Births to teenagers in the United States, 1940-2000.

OBJECTIVES: This report presents trends in national birth rates for teenagers, with particular focus on the decade of the 1990s. The percent change in rates for 1991-2000 is presented for the United States, and the change for 1991-99 is presented for States. METHODS: Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin, are discussed. RESULTS: Birth rates for teenagers 15-19 years generally declined in the United States since the late 1950s, except for a brief, but steep, upward climb in the late 1980s until 1991. The 2000 rate (49 births per 1,000) is about half the peak rate recorded in 1957 (96 per 1,000). Still the U.S. rate is considerably higher than rates for other developed countries. During the 1990s rate declines were especially large for black teenagers. State-specific rates fell significantly in all States for ages 15-19 and 15-17 years, and in all but three States for ages 18-19 years. Overall the range of decline in State rates for ages 15-19 years was 11 to 36 percent. For teenagers 15-17 years, the range of decline by State was 13 to 43 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 40 percent or more in seven States. The factors accounting for these declines include decreased sexual activity reflecting changing attitudes towards premarital sex, increases in condom use, and adoption of newly available hormonal contraception, implants, and injectables.

Births: preliminary data for 2000.

OBJECTIVES: This report presents preliminary data for 2000 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, prenatal care, cesarean delivery, and low birthweight are also presented. METHODS: Data in this report are based on more than 96 percent of births for 2000. The records are weighted to independent control counts of births received in State vital statistics offices in 2000. Comparisons are made with 1999 final data. RESULTS: The number of births rose 3 percent between 1999 and 2000. The crude birth rate increased to 14.8 per 1,000 population in 2000, 2 percent higher than the 1999 rate. The fertility rate rose 3 percent to 67.6 per 1,000 women aged 15-44 years between 1999 and 2000. The birth rate for teenagers, which has been falling since 1991, declined 2 percent in 2000 to 48.7 births per 1,000 females aged 15-19 years, another historic low. The rate for teenagers 15-17 years fell 4 percent, and the rate for 18-19 year olds was down 1 percent. Since 1991, rates have fallen 29 percent for teenagers 15-17 years and 16 percent for teenagers 18-19 years. Birth rates for all of the older age groups increased for 1999-2000: 1 percent among women aged 20-24 years, 3 percent for women aged 25-29 years, and 5 percent for women in their thirties. Rates for women aged 40-54 years were also up for 2000. The birth rate for unmarried women increased 2 percent to 45.2 births per 1,000 unmarried women aged 15-44 years in 2000, but was still lower than the peak reached in 1994. The number of births to unmarried women was up 3 percent, the highest number ever reported in the United States. However, the number of births to unmarried teenagers declined. The proportion of women who began prenatal care in the first trimester of pregnancy (83.2 percent) did not improve for 2000, nor did the rate of low birthweight (7.6 percent). The total cesarean rate rose for the fourth consecutive year to 22.9 percent, the result of both a rise in the rate of primary cesarean deliveries and a decline in the rate of vaginal births after previous cesarean delivery.

Trends in pregnancy rates for the United States, 1976-97: an update.

OBJECTIVES: This report presents detailed pregnancy rates for 1996 and 1997 to update a recently published comprehensive report on pregnancies and pregnancy rates for U.S. women. METHODS: Tabular and graphic data on pregnancy rates by age, race, and Hispanic origin, and by marital status are presented and described. RESULTS: In 1997 an estimated 6.19 million pregnancies resulted in 3.88 million live births, 1.33 million induced abortions, and 0.98 million fetal losses. The 1997 pregnancy rate of 103.7 pregnancies per 1,000 women aged 15-44 years is the lowest recorded since 1976 (102.7), the first year for which a consistent series of national pregnancy rates is available. The 1997 rate was 10 percent lower than the peak rate in 1990 (115.6). The teenage pregnancy rate dropped steadily through 1997, falling to a record low of 94.3 pregnancies per 1,000 teenagers 15-19 years, 19 percent below the 1990 level (116.3). Rates for younger teenagers declined more than for older teenagers.

Births: final data for 1999.

