Births: Final Data for 2022.

Objectives- This report presents 2022 data on U.S. births by selected characteristics. Trends in fertility patterns and maternal and infant characteristics are described. Methods-Descriptive tabulations based on birth certificates of the 3.67 million births registered in 2022 are shown by maternal age, live-birth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality. Selected data by mother's state of residence and birth rates also are shown. Trends for 2010 to 2022 are presented for selected items, and by race and Hispanic origin for 2016-2022. Results-A total of 3,667,758 births occurred in the United States in 2022, essentially unchanged from 2021. The general fertility rate declined 1% from 2021 to 56.0 births per 1,000 females ages 15-44 in 2022. The birth rate for females ages 15-19 declined 2% from 2021 to 2022; birth rates fell 7% for women ages 20-24, rose 1% to 5% for women ages 25-29 and 35-44, and rose 12% for women ages 45-49 (the first increase since 2016). The total fertility rate declined less than 1% to 1,656.5 births per 1,000 women in 2022. Birth rates declined for unmarried women but increased for married women from 2021 to 2022. Prenatal care beginning in the first trimester declined to 77.0% in 2022; the percentage of women who smoked during pregnancy declined to 3.7%. The cesarean delivery rate was unchanged in 2022 (32.1%); Medicaid was the source of payment for 41.3% of births. The preterm birth rate declined 1% to 10.38%; the low birthweight rate rose 1% to 8.60%. The twin birth rate was unchanged in 2022 (31.2 per 1,000 births); the 2% decrease in the triplet and higher-order multiple birth rate.

Perinatal Mortality in the United States, 2020-2021.

Perinatal mortality(late fetal deaths at 28 completed weeks of gestation or more and early neonatal deaths younger than age 7 days) can be an indicator of the quality of health care before, during, and after delivery, and of the health status of the nation (1,2). The U.S. perinatal mortality rate declined 30% from 1990 through 2011, was stable from 2011 through 2016, and declined 4% from 2017 through 2019 (1,3-5). This report describes changes in perinatal mortality, as well as its components, late fetal and early neonatal mortality, from 2020 to 2021, during the COVID-19 pandemic. Also shown are perinatal mortality rates by mother's age, the three largest race and Hispanic-origin groups, and state for 2021 compared with 2020.

Fetal Mortality: United States, 2021.

Objectives-This report presents 2021 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined. Methods-Descriptive tabulations of data are presented and interpreted for all fetal deaths reported for the United States for 2021 with a stated or presumed period of gestation of 20 weeks or more. Cause-of-fetal-death data are restricted to residents of the 41 states and the District of Columbia, where cause of death was based on the 2003 fetal death report revision and less than 50% of deaths were attributed to Fetal death of unspecified cause (P95). Results-A total of 21,105 fetal deaths at 20 weeks of gestation or more were reported in the United States in 2021. The 2021 U.S. fetal mortality rate was 5.73 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, which was essentially unchanged from the rate of 5.74 in 2020. The fetal mortality rate in 2021 for deaths occurring at 20-27 weeks of gestation was 2.95, essentially unchanged from 2020 (2.97). For deaths occurring at 28 weeks of gestation or more, the rate in 2021 (2.80) was not significantly different from 2020 (2.78). In 2021, the fetal mortality rate ranged from 3.94 for non-Hispanic, single-race Asian women to 9.89 for non-Hispanic, single-race Black women. Fetal mortality rates were highest for females under age 15 and aged 40 and over, for women who smoked during pregnancy, and for women with multiple gestation pregnancies. Five selected causes accounted for 89.9% of fetal deaths in the 41-state and District of Columbia reporting area.

Characteristics of Mothers by Source of Payment for the Delivery: United States, 2021.

Access to health care coverage during pregnancy and delivery allows women to receive the care needed to maximize the likelihood of a healthy pregnancy and baby (1). National birth certificate data on the principal source of payment for the delivery became available in 2016, when all states implemented the 2003 U.S. Standard Certificate of Live Birth. This certificate provides information on payment through private insurance; Medicaid; CHAMPUS, TRICARE, and other types of government insurance; and self-pay, which has been shown to reflect the uninsured status of the mother at the time of delivery (2). This report describes the principal source of payment for the delivery in 2021 overall and by maternal race and Hispanic origin, age, and education.

Births: Final Data for 2021.

Objectives-This report presents 2021 data on U.S. births according to a variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.

Changes in Home Births by Race and Hispanic Origin and State of Residence of Mother:United States, 2019-2020 and 2020- 2021.

Objectives-This report describes changes between 2020 and 2021 in the percentage of home births by month, race and Hispanic origin, and state of residence of the mother, and makes comparisons with changes occurring between 2019 and 2020.

Fetal Mortality: United States, 2020.

Objectives-This report presents 2020 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined.

Maternal Characteristics and Infant Outcomes of Women Born in and Outside the United States:United States, 2020.

This report describes and compares maternalcharacteristics and infant outcomes by maternal place of birth (that is, whether the mother was born in the United States or in regions, subregions, and selected countries outside the United States) among births occurring in 2020.

Decline in Perinatal Mortality in the United States, 2017-2019.

Perinatal mortality (late fetal deaths at 28 completed weeks of gestation or more and early neonatal deaths under age 7 days) can be an indicator of the quality of health care before, during, and after delivery, and of the health status of the nation (1,2). The U.S. perinatal mortality rate declined 30% from 1990 to 2011, but was stable from 2011 through 2016 (1,3,4). This report presents trends in perinatal mortality as well as its components, late fetal and early neonatal mortality, for 2017 through 2019. Also shown are perinatal mortality trends by mother's age, race and Hispanic origin, and state for 2017-2019.

Changes in Home Births by Race and Hispanic Origin and State of Residence of Mother: United States, 2018-2019 and 2019-2020.

Objectives-This report describes changes between 2019 and 2020 in the percentage of U.S. home births by month, race and Hispanic origin, and state of residence of the mother and makes comparisons with changes occurring between 2018 and 2019.

Fetal Mortality: United States, 2019.

Objectives-This report presents 2019 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined.

Births: Final Data for 2020.

Objectives-This report presents 2020 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.