Births
·
Abnormal
Conditions of the Newborn (Martin, et al., 2002):
o
Anemia: hemoglobin level of less than 13.0 g/dL or a
hemocrit of less than 39 percent.
o
Birth
Injury: impairment of the
infant's
body function or structure due to adverse influences which
occurred at birth.
o
Fetal Alcohol Syndrome: a syndrome of altered perinatal growth and development
occurring in infants born of women who consumed excessive
amounts of alcohol during pregnancy.
o
Hyaline
Membrane Disease/RDS: a
disorder primarily of prematurity, manifested clinically by
respiratory distress and pathologically by pulmonary hyaline
membranes and incomplete expansion of the lungs at birth.
o
Meconium
Aspiration Syndrome:
aspiration of meconium by the fetus or newborn affecting
the lower respiratory system.
o
Assisted
Ventilation: a
mechanical method of assisting respiration for newborns with
respiratory failure.
o
Seizures: a seizure of any etiology.
·
Apgar
Score: a summary measure
of an infant's clinical condition based on heart rate, respiratory
effort, muscle tone, reflex irritability, and color taken
at one and five minutes after delivery.
Each of the factors is given a score of 0, 1, or 2;
the sum of these five values is the Apgar score which can
range from 0 to 10. A
score of 10 is optimal and a low score (usually considered
to be less than 7) is considered an indication of potential
health problems and raises concerns about the subsequent health
and survival of the infant.
·
Birth
Weight: the first weight of
the fetus or newborn obtained after delivery.
Birth weight is recorded in grams.
·
Complications
of Labor and/or Delivery (Martin, et al., 2002):
o
Febrile: a fever greater than 100 degrees F or 38 C occurring
during labor and/or delivery.
o
Moderate
or Heavy Meconium: meconium
consists of undigested debris from swallowed amniotic fluid,
various products of secretion, excretion, and shedding by
the gastrointestinal tract; moderate to heavy amounts of meconium
in the amniotic fluid noted during labor and/or delivery.
o
Premature
Rupture of Membranes (more than 12 hours):
rupture of the membranes at any time during pregnancy and more
than 12 hours before the onset of labor.
o
Abruptio
Placenta: premature separation
of a normally implanted placenta from the uterus.
o
Placenta
Previa: implantation of the
placenta over or near the internal opening of the cervix.
o
Other
Excessive Bleeding: the
loss of a significant amount of blood from conditions other
than abruptio placenta or placenta previa.
[An EBC software cross-edit does not allow this complication
to be selected unless blood loss greater than or equal to
750 cc for vaginal deliveries and 1,200 cc for cesarean deliveries
is entered.]
o
Seizures During Labor: maternal seizures occurring during labor from
any cause.
o
Precipitous
Labor (less than 3 hours):
extremely rapid labor and delivery lasting less then
3 hours.
o
Prolonged
Labor (more than 20 hours):
abnormally slow progress of labor lasting more than
20 hours.
o
Dysfunctional
Labor: failure to progress
in a normal pattern of labor.
o
Breech/Malpresentation:
at birth, the presentation
of the fetal buttocks rather than the head, or other malpresentation.
o
Cephalopelvic
Disproportion: the relationship of the size, presentation, and
position of the fetal head to the maternal pelvis which prevents
dilation of the cervix and/or descent of the fetal head.
o
Cord
Prolapse: premature expulsion
of the umbilical cord in labor before the fetus is delivered.
o
Anesthetic Complications: any complication during labor and/or delivery
brought on by an anesthetic agent or agents.
o
Fetal
Distress: signs indicating fetal
hypoxia (deficiency in amount of oxygen reaching fetal tissues).
·
Congenital
Anomalies of the Child (Martin, et al., 2002):
o
Central
Nervous System Anomaly:
includes anencephalus, spina bifida/meningocele, hydrocephalus,
microcephalus, or other anomaly of the brain, spinal cord,
or nervous system.
o
Heart
Malformation: congenital
anomaly of the heart.
o
Other
Circulatory/Respiratory Anomaly: other specified anomalies of the circulatory
or respiratory systems.
o
Gastrointestinal
Anomaly: includes rectal atresia/stenosis,
tracheo-esophageal fistula/esophageal atresia, omphalocele/gastroschisis,
or other anomaly of the gastrointestinal system.
o
Urogenital
Anomaly: includes malformed
genitalia, renal agenesis, or other anomaly of the organs
concerned in the production and excretion of urine, together
with organs of reproduction.
o
Cleft
Lip/Palate: cleft lip is a fissure or elongated opening of
the lip; cleft palate is a fissure in the roof of the mouth.
o
Polydactyly/Syndactyly/Adactyly: polydactyly is the presence of more than five
digits on either hands and/or feet; syndactyly is having fused
or webbed fingers and/or toes; adactyly is the absence of
fingers and/or toes.
o
Club
Foot: deformities of the foot,
which is twisted out of shape or position.
o
Other
Musculoskeletal/Integumental Anomaly: includes diaphragmatic hernia or other anomaly
of the muscles, skeleton, or skin.
o
Down's
Syndrome: the most common chromosomal
defect with most cases resulting from an extra chromosome.
o
Other
Chromosomal Anomaly: any other chromosomal aberration.