OBJECTIVES: This report presents 1999 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 3.96 million births that occurred in 1999 are presented. RESULTS: Overall birth and fertility rates changed less than 1 percent in 1999. Teenage birth rates fell 2 to 6 percent. The rate for women aged 20-24 years declined slightly, while rates for women in their late twenties and their thirties rose 2 to 3 percent each. The number of births to unmarried women, the birth rate, and the percent of births that were to unmarried women each rose 1 percent or less. Smoking by pregnant women overall dropped again, but rose among women aged 18-24 years. Improvements in prenatal care utilization continued. The cesarean delivery rate increased for the third year after declining for 7 consecutive years. The proportion of multiple births continued to rise; however, higher order multiple births (e.g., triplets, quadruplets) declined for the first time in over a decade, following increases of 13 percent per year during 1990-98. The percent low birthweight remained at 7.6 percent, while preterm births rose to 11.8 percent. These trends are in large part the result of increases in multiple births.

Nonmarital childbearing in the United States, 1940-99.

OBJECTIVES: This report presents information on trends and variations in nonmarital childbearing in the United States and includes information on the factors that have contributed to the recent changes. Data are presented for 1940-99 with emphasis on the trends in the 1990's. METHODS: Data in this report are presented on a variety of measures of nonmarital childbearing, including numbers, rates, and percent of births to unmarried women. Most of the data is from the National Vital Statistics System. Additional data explaining the trends shown are from the National Survey of Family Growth, the U.S. Census Bureau, and other national surveys. Data are presented and interpreted principally in charts and related tables. RESULTS: After rising dramatically during the half century from 1940 to 1990, out-of-wedlock childbearing leveled off, or slowed its rate of increase, in the 1990's. Many factors contributing to the long-term changes as well as more recent trends are described. These include changes in marriage patterns, sexual activity, contraceptive use, and abortion. The experience of the United States is put into context with data on nonmarital childbearing for other industrialized countries. Possible future trends in out-of-wedlock births are considered in the context of current population and birth patterns.

Teenage childbearing in the United States, 1960-1997.

Teenage childbearing in the United States has declined significantly in the 1990s. Still the U.S. teen birth rate is higher than in other developed countries; in 1997 it was 52.3 births per 1000 women aged 15 to 19. A steep rise in teen birth rates in the late 1980s generated a great deal of public concern and a variety of initiatives targeted to reducing teen births. Data from the National Center for Health Statistics' National Vital Statistics System are used to review and describe trends and variations in births and birth rates for teenagers for the period 1960-1997. Teen birth rates were much higher in the early 1960s than at present; in fact, rates for 18- to 19-year-olds were double what they are currently. In the 1990s, birth rates for teenagers dropped for younger and older teenagers, with greater declines recorded for younger teens. While rates have fallen in all population groups, the greatest declines have been experienced by black teenagers, whose rates have dropped 24% on average. %Trends in teen births and birth rates since 1960 have been affected by a variety of factors. These include wide swings in the number of female teenagers, substantial declines in marriage among older teens, falling birth rates for married teens concurrent with rapidly rising birth rates for unmarried teens, and sharp increases in sexual activity among teens that have abated only recently, according to the National Center for Health Statistics' National Survey of Family Growth. This review article also tracks changes in contraceptive practice and abortion rates.

Variations in teenage birth rates, 1991-98: national and state trends.

OBJECTIVES: This report presents national birth rates for teenagers for 1991-98 and the percent change, 1991-98. State-specific teenage birth rates by age, race, and Hispanic origin for 1991 and 1998 and the percent change, 1991 to 1998, are also presented. METHODS: Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin of the mother, are discussed. RESULTS: Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age and race and Hispanic origin populations, with the steepest declines recorded for black teenagers. State-specific rates fell significantly in all States for ages 15-19 years; declines ranged from 10 to 38 percent. In general, rates by State fell more for younger than for older teenagers, ranging by State from 10 to 46 percent for ages 15-17 years. Statistically significant reductions for older teenagers ranged from 3 to 39 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 30 percent or more in 15 States. Among the factors accounting for these declines are decreased sexual activity, increases in condom use, and the adoption of the implant and injectable contraceptives.

