Birds as bioindicators of plastic pollution in terrestrial and freshwater environments: A 30-year review.

Plastic pollution is a global concern that has grown ever more acute in recent years. Most research has focused on the impact of plastic pollution in marine environments. However, plastic is increasingly being detected in terrestrial and freshwater environments with key inland sources including landfills, where it is accessible to a wide range of organisms. Birds are effective bioindicators of pollutants for many reasons, including their high mobility and high intra- and interspecific variation in trophic levels. Freshwater and terrestrial bird species are under-represented in plastic pollution research compared to marine species. We reviewed 106 studies (spanning from 1994 onwards) that have detected plastics in bird species dwelling in freshwater and/or terrestrial habitats, identifying knowledge gaps. Seventy-two studies focused solely on macroplastics (fragments >5 mm), compared to 22 microplastic (fragments <5 mm) studies. A further 12 studies identified plastics as both microplastics and macroplastics. No study investigated nanoplastic (particles <100 nm) exposure. Research to date has geographical and species' biases while ignoring nanoplastic sequestration in free-living freshwater, terrestrial and marine bird species. Building on the baseline search presented here, we urge researchers to develop and validate standardised field sampling techniques and laboratory analytical protocols such as Raman spectroscopy to allow for the quantification and identification of micro- and nanoplastics in terrestrial and freshwater environments and the species therein. Future studies should consistently report the internalised and background concentrations, types, sizes and forms of plastics. This will enable a better understanding of the sources of plastic pollution and their routes of exposure to birds of terrestrial and freshwater environments, providing a more comprehensive insight into the potential impacts on birds.

Educational Attainment of Mothers Aged 25 and Over: United States, 2017.

Maternal education has been shown to be associated with the number of children a woman has during her childbearing years, as well as maternal and infant health (1-5). Using 2017 national birth certificate data, this report describes educational attainment of mothers aged 25 and over, overall and by race and Hispanic origin and state, and the mean numbers of live births by mothers' educational attainment.

Total Fertility Rates by State and Race and Hispanic Origin: United States, 2017.

Objectives-This report presents 2017 total fertility rates by state of residence and race and Hispanic origin of mother for the United States. Methods-Data are from birth certificates of the 50 states and the District of Columbia. Total fertility rates, the expected number of lifetime births per 1,000 women given current birth rates by age, are shown by state for all births, and for non-Hispanic single-race white, non-Hispanic single-race black, and Hispanic women for 2017. Results-Total fertility rates varied by state for each race and Hispanic-origin group. In 2017, South Dakota (2,227.5) had the highest total fertility rate of the 50 states and the District of Columbia; the District of Columbia had the lowest (1,421.0). For non-Hispanic white women, the highest total fertility rate was in Utah (2,099.5) and the lowest in the District of Columbia (1,012.0). Among non-Hispanic black women, the highest total fertility rate was in Maine (4,003.5) and the lowest in Wyoming (1,146.0) along with California (1,503.5), Connecticut (1,575.5), Montana (1,641.0), New Mexico (1,651.0), New York (1,574.5), Rhode Island (1,594.0), and West Virginia (1,579.5). For Hispanic women, the highest total fertility rate was in Alabama (3,085.0) and the lowest in Vermont (1,200.5) and Maine (1,281.5).

Infant Mortality by Age at Death in the United States, 2016.

Infant mortality is an important public health measure in the United States and other countries (1-3). The United States' infant mortality rate started to decline in 2007 (the most recent high), but has remained relatively unchanged in recent years (4,5). Previous research shows differences in infant mortality rates by age at death (i.e., neonatal, or deaths to infants aged 0-27 days, and postneonatal, or deaths to infants aged 28-364 days), age and race and Hispanic origin of the mother, and leading causes of death (4-6). This report examines infant mortality rates for the United States by age at death in 2016, by maternal age and race and Hispanic origin, and for the five leading causes of neonatal and postneonatal mortality.

Declines in Births to Females Aged 10-14 in the United States, 2000-2016.

The birth rate for teen mothers aged 15-19 declined 57% from 2000 through 2016. During this time, the rate for young adolescent mothers aged 10-14 also declined. Childbearing by very young mothers is a matter of public concern because of the elevated health risks for these mothers and their infants and the socioeconomic consequences. This report describes recent trends and variations in births to young mothers aged 10-14 by race and Hispanic origin and state.

State Variations in Infant Mortality by Race and Hispanic Origin of Mother, 2013-2015.