·
Live
Birth: the complete expulsion
or extraction from its mother of a product of conception,
irrespective of the duration of pregnancy, which, after such
separation, breathes or shows any evidence of life, such as
beating of the heart, pulsation of the umbilical cord, or
definite movement of voluntary muscles.
·
Low
Birth Weight: birth
weight of less than 2,500 grams or approximately 5 pounds,
8 ounces. Prior to
1989, New Jersey defined low birth weight as 2,500 grams or
less.
·
Marital
Status: the marital status
of the mother for statistical purposes is determined for
data
years after 1988 by the response to the birth certificate
item, "Mother married? (At birth, conception, or any time between)".
·
Medical
Risk Factors for This Pregnancy (Martin, et al., 2002):
o
Anemia: hemoglobin level of less than 10.0 g/dL during
pregnancy or a hematocrit of less than 30 percent during pregnancy.
o
Cardiac
Disease: disease of the heart.
o
Acute
or Chronic Lung Disease:
disease of the lungs during pregnancy.
o
Diabetes:
metabolic disorder characterized
by excessive discharge of urine and persistent thirst; includes
juvenile onset, adult onset, and gestational diabetes during
pregnancy.
o
Genital
Herpes: infection of the skin
of the genital area by herpes simplex virus.
o
Hydramnios/Oligohydramnios: any noticeable excess (hydramnios) or lack (oligohydramnios)
of amniotic fluid.
o
Hemoglobinopathy:
a blood disorder caused
by alteration in the genetically determined molecular structure
of hemoglobin (example: sickle
cell anemia).
o
Chronic
Hypertension: blood
pressure persistently greater than 140/90, diagnosed prior
to onset of pregnancy or before the 20th week of gestation.
o
Pregnancy-Associated
Hypertension: an
increase in blood pressure of at least 30mm Hg systolic or
15mm Hg diastolic on two measurements taken 6 hours apart
after the 20th week of gestation.
o
Eclampsia: the occurrence of convulsions and/or coma unrelated
to other cerebral conditions in women with signs and symptoms
of preeclampsia.
o
Incompetent
Cervix: characterized by painless
dilation of the cervix in the second trimester or early in
the third trimester of pregnancy, with premature expulsion
of membranes through the cervix and ballooning of the membranes
into the vagina, followed by rupture of the membranes and
subsequent expulsion of the fetus.
o
Previous
Infant 4,000+ Grams: the
birth weight of a previous live-born child was over 4,000
grams (8 pounds, 14 ounces).
o
Previous
Preterm or Small-for-Gestational Age Infant: previous birth of an infant prior to term (before
37 completed weeks of gestation) or of an infant weighing
less than the tenth percentile for gestational age using a
standard weight-for-age chart.
o
Renal
Disease: kidney disease.
o
Rh
Sensitization: the process or state of becoming sensitized to
the Rh factor as when an Rh-negative woman is pregnant with
an Rh-positive fetus.
o
Uterine
Bleeding: any clinically significant bleeding during the
pregnancy taking into consideration the stage of pregnancy;
any second or third trimester bleeding of the uterus prior
to the onset of labor.
·
Multiple
Births: individual
births in twin, triplet, quadruplet, and higher order multiple
deliveries.
·
Obstetric
Procedures (Martin, et al., 2002):
o
Amniocentesis: surgical transabdominal perforation of the uterus
to obtain amniotic fluid to be used in the detection of genetic
disorders, fetal abnormalities, and fetal lung maturity.
o
Electronic
Fetal Monitoring: monitoring with external devices applied to the
maternal abdomen or with internal devices with an electrode
attached to the fetal scalp and a catheter through the cervix
into the uterus, to detect and record fetal heart tones and
uterine contractions.
o
Induction
of Labor: the initiation of uterine
contractions before the spontaneous onset of labor by medical
and/or surgical means for the purpose of delivery.
o
Stimulation
of Labor: augmentation of previously
established labor by use of oxytocin.
o
Tocolysis: use of medications to inhibit preterm uterine
contractions to extend the length of pregnancy and, therefore,
avoid a preterm birth.
o
Ultrasound: visualization of the fetus and the placenta
by means of sound waves.
·
Plurality: singleton, twin, triplet, quadruplet, etc.
·
Previous
Pregnancy Terminations:
from the mother's pregnancy history on the certificate
of live birth, a previous spontaneous or induced termination
of pregnancy at any time after conception that did not result
in a live birth.
·
Teen
Birth: birth
to a mother under 20 years of age.
·
Tobacco,
Alcohol, and Drug Use during Pregnancy: use of these substances self-reported by mother.
·
Trimester
of Pregnancy: the first trimester includes the first 12 weeks
of pregnancy, the second trimester encompasses the thirteenth
through twenty-fourth weeks and the third trimester is the
period after the twenty-fourth week through delivery.
·
Very
Low Birth Weight: birth
weight of less than 1,500 grams or approximately 3 pounds,
5 ounces.
Deaths
·
Cause
of Death Classification:
a system of specification of the diseases and/or injuries
which led to death and the sequential order of their occurrence. The version of the system in use in 2001 was
the International Statistical
Classification of Diseases and Related Health Problems, Tenth
Revision, sponsored by the World Health Organization. