Births: final data for 2007.

OBJECTIVES: This report presents 2007 data on U.S. births according to a wide variety of characteristics; preliminary 2008 data are also referenced on key measures where available. Final 2007 data are presented for maternal demographic characteristics including age, live-birth order, race and Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Birth and fertility rates by age, live-birth order, race and Hispanic origin, and marital status also are presented. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations are presented of data reported on the birth certificates of the 4.3 million births that occurred in 2007. Preliminary 2008 data are based on 99.9 percent of births occurring in 2008. Denominators for population-based rates are postcensal estimates derived from the U.S. 2000 census. RESULTS: A total of 4,316,233 births were registered in the United States in 2007, the largest number of births ever reported. The general fertility rate increased 1 percent to 69.5 per 1,000. Birth rates increased for women in nearly all age groups. The rate for teenagers rose 1 percent for the year and is up 5 percent from 2005. The total fertility rate increased 1 percent to 2,122.0 births per 1,000 women. Preliminary data for 2008, however, suggest a decline in the number and rate of births overall, and for most age groups under age 40 years. All measures of unmarried childbearing reached record levels in 2007. The cesarean delivery rate rose to another all-time high--31.8 percent. Preterm and low birthweight rates declined slightly, and twin and triplet and higher-order multiple birth rates were essentially unchanged. Preliminary findings for 2008 suggest that these trends continued for cesarean delivery, unmarried childbearing, and preterm births.

Sexual and reproductive health of persons aged 10-24 years - United States, 2002-2007.

This report presents data for 2002-2007 concerning the sexual and reproductive health of persons aged 10-24 years in the United States. Data were compiled from the National Vital Statistics System and multiple surveys and surveillance systems that monitor sexual and reproductive health outcomes into a single reference report that makes this information more easily accessible to policy makers, researchers, and program providers who are working to improve the reproductive health of young persons in the United States. The report addresses three primary topics: 1) current levels of risk behavior and health outcomes; 2) disparities by sex, age, race/ethnicity, and geographic residence; and 3) trends over time. The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes. In 2004, approximately 745,000 pregnancies occurred among U.S. females aged <20 years. In 2006, approximately 22,000 adolescents and young adults aged 10-24 years in 33 states were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and approximately 1 million adolescents and young adults aged 10-24 years were reported to have chlamydia, gonorrhea, or syphilis. One-quarter of females aged 15-19 years and 45% of those aged 20-24 years had evidence of infection with human papillomavirus during 2003-2004, and approximately 105,000 females aged 10--24 years visited a hospital emergency department (ED) for a nonfatal sexual assault injury during 2004-2006. Although risks tend to increase with age, persons in the youngest age group (youths aged 10--14 years) also are affected. For example, among persons aged 10-14 years, 16,000 females became pregnant in 2004, nearly 18,000 males and females were reported to have sexually transmitted diseases (STDs) in 2006, and 27,500 females visited a hospital ED because of a nonfatal sexual assault injury during 2004-2006. Noticeable disparities exist in the sexual and reproductive health of young persons in the United States. For example, pregnancy rates for female Hispanic and non-Hispanic black adolescents aged 15-19 years are much higher (132.8 and 128.0 per 1,000 population) than their non-Hispanic white peers (45.2 per 1,000 population). Non-Hispanic black young persons are more likely to be affected by AIDS: for example, black female adolescents aged 15-19 years were more likely to be living with AIDS (49.6 per 100,000 population) than Hispanic (12.2 per 100,000 population), American Indian/Alaska Native (2.6 per 100,000 population), non-Hispanic white (2.5 per 100,000 population) and Asian/Pacific Islander (1.3 per 100,000 population) adolescents. In 2006, among young persons aged 10-24 years, rates for chlamydia, gonorrhea, and syphilis were highest among non-Hispanic blacks for all age groups. The southern states tend to have the highest rates of negative sexual and reproductive health outcomes, including early pregnancy and STDs. Although the majority of negative outcomes have been declining for the past decade, the most recent data suggest that progress might be slowing, and certain negative sexual health outcomes are increasing. For example, birth rates among adolescents aged 15-19 years decreased annually during 1991-2005 but increased during 2005-2007, from 40.5 live births per 1,000 females in 2005 to 42.5 in 2007 (preliminary data). The annual rate of AIDS diagnoses reported among males aged 15-19 years has nearly doubled in the past 10 years, from 1.3 cases per 100,000 population in 1997 to 2.5 cases in 2006. Similarly, after decreasing for >20 years, gonorrhea infection rates among adolescents and young adults have leveled off or had modest fluctuations (e.g., rates among males aged 15-19 years ranged from 285.7 cases per 100,000 population in 2002 to 250.2 cases per 100,000 population in 2004 and then increased to 275.4 cases per 100,000 population in 2006), and rates for syphilis have been increasing (e.g., rates among females aged 15-19 years increased from 1.5 cases per 100,000 population in 2004 to 2.2 cases per 100,000 population in 2006) after a significant decrease during 1997-2005.

Births: final data for 2005.

OBJECTIVES: This report presents 2005 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. 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 4.1 million births that occurred in 2005 are presented. Denominators for population-based rates are postcensal estimates derived from the U.S. 2000 census. RESULTS: In 2005, 4,138,349 births were registered in the United States, 1 percent more than in 2004. The 2005 crude birth rate was 14.0, unchanged from the previous year; the general fertility rate increased slightly to 66.7. Teenage childbearing continued to decline, dropping to the lowest levels recorded. Rates for women aged 20-29 were fairly stable, whereas childbearing among women 30 years of age and older increased. All measures of unmarried childbearing rose substantially in 2005. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate climbed to more than 30 percent of all births, another all-time high. Preterm and low birthweight rates also continued to rise; the twin birth rate was unchanged and the rate of triplet and higher order multiple births declined for the 7th consecutive year.

Births: final data for 2004.

OBJECTIVES: This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. 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 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. RESULTS: In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise. The twinning rate increased, but the rate of triplet and higher order multiple births was down slightly.

Births: final data for 2003.

OBJECTIVES: This report presents 2003 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. 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 4.09 million births that occurred in 2003 are presented. Denominators for population-based rates are derived from the U.S. 2000 census. RESULTS: In 2003 there were 4,089,950 live births reported in the United States, 2 percent more than the number in 2002. The crude birth rate (CBR) and general fertility rate (GFR) rose slightly. Childbearing among teenagers declined for the 12th straight year to another historic low. Birth rates for women aged 20-24 years also declined, whereas rates for women aged 25-44 years increased 2-6 percent, reaching highs not reported since the mid- to late 1960s. All measures of unmarried childbearing increased considerably in 2003, but smoking during pregnancy continued to decline. Timely initiation of prenatal care improved slightly. The cesarean delivery rate jumped another 5 percent to another all-time high, and the rate of vaginal birth after previous cesarean dropped 16 percent, an all-time low. Key measures of birth outcome-the percentages of preterm and low birthweight (LBW) births-rose. The twinning rate increased, but the rate of triplet and higher order multiple births was essentially stable.

Births: preliminary data for 2004.

OBJECTIVES: This report presents preliminary data for 2004 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, tobacco use, prenatal care, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. METHODS: Data in this report are based on 99.1 percent of births for 2004. The records are weighted to independent control counts of all births received in State vital statistics offices in 2004. Comparisons are made with 2003 data. RESULTS: The crude birth rate declined 1 percent to 14.0 births per 1,000 population. The fertility rate, however, rose slightly to 66.3 births per 1,000 women aged 15-44 years. Birth rates for teenagers 15-19 years declined modestly. The rate in 2004 was 41.2 births per 1,000 females aged 15-19 years, 1 percent lower than in 2003. Rates declined 1 percent each for teenagers 15-17 and 18-19 years. The rate for 10-14 year-olds increased slightly. The birth rate for women aged 20-24 years declined 1 percent to 101.8, a record low for the Nation. The rate for women aged 25-29 years remained essentially unchanged at 115.5 per 1,000. The birth rate for women aged 30-34 years rose less than 1 percent to 95.5 per 1,000, whereas the rates for women aged 35-39 and 40-44 years increased 3 to 4 percent each. The rate for women aged 45-49 years rose to 0.6 per 1,000. Childbearing by unmarried women rose to a record high of almost 1.5 million births in 2004, a 4-percent increase from 2003. The proportion of all births to unmarried women increased to 35.7 percent. Smoking during pregnancy declined slightly in 2004, to 10.2 percent of mothers in the 40-State reporting area. There was no improvement in timely receipt of prenatal care. In 2004, 83.9 percent of mothers in the 41-State reporting area began care in the first trimester. A record high cesarean delivery rate was reported in 2004, at 29.1 percent of all births, a 6-percent increase from 2003. The primary cesarean rate rose 8 percent, whereas the rate of vaginal birth after cesarean delivery declined 13 percent. Preterm and LBW rates each increased in 2004. More than 500,000 infants were born preterm, a rate of 12.5 percent. The LBW rate increased to 8.1 percent.

Trends and variations in smoking during pregnancy and low birth weight: evidence from the birth certificate, 1990-2000.