Births: final data for 1998.

OBJECTIVES: This report presents 1998 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 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 health 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 including teenage birth rates and total fertility rates, 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 3.94 million births that occurred in 1998 are presented. RESULTS: Birth and fertility rates increased in 1998 by about 1 percent, the first increase since 1990. Birth rates for teenagers fell 2-5 percent. Rates for women in their twenties increased 1-2 percent each, whereas rates for women in their thirties rose 2-4 percent. All measures of childbearing by unmarried women increased in 1998; the number of births rose 3 percent, the birth rate increased about 1 percent while the percent of births that were to unmarried women rose to 32.8 percent. Smoking by pregnant women overall dropped again in 1998, but continued to increase among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate increased for the second year after declining for 7 consecutive years. The proportion of multiple births continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 13 percent in 1998, following a 14 percent rise from 1996 to 1997. Key measures of birth outcome--the percents of low birthweight and preterm births--increased. These changes are in large part the result of increases in multiple births.

Trends in pregnancies and pregnancy rates by outcome: estimates for the United States, 1976-96.

OBJECTIVES: This report presents national estimates of pregnancies and pregnancy rates according to women's age, race, and Hispanic origin, and by marital status, race, and Hispanic origin. Data are presented for 1976-96. Data from the National Survey of Family Growth (NSFG) are used to show information on sexual activity, contraceptive practices, and infertility, as well as women's reports of pregnancy intentions. METHODS: Tables of pregnancy rates and the factors affecting pregnancy rates are presented and interpreted. Birth data are from the birth-registration system for all births registered in the United States and reported by State health departments to NCHS; abortion data are from The Alan Guttmacher Institute (AGI) and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC); and fetal loss data are from pregnancy history information collected in the NSFG. RESULTS: In 1996 an estimated 6.24 million pregnancies resulted in 3.89 million live births, 1.37 million induced abortions, and 0.98 million fetal losses. The pregnancy rate in 1996 was 104.7 pregnancies per 1,000 women aged 15-44 years, 9 percent lower than in 1990 (115.6), and the lowest recorded since 1976 (102.7). Since 1990 rates have dropped 8 percent for live births, 16 percent for induced abortions, and 4 percent for fetal losses. The teenage pregnancy rate has declined considerably in the 1990's, falling 15 percent from its 1991 high of 116.5 per 1,000 women aged 15-19 years to 98.7 in 1996. Among the factors accounting for this decline are decreased sexual activity, increases in condom use, and the adoption of the injectable and implant contraceptives.

Annual summary of vital statistics--1998.

Most vital statistics indicators of the health of Americans were stable or showed modest improvements between 1997 and 1998. The preliminary birth rate in 1998 was 14.6 births per 1000 population, up slightly from the record low reported for 1997 (14.5). The fertility rate, births per 1000 women aged 15 to 44 years, increased 1% to 65.6 in 1998, compared with 65.0 in 1997. The 1998 increases, although modest, were the first since 1990, halting the steady decline in the number of births and birth and fertility rates in the 1990s. Fertility rates for total white, non-Hispanic white, and Native American women each increased from 1% to 2% in 1998. The fertility rate for black women declined 19% from 1990 to 1996, but has changed little since 1996. The rate for Hispanic women, which dropped 2%, was lower than in any year for which national data have been available. Birth rates for women 30 years or older continued to increase. The proportion of births to unmarried women remained about the same at one third. The birth rate for teen mothers declined again for the seventh consecutive year, and the use of timely prenatal care (82.8%) improved for the ninth consecutive year, especially for black (73.3%) and Hispanic (74.3%) mothers. The number and rate of multiple births continued their dramatic rise; the number of triplet and higher-order multiple births jumped 16% between 1996 and 1997, accounting, in part, for the slight increase in the percentage of low birth weight (LBW) births. LBW continued to increase from 1997 to 1998 to 7.6%. The infant mortality rate (IMR) was unchanged from 1997 to 1998 (7.2 per 1000 live births). The ratio of the IMR among black infants to that for white infants (2.4) remained the same in 1998 as in 1997. Racial differences in infant mortality remain a major public health concern. In 1997, 65% of all infant deaths occurred to the 7.5% of infants born LBW. Among all of the states, Maine, Massachusetts, and New Hampshire had the lowest IMRs. State-by-state differences in IMR reflect racial composition, the percentage LBW, and birth weight-specific neonatal mortality rate for each state. The United States continues to rank poorly in international comparisons of infant mortality. Expectation of life at birth increased slightly to 76.7 years for all gender and race groups combined. Death rates in the United States continue to decline, including a drop in mortality from human immunodeficiency virus. The age-adjusted death rate for suicide declined 6% in 1998; homicide declined 14%. Death rates for children from all major causes declined again in 1998. A large proportion of childhood deaths, however, continue to occur as a result of preventable injuries.