Infant mortality has long been a basic measure of public health for countries around the world (1­3). While the overall infant mortality rate in the United States is lower than a decade ago, declining 14% from 6.86 infant deaths per 1,000 live births in 2005, a recent high, to 5.90 in 2015, the rate in 2015 was not statistically different from that in 2014 (5.82) (4­6). The variability in infant mortality rates by state and by race and Hispanic origin continues to receive attention (7,8). This report uses linked birth and infant death data from 2013 through 2015 to describe infant mortality rates in the United States by state, and for race and Hispanic-origin groups by state.

Infant Mortality Rates in Rural and Urban Areas in the United States, 2014.

The infant mortality rate is often used as a measure of a country's health because similar factors influence population health and infant mortality (1). Although infant mortality has declined in the United States, disparities still exist across geographic areas and demographic groups (2­4). Urbanization level, based on the number and concentration of people in a county, can impact health outcomes (3­9). Previous research indicates that infant mortality rates vary by urbanization level and also by maternal and infant characteristics (3­9). This report describes differences in infant mortality among rural, small and medium urban, and large urban counties in the United States by infant's age at death, mother's age, and race and Hispanic origin in 2014.

Maternal obesity programs mitochondrial and lipid metabolism gene expression in infant umbilical vein endothelial cells.

BACKGROUND/OBJECTIVES: Maternal obesity increases risk for childhood obesity, but molecular mechanisms are not well understood. We hypothesized that primary umbilical vein endothelial cells (HUVEC) from infants of overweight and obese mothers would harbor transcriptional patterns reflecting offspring obesity risk. SUBJECTS/METHODS: In this observational cohort study, we recruited 13 lean (pre-pregnancy body mass index (BMI) <25.0 kg m-2) and 24 overweight-obese ('ov-ob', BMI⩾25.0 kg m-2) women. We isolated primary HUVEC, and analyzed both gene expression (Primeview, Affymetrix) and cord blood levels of hormones and adipokines. RESULTS: A total of 142 transcripts were differentially expressed in HUVEC from infants of overweight-obese mothers (false discovery rate, FDR<0.05). Pathway analysis revealed that genes involved in mitochondrial and lipid metabolism were negatively correlated with maternal BMI (FDR<0.05). To test whether these transcriptomic patterns were associated with distinct nutrient exposures in the setting of maternal obesity, we analyzed the cord blood lipidome and noted significant increases in the levels of total free fatty acids (lean: 95.5±37.1 µg ml-1, ov-ob: 124.1±46.0 µg ml-1, P=0.049), palmitate (lean: 34.5±12.7 µg ml-1, ov-ob: 46.3±18.4 µg ml-1, P=0.03) and stearate (lean: 20.8±8.2 µg ml-1, ov-ob: 29.7±17.2 µg ml-1, P=0.04), in infants of overweight-obese mothers. CONCLUSIONS: Prenatal exposure to maternal obesity alters HUVEC expression of genes involved in mitochondrial and lipid metabolism, potentially reflecting developmentally programmed differences in oxidative and lipid metabolism.

Elevated serum thyroglobulin levels at the time of ablative radioactive iodine therapy indicate a worse prognosis in thyroid cancer: an Australian retrospective cohort study.

BACKGROUND: Serum thyroglobulin is used as a surrogate marker for well-differentiated thyroid carcinoma recurrence. This study investigates whether thyroglobulin measured at the time of ablative radioactive iodine therapy predicts disease-free survival. METHODS: A retrospective review was conducted of patients with well-differentiated thyroid carcinoma presenting from 1989 to 2010 at the Royal Prince Alfred Hospital, New South Wales, Australia. Disease-free survival of patients with a significantly elevated stimulated thyroglobulin level (27.5 µg/l or higher) at the time of ablative radioactive iodine therapy was compared to that of patients without a significantly elevated thyroglobulin level using univariate analysis. RESULTS: Patients with a thyroglobulin level of 27.5 µg/l or higher had an increased relative risk of disease recurrence of 4.50 (95 per cent confidence interval = 1.35-15.04). If lateral neck dissection was required at the time of surgery, patients also had an increased relative risk of macroscopic disease recurrence of 4.94 (95 per cent confidence interval = 1.47-16.55). CONCLUSION: An elevated thyroglobulin level of 27.5 µg/l or higher at the time of ablative radioactive iodine therapy is a prognostic indicator for macroscopic disease recurrence in well-differentiated thyroid carcinoma.

Smoking Prevalence and Cessation Before and During Pregnancy: Data From the Birth Certificate, 2014.

