6 9.7 10.0 10.0 10.4 9.6 9.6
Black 14.5 13.9 14.2 14.3 14.3 14.3 14.1 13.9 13.9
Hispanic 8.6 9.1 8.8 9.1 9.4 9.7 9.3 8.9 9.4
2000 2001 2002 2003 2004 2005 2006 2007 2008
Data Source: MD DHMH, Vital Statistics Administration* Gestational age computed via clinical estimate of gestationStarting in 2007, MD data include births of unknow n gestational age in the denominator
Racial Disparity in Low Birth Weight
Percentage of Low Birth Weight (<2500g) Infants, Maryland, 1999-2008
0
2
4
6
8
10
12
14
16
Pe
rce
nt
All Races 9.1 8.7 9.0 9.0 9.1 9.4 9.2 9.4 9.1 9.3
White 6.7 6.4 7.0 7.0 7.1 7.4 7.1 7.4 7.1 7.2
Black 13.7 12.9 13.0 13.3 13.1 13.2 13.2 13.4 12.9 13.2
Hispanic 6.5 6.9 6.9 7.0 7.3 7.2 6.8 7.3 7.1
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Data Sources: MD DHMH, Vital Statistics Administration, NCHS National Vital Statistics System
Racial Disparity in Leading Causes of Infant Mortality
In Maryland ….
– a Black infant is 1 ½ times as likely to be born prematurely,
– almost twice as likely to be born at low birth weight,
– almost 2 ½ times as likely to die of SIDS/SUID
as a white infant.
BaltimoreCity
AnneArundel
Howard
Baltimore
Caroline
QueenAnne’s
PrinceGeorge’s
St. Mary's
Charles
AlleganyCarroll Harford
Cecil
Kent
Wicomico
Dorchester
Worcester
WashingtonGarrett
Frederick
Montgomery
Talbot
Calvert
Somerset
Geographic Disparity in MarylandAverage Infant Mortality Rate, By Jurisdiction, 2003-07
Legend
Rate per 1000 live births
3.6 – 5.0
5.1 – 10.0
10.1 -14.8
Data Source: MD Vital Statistics Administration
Risk Factors for Poor Birth Outcomes
• Behavioral risks– Drug, alcohol, cigarette use – Unintended pregnancy
• Health and healthcare risks– Chronic conditions – obesity, diabetes, hypertension– Access to care / Prenatal care
Early Prenatal Care – Maryland & U.S.
Percent of Births to Women Receiving 1st Trimester Prenatal Care, Maryland and U.S., 1999-2008
78
81
84
87
90
% o
f B
irth
s
MD 87.0 86.4 83.7 84.1 83.7 82.3 81.3 80.4 79.5 80.2
U.S.* 83.2 83.2 83.4 83.7 84.1 84.2 83.9 83.2
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Data Sources: MD: DHMH, Vital Statistics Administration, US: National Center for Health Statistics* US data for 2003-2006 represents 32 states using 1989 birth certif icate, US data for 2007, 2008 not available
Late or No Prenatal Care – Maryland & U.S.
Percentage of Births to Women Receiving Late or No Prenatal Care, Maryland, 1999-2008
2
4
Per
cen
t
Maryland 3.1 3.1 3.7 3.6 3.8 3.9 4.3 4.3 4.7 4.2
U.S. 3.8 3.9 3.8 3.6 3.5 3.6 3.5 3.6
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Data Sources: MD DHMH, Vital Statistics Administration, NCHS, National Vital Statistics Reports, U.S. data for 2007,2008 not available
Infant Mortality and Timing of Prenatal Care
Infant Mortality Rate by Timing of Prenatal Care Initiation and Race/Ethnicity, Maryland, 2003-2007
0
5
10
15
20
25
30
35
Rat
e p
er 1
,000
bir
ths
(in
PN
C s
ub
cate
go
ry)
1st or 2nd Trim PNC 10.7 7.4 17.8 6.4
3rd Trim or No PNC 24.0 18.5 33.1 10.8
All Races White Non-Hisp Black Non-Hisp Hispanic
Data Source: MD DHMH, Vital Statistics Administration
Risk Factors for Poor Birth Outcomes
• Behavioral risks– Drug, alcohol, cigarette use – Unintended pregnancy
• Health and healthcare risks – Chronic conditions – obesity, diabetes, hypertension– Access to care / Prenatal care
• Socio-demographic risks– Race– Socio-economic status– Maternal age