Births and deaths: preliminary data for July 1997-June 1998.

OBJECTIVES: This report presents preliminary data on births and deaths in the United States from the National Center for Health Statistics (NCHS) for the 12 months ending June 1998. U.S. data on births are shown by age, race, and Hispanic origin of mother. Natality data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include leading causes of death and infant mortality. METHODS: Data in this report are based on more than a 99-percent sample of births and on more than an 89-percent sample of deaths in the United States for the 12 months ending June 1998. The records are weighted to independent control counts of births, infant deaths, and deaths 1 year and over received in State vital statistics offices from July 1997 to June 1998. Unless otherwise indicated, comparisons are made with final data for the 12-month period ending June 1997. RESULTS: For the period July 1997-June 1998, the birth rate for teenagers dropped 4 percent to 51.5 births per 1,000 women aged 15-19 years, the lowest level since 1987. Birth rates for teenagers have been declining since 1991. Birth rates for women aged 20-29 years changed very little, whereas rates for women in their thirties and forties rose 2 to 4 percent. The birth rate for unmarried women declined slightly, but the number of births to unmarried women was up about 1 percent because of an increase in the number of unmarried women. The rate of prenatal care utilization continued to improve. The percent of births delivered by cesarean section rose from 20.7 percent to 20.9 percent as the result of a slight increase in the primary cesarean rate and a substantial decline in the rate of vaginal births after previous cesarean (VBAC). The overall low birthweight rate was unchanged at 7.5 percent. Age-adjusted death rates reached a record low, 2 percent below the rate for the previous 12-month period. The largest declines in estimated age-adjusted death rates among the leading causes of death were for Human immunodeficiency virus (HIV) infection (37 percent) and homicide (9 percent). Smaller declines were noted for most of the other leading causes of death, but no increases occurred. Mortality also decreased for firearm injuries and alcohol-induced deaths. The infant mortality rates for all races and white and black infants were about the same as the corresponding rates for the previous 12-month period.

Births: final data for 1997.

OBJECTIVES: This report presents 1997 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 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 health 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 including teenage birth rates and total fertility rates, 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 3.9 million births that occurred in 1997 are presented. RESULTS: Birth and fertility rates declined very slightly in 1997. Birth rates for teenagers fell 3 to 5 percent. Rates for women in their twenties changed very little, whereas rates for women in their thirties rose 2 percent. The number of births and the birth rate for unmarried women each declined slightly in 1997 while the percent of births that were to unmarried women was unchanged. Smoking by pregnant women overall dropped again in 1997, but continued to increase among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate increased slightly after declining for 7 consecutive years. The proportion of multiple birth continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 14 percent in 1997, following a 20 percent rise from 1995 to 1996. Key measures of birth outcome--the percents of low birthweight and preterm births--increased, with particularly large increases in the preterm rate. These changes are in large part the result of increases in multiple births.

Recent trends in teen births in the United States.