OBJECTIVES: This report presents findings for 2014 on maternal smoking prevalence and cessation before and during pregnancy as collected on the 2003 U.S. Standard Certificate of Live Birth, for a 46-state and District of Columbia reporting area, representing 95% of all births in the United States. METHODS: Cigarette smoking and cessation rates 3 months before and during pregnancy are presented by maternal age; race and ethnicity; marital status; educational attainment; source of payment at delivery (private insurance, Medicaid, and self-pay); receipt of benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children; prenatal care initiation; and jurisdiction. RESULTS: About 1 in 10 women who gave birth in 2014 smoked during the 3 months before pregnancy (10.9%), and about one-quarter of these women (24.2%) did not smoke during pregnancy (i.e., quit before pregnancy). The smoking rate at any time during pregnancy was 8.4%, with 20.6% of women who smoked in the first or second trimesters quitting by the third trimester. Smoking during pregnancy was more prevalent for women aged 20­24 (13.0%) than for other ages, and by race and Hispanic origin, the highest rate was for non- Hispanic American Indian or Alaska Native women (18.0%). Smoking during pregnancy ranged from 1.8% in California to 27.1% in West Virginia. The highest smoking cessation rates before and during pregnancy were for women with the highest educational attainment, private insurance, and non-Hispanic Asian and Hispanic race and ethnicity. On average, women who continued to smoke during pregnancy smoked fewer cigarettes as the pregnancy progressed, from 13 per day before pregnancy to 9 per day by the third trimester.

Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

OBJECTIVES: This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. METHODS: Descriptive tabulations of data are presented and interpreted. RESULTS: The U.S. infant mortality rate was 5.96 infant deaths per 1,000 live births in 2013, similar to the rate of 5.98 in 2012. The number of infant deaths was 23,446 in 2013, a decline of 208 infant deaths from 2012. From 2012 to 2013, infant mortality rates were stable for most race and Hispanic origin groups; declines were reported for two Hispanic subgroups: Cuban and Puerto Rican. Since 2005, the most recent high, the U.S. infant mortality rate has declined 13% (from 6.86), with declines in both neonatal and postneonatal mortality overall and for most groups. In 2013, infants born at 37­38 weeks of gestation (early term) had mortality rates that were 63% higher than for full-term (39­40 week) infants. For multiple births, the infant mortality rate was 25.84, 5 times the rate of 5.25 for singleton births. In 2013, 36% of infant deaths were due to preterm-related causes of death, and an additional 15% were due to causes grouped into the sudden unexpected infant death category.

Births: final data for 2013.

OBJECTIVES: This report presents 2013 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, attendant at birth, method of delivery, period of gestation, birthweight, and plurality. Birth and fertility rates are presented by age, live-birth order, race and Hispanic origin, and marital status. Selected data by mother's state of residence and birth rates by age and race of father also are shown. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.93 million U.S. births that occurred in 2013 are presented. RESULTS: A total of 3,932,181 births were registered in the United States in 2013, down less than 1% from 2012. The general fertility rate declined to 62.5 per 1,000 women aged 15-44. The teen birth rate fell 10%, to 26.5 per 1,000 women aged 15-19. Birth rates declined for women in their 20s and increased for most age groups of women aged 30 and over. The total fertility rate (estimated number of births over a woman's lifetime) declined 1% to 1,857.5 per 1,000 women. Measures of unmarried childbearing were down in 2013 from 2012. The cesarean delivery rate declined to 32.7%. The preterm birth rate declined for the seventh straight year to 11.39%, but the low birthweight rate was essentially unchanged at 8.02%. The twin birth rate rose 2% to 33.7 per 1,000 births; the triplet and higher-order multiple birth rate dropped 4% to 119.5 per 100,000 total births.

Births: Final Data for 2014.

This report presents 2014 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, attendant at birth, method of delivery, period of gestation, birthweight, and plurality. Birth and fertility rates are presented by age, live-birth order, race and Hispanic origin, and marital status. Selected data by mother's state of residence and birth rates by age and race of father also are shown. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.

International comparisons of infant mortality and related factors: United States and Europe, 2010.