OBJECTIVE: This study compares patterns of tobacco use during pregnancy over time and across population subgroups and examines the impact of maternal smoking on the incidence of low birth weight (LBW). The study also evaluates the use of birth certificates to monitor prenatal smoking. METHODS: The birth certificates of all states (except California) and the District of Columbia for 2000 provided to Centers for Disease Control and Prevention's National Center for Health Statistics were analyzed. Trends in maternal smoking were examined with data from birth certificates and other relevant sources. RESULTS: Smoking during pregnancy was reported for 12.2% of women who gave birth in 2000, down 37% from 1989 (19.5%), when this information was first collected on birth certificates. Throughout the 1990s, prenatal smoking rates were highest for older teenagers and women in their early 20s. Among population subgroups, the highest rates were reported for non-Hispanic white women who attended but did not complete high school. The incidence of LBW among singleton infants who were born to smokers was double that for nonsmokers. This relationship was observed in all age groups, for births to Hispanic and non-Hispanic white and black women, and within educational attainment subgroups. Even light smoking (<5 cigarettes daily) was associated with elevated rates of LBW. CONCLUSION: Although prenatal smoking may be underreported on the birth certificate, the trends and variations in smoking based on birth certificate data have been confirmed with data from other sources. Birth certificate data can be useful in monitoring prenatal smoking patterns. Changes in the birth certificate questions that are to be implemented beginning in 2003 will help to clarify the levels and changes in smoking behavior during pregnancy so that smoking cessation programs can be more effectively designed to meet the needs of the populations at risk.

Births: final data for 2002.

OBJECTIVES: This report presents 2002 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. 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 4.022 million births that occurred in 2002 are presented. Denominators for population-based rates are derived from the 2000 U.S. census. Rates for 1991-2001 may differ from those published previously based on the 1990 U.S. census. RESULTS: There were 4,021,726 live births in 2002, essentially unchanged from 2001. The birth rate, fertility rate, and total fertility rates all declined 1 percent in 2002. The teenage birth rate dropped 5 percent, reaching another record low. The birth rates for women 20-24 years declined, whereas the rate for women 25-29 years was stable. The birth rate for women 30-34 years declined, but the rate for women 35-44 years continued to rise. Births to unmarried women changed very little. Smoking during pregnancy was down again. The timeliness of prenatal care continued to improve. The cesarean delivery rate climbed to the highest level ever reported in the United States (26.1 percent) and the rate of vaginal birth after previous cesarean plummeted 23 percent to 12.6 percent. Preterm and low birthweight levels both rose for 2002. The twin birth rate continued to climb, but the rate of triplet/+ births was down slightly.

Births: final data for 2000.

OBJECTIVES: This report presents 2000 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. 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 4.059 million births that occurred in 2000 are presented. RESULTS: The number of births rose 3 percent in 2000; birth and fertility rates rose 1 to 2 percent. The total fertility rate was above "replacement" for the first time in almost 30 years. Teenage birth rates continued to fall while birth rates for women aged 20-24 years rose slightly, and rates for women in their late twenties and thirties rose 3 to 5 percent. Births to women in their forties and early fifties were also up for 2000. The number of births to unmarried women, the birth rate, and the percent of births that were to unmarried women rose 1 to 3 percent, but birth rates for unmarried teenagers declined. Smoking by pregnant women was down again. The cesarean delivery rate rose 4 percent to 22.9, the fourth consecutive increase; the primary cesarean rate was up and the rate of vaginal births after a previous cesarean was down. The number and rate of twin births continued to rise, but the triplet/+ birth rate declined for the second year in a row. For the first year in almost a decade the preterm birth rate declined (to 11.6 percent); the low birthweight rate, however, was unchanged at 7.6 percent.

Births: final data for 2001.

OBJECTIVES: This report presents 2001 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. 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 4.026 million births that occurred in 2001 are presented. Denominators for population-based rates are derived from the 1990 U.S. census. As a result, rates are generally larger than would be the case if 2000-based estimates were used. The magnitude of the overestimate will vary by population subgroup; overestimates are likely greatest for those of Hispanic origin. RESULTS: The number of births, the birth rate, fertility rate, and total fertility rates all declined 1 percent in 2001. The teenage birth rate reached another historic low. Birth rates for women in their twenties declined slightly, whereas rates for women aged 30 to 44 years continued to rise. Births to unmarried women changed very little. Smoking by pregnant women was down again. Women were more likely to begin care in the first trimester of pregnancy (83.4 percent). The cesarean delivery rate rose for the fifth consecutive year to 24.4 percent; the primary cesarean rate was up 5 percent and the rate of vaginal births after a previous cesarean fell 20 percent. Preterm and low birthweight levels both rose for 2001. The twin birth rate continued to climb, and following 2 years of decline, the rate of triplet/+ births also increased.