Teenage births and birth rates have dropped steadily during the 1990s. Overall, the teen birth rate declined 15 percent between 1991 and 1997. The trend in the 1990s reverses a period of steep increases from 1986 to 1991. Despite the recent declines, the teen birth rate in 1997 is still higher than rates in the mid 1980s when they were at an all-time low (50-51 per 1,000). In general, teen birth rates have declined more for younger teenagers (15-17 years) than for older teens (18-19 years). Among all race and ethnic groups, black teenagers have experienced the greatest declines in childbearing during the 1990s. From 1991 to 1997, the rate for black teens 15-19 years dropped 23 percent to the lowest level on record. A particularly noteworthy finding is that the birth rate for second births to all teenagers who have had a first birth (repeat childbearing) declined by 21 percent between 1991 and 1996. Despite the recent decline in teen births and birth rates, a growing number and proportion are to unmarried teens. Most teenagers giving birth in the 1990s are not married--78 percent overall in 1997. Teenage childbearing has important social and health consequences for the teenage mother herself and for her baby. Most teen births are unintended, the educational attainment of teen mothers is limited, teen mothers are less likely to receive timely prenatal care, and teens are more likely to smoke during pregnancy than are older women. As a consequence of these and other factors, babies born to teen mothers are at greater risk of preterm delivery and low birthweight. Teen pregnancy prevention has become a major focus of attention over the past several years, contributing to a wide variety of initiatives and strategies at the national, state and community level.

Births and deaths: preliminary data for 1998.

OBJECTIVES: This report presents preliminary data for 1998 on births and deaths in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Natality data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include life expectancy, leading causes of death, and infant mortality. METHODS: Data in this report are based on more than a 99-percent sample of births and on more than an 85-percent sample of deaths in the United States for 1998. The records are weighted to independent control counts of births, infant deaths, and deaths 1 year and over received in State vital statistics offices in 1998. Comparisons are made with 1997 final data. RESULTS: The birth rate for teenagers continued to decline, dropping another 2 percent for 1997-98. The rate for young teens aged 15-17 years fell 5 percent, and the rate for teens aged 18-19 years declined 2 percent. Since 1991 rates have fallen 21 percent for teens aged 15-17 years and 13 percent for teens aged 18-19 years. Birth rates for women aged 20-29 years rose slightly. Among women in their thirties, birth rates rose 3 to 4 percent to the highest levels observed in three decades. The birth rate for women aged 40-44 years was the highest level reported since 1970. The birth rate for unmarried women was 44.3 per 1,000, 1 percent higher than 1997, but below the peak level reported for 1994 (46.9). The rate of prenatal care utilization continued to improve. The total cesarean rate increased to 21.2 percent. The low birthweight rate rose from 7.5 to 7.6 percent. In 1998 the age-adjusted death rate reached a record low, 2 percent below the rate for 1997. Human immunodeficiency virus infection (HIV infection) moved off the list of the 15 leading causes of death for the first time since 1987. Declines in age-adjusted rates occurred for Homicide and legal intervention (homicide) (14 percent) and Atherosclerosis (10 percent), while rates for Septicemia and Pneumonia and influenza increased 5 percent. Mortality also decreased for drug-induced deaths, deaths from injury by firearms, and alcohol-induced deaths. The infant mortality rate was unchanged. Life expectancy reached a record high of 76.7 in 1998.

Declines in teenage birth rates, 1991-98: update of national and state trends.

OBJECTIVES: This report presents national birth rates for teenagers for 1991-98; the percent change, 1991-98; State-specific teenage birth rates for 1991 and 1997; and the percent change, 1991-97. METHODS: Tabular and graphical descriptions of the trends in teenage birth rates by age group, race, and Hispanic origin of the mother are discussed. RESULTS: Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age, race, and Hispanic origin populations, with the steepest declines recorded for black women. State-specific rates by age fell in all States, with most declines statistically significant; overall declines ranged from 9 to 32 percent.

Highlights of trends in pregnancies and pregnancy rates by outcome: estimates for the United States, 1976-96.