OBJECTIVES: This report investigates the reasons for the United States' high infant mortality rate when compared with European countries. Specifically, the report measures the impact on infant mortality differences of two major factors: the percentage of preterm births and gestational age-specific infant mortality rates. METHODS: Infant mortality and preterm birth data are compared between the United States and European countries. The percent contribution of the two factors to infant mortality differences is computed using the Kitagawa method, with Sweden as the reference country. RESULTS: In 2010, the U.S. infant mortality rate was 6.1 infant deaths per 1,000 live births, and the United States ranked 26th in infant mortality among Organisation for Economic Co-operation and Development countries. After excluding births at less than 24 weeks of gestation to ensure international comparability, the U.S. infant mortality rate was 4.2, still higher than for most European countries and about twice the rates for Finland, Sweden, and Denmark. U.S. infant mortality rates for very preterm infants (24-31 weeks of gestation) compared favorably with most European rates. However, the U.S. mortality rate for infants at 32-36 weeks was second-highest, and the rate for infants at 37 weeks of gestation or more was highest, among the countries studied. About 39% of the United States' higher infant mortality rate when compared with that of Sweden was due to a higher percentage of preterm births, while 47% was due to a higher infant mortality rate at 37 weeks of gestation or more. If the United States could reduce these two factors to Sweden's levels, the U.S. infant mortality rate would fall by 43%, with nearly 7,300 infant deaths averted annually.

Systematic review of congenital and acquired portal-systemic shunts in otherwise normal livers.

BACKGROUND: Portal-systemic shunts (PSSs) are rarely seen in healthy individuals or patients with non-cirrhotic liver disease. They may play an important role in hepatic metabolism as well as in the spread of gastrointestinal metastatic tumours to specific organs. Small spontaneous PSSs may be more common than generally thought. However, epidemiological data are scarce and inconclusive. This systematic review examined the prevalence of reported PSSs and the associated detection methods. METHODS: Literature up to 2011 was reviewed for adult patients with proven congenital or acquired PSSs. Only PSSs in normal livers were analysed for the methods of diagnosis. Eligible studies were identified by searching relevant databases, including PubMed, Embase, MEDLINE and the Cochrane Library. The selection of eligible articles was carried out using predefined inclusion criteria (adult, non-surgical PSS) and a set of search terms that were established before the articles were identified. RESULTS: Eighty studies were included describing 112 patients with congenital or acquired PSSs. The majority were diagnosed incidentally using Doppler ultrasound imaging and CT. CONCLUSION: Congenital and acquired PSSs are rare. They are usually clinically asymptomatic and discovered incidentally by radiological techniques. They may be clinically relevant owing to drug, tumour cell, metabolic and pathogen shunting.

National and state patterns of teen births in the United States, 1940-2013.

OBJECTIVES: This report presents trends from 1940 through 2013 in national birth rates for teenagers, with particular focus on the period since 1991. The percent changes in rates for 1991-2012 and for 2007-2012 are presented for the United States and for states. Preliminary data for 2013 are shown where available. METHODS: Tabular and graphical descriptions of the trends in teen birth rates for the United States and each state, by age group, race, and Hispanic origin, are presented and discussed. Data are shown for the U.S. territories. RESULTS: Birth rates for U.S. teenagers have generally fallen in the United States since peaking in 1957. The rate fell 57% between 1991 and 2013. The 2013 preliminary rate (26.6 per 1,000 aged 15-19) is less than one-third of the historically highest rate (96.3 in 1957). During 1991-2012, rates fell for all race and Hispanic ethnicity groups, with the largest declines measured for non-Hispanic black teenagers. In the more recent period, 2007-2012, the declines have been steepest for Hispanic teenagers. Birth rates declined significantly for teenagers in all states during 1991-2012; during 2007-2012, rates fell for all but two states. The drop in teen birth rates translates into an estimated 4 million fewer births to teenagers from 1992 through 2012. The declines in teen birth rates reflect a number of behavioral changes, including decreased sexual activity, increases in the use of contraception at first sex and at most recent sex, and the adoption and increased use of hormonal contraception, injectables, and intrauterine devices.

First births to older women continue to rise.

KEY FINDINGS: Data from the National Vital Statistics System The first birth rate for women aged 35-39 increased from 1970 to 2006, decreased from 2006 to 2010, and increased again in both 2011 and 2012. The first birth rate for women aged 40-44 was steady in the 1970s and started increasing in the 1980s. The rate more than doubled from 1990 to 2012. For women aged 35-39 and 40-44 all race and Hispanic origin groups had increasing first birth rates from 1990 to 2012. Since 2000, 46 states and DC had an increase in the first birth rate for women aged 35-39. For women aged 40-44, rates increased in 31 states and DC. The average age of women at first birth has risen over the past 4 decades (1-3). This increase is in part a reflection of the shift in first births to women 35 years and older. Delayed childbearing affects the size, composition, and future growth of the population in the United States (2). Increased health risks to older mothers, especially those 40 years and older, and their infants are well documented (4-7), first time older mothers are generally better educated and more likely to have more resources including higher incomes than those at the youngest reproductive ages (8). This report explores trends in first births to women aged 35-39 and 40-44 years from 1970 to 2012, and by race and Hispanic origin from 1990 to 2012 (the most recent year for which comparable data are available). Trends in first births for older women by state are examined for the recent period, 2000 to 2012.

Trends in out-of-hospital births in the United States, 1990-2012.

Although still relatively rare, out-of-hospital births have accounted for a growing share of U.S. births since 2004. In 2012, 1.36% of U.S. births were born outside a hospital, up from 1.26% in 2011 and 0.87% in 2004. The 2012 level is the highest level since 1975. Most of the total increase in out-of-hospital births from 2004­2012 was a result of the increase among non-Hispanic white women, and by 2012, 1 in 49 births to non-Hispanic white women (2.05%) occurred outside a hospital. In 2012, six states had 3%­6% of their births occur outside a hospital. For an additional five states, between 2% and 3% of their births were out-of-hospital births. Variations in the percentages of out-of-hospital births by state may be influenced by differences in state laws pertaining to midwifery practice or out-of-hospital births, as well as by the availability of a nearby birthing center. The number of U.S. birthing centers increased from 170 in 2004 to 195 in 2010 and to 248 in January 2013; 13 states still did not have a birthing center in the most recent period. Compared with hospital births, home and birthing center births tended to have lower risk profiles, with fewer births to teen mothers and fewer preterm, low birthweight, and multiple births. From 2004 through 2012, there was a decline in the risk profile of out-of-hospital births, with fewer births in 2012 than in 2004 to teen and older mothers and fewer preterm and low birthweight births. The lower risk profile of out-of-hospital than hospital births suggests that appropriate selection of low-risk women as candidates for out-of-hospital birth is occurring. Although not representative of all U.S. births, 88% of home births in a 36-state reporting area (comprising 71% of U.S. births) were planned in 2012. Unplanned home births are more likely than planned home births to be born preterm and at low birthweight.

Newly released data from the revised U.S. birth certificate, 2011.

OBJECTIVES: This report is the first release of multistate data for selected items exclusive to the 2003 revision of the U.S. Standard Certificate of Live Birth. Included is information for prepregnancy body mass index, smoking and quitting smoking in the 3 months prior to pregnancy, receipt of food from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during pregnancy, pregnancy resulting from infertility treatment, source of payment for delivery, and maternal morbidities. METHODS: Descriptive statistics are presented for 100% of 2011 births to residents of the 36 states, the District of Columbia (D.C.), and Puerto Rico that had implemented the revised birth certificate by January 1, 2011. This reporting area is not a random sample, and results are not generalizable to the United States as a whole. RESULTS: The 3,267,934 births to residents of the 36-state and D.C. reporting area represented 83% of all 2011 U.S. births. Levels of prepregnancy obesity ranged from 18.0% in Utah to 28.6% in South Carolina. Hispanic women were the least likely to smoke in the 3 months prior to pregnancy and were the most likely to quit smoking prior to pregnancy. Women under age 20 were more than twice as likely to receive WIC food during pregnancy as women aged 35 and over in nearly all states and D.C. The percentage of births resulting from infertility treatment ranged from 0.3% in New Mexico to over 3.5% in Maryland and Utah. The percentage of deliveries covered by Medicaid ranged from 28.8% in North Dakota to 64.2% in Louisiana.

Births: final data for 2012.

OBJECTIVES: This report presents 2012 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, attendant at birth, method of delivery, period of gestation, birthweight, and plurality. Birth and fertility rates are presented by age, live-birth order, race and Hispanic origin, and marital status. Selected data by mother's state of residence and birth rates by age and race of father also are shown. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.95 million births that occurred in 2012 are presented. RESULTS: A total of 3,952,841 births were registered in the United States in 2012. The general fertility rate declined to 63.0 per 1,000 women aged 15-44. The teen birth rate fell 6%, to 29.4 per 1,000 women. Birth rates declined for women in their twenties and increased for women aged 30-44. The total fertility rate (estimated number of births over a woman's lifetime) declined 1% to 1,880.5 per 1,000 women. The rate of births to unmarried women declined; the percentage of births to unmarried women was essentially stable at 40.7%, but the number of births to unmarried women increased slightly. The cesarean delivery rate was unchanged at 32.8%. The preterm birth rate declined for the sixth straight year to 11.55%; the low birthweight rate declined slightly to 7.99%. The twin birth rate was stable at 33.1 per 1,000 births; the rate of triplet and higher-order multiple births dropped 9% to 124.4 per 100,000 total births.