OBJECTIVES: This report presents key findings from a comprehensive report on pregnancies and pregnancy rates for U.S. women. The study incorporates birth, abortion, and fetal loss data to compile national estimates of pregnancy rates according to a variety of characteristics including age, race, Hispanic origin, and marital status. Summary data are presented for 1976-96. Data from the National Survey of Family Growth (NSFG) are used to show information on sexual activity and contraceptive practices, as well as women's reports of pregnancy intentions. METHODS: Tabular and graphic data on pregnancy rates by demographic characteristics are presented and interpreted. Birth data are from the birth registration system for all births registered in the United States and reported by State health departments to NCHS; abortion data are from The Alan Guttmacher Institute (AGI) and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC); and fetal loss data are from pregnancy history information collected in the NSFG. RESULTS: In 1996 an estimated 6.24 million pregnancies resulted in 3.89 million live births, 1.37 million induced abortions, and 0.98 million fetal losses. The pregnancy rate in 1996 was 104.7 pregnancies per 1,000 women aged 15-44 years, 9 percent lower than in 1990 (115.6), and the lowest recorded since 1976 (102.7). Since 1990 rates have dropped 8 percent for live births, 16 percent for induced abortions, and 4 percent for fetal losses. The teenage pregnancy rate has declined considerably in the 1990's, falling 15 percent from its 1991 high of 116.5 per 1,000 women aged 15-19 to 98.7 in 1996. Among the factors accounting for this decline are decreased sexual activity, increases in condom use, and the adoption of the injectable and implant contraceptives.

Births and deaths: preliminary data for 1997.

OBJECTIVES: This report presents preliminary data on births and deaths in the United States from the National Center for Health Statistics (NCHS) for 1997. U.S. data on births are shown by age, race, and Hispanic origin of mother. National and State data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include life expectancy, leading causes of death, and infant mortality. METHODS: Data in this report are based on a 99 percent sample of births and more than an 85 percent sample of deaths in the United States in 1997. The records are weighted to independent control counts of births, infant deaths, and deaths 1 year and over received in State vital statistics offices in 1997. RESULTS: According to preliminary data for 1997, the birth rate for teenagers dropped to 52.9 births per 1,000 women aged 15-19 years, 3 percent lower compared with 1996. Birth rates for teenagers have been declining since 1991. Declines for younger teenagers (15-17 years) were greater than for older teenagers. Birth rates for women aged 25-44 years increased 1 to 2 percent; the rate for women aged 20-24 years rose very slightly. The number of births to unmarried women was essentially unchanged and the percent of all births to unmarried women remained at 32.4 percent; the birth rate for unmarried women declined 2 percent. The rate of prenatal care utilization continued to improve. The cesarean delivery rate increased slightly. The overall low birthweight rate increased to 7.5 percent. The largest declines in estimated age-adjusted death rates among the leading causes of death were for Human immunodeficiency virus (HIV) infection (47 percent) and homicide (12 percent). Mortality also decreased for firearm injuries, drug-induced deaths, and alcohol-induced deaths. The age-adjusted death rate increased for Pneumonia and influenza, Chronic obstructive pulmonary diseases, kidney disease, and Septicemia. The preliminary infant mortality rate for 1997 was 7.1 infant deaths per 1,000 live births, down from a rate of 7.3 for 1996. The infant mortality rate for black infants declined 7 percent to 13.7; the white rate was 6.0. Life expectancy reached a record high of 76.5 years in 1997.

Teenage births in the United States: state trends, 1991-96, an update.

OBJECTIVES: This report provides State-specific birth rates for teenagers for 1991 and 1996 and the percent change, 1991-96. METHODS: Tabular and graphical description of trends in teenage birth rates by age group for each State. RESULTS: Birth rates for teenagers 15-19 years declined significantly in all but three States between 1991 and 1996. Declines by State ranged from 6 to 29 percent.

Report of final natality statistics, 1996.

OBJECTIVES: This report presents 1996 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, 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 health 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 including teenage birth rates and total fertility rates, 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 3.9 million births that occurred in 1996 are presented. RESULTS: Birth and fertility rates declined very slightly in 1996. Birth rates for teenagers fell 3 to 8 percent. Rates for women in their twenties increased slightly in 1996, the first increase since 1990, while rates for women in their thirties rose 2 to 3 percent. The number and percent of births to unmarried women increased slightly in 1996 while the birth rate for unmarried women declined modestly. Smoking by pregnant women overall dropped again in 1996, but increased among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate declined. The proportion of multiple births continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 19 percent. Key measures of birth outcome--the percents of low birthweight and preterm births--increased slightly, in large part the result of increases in multiple births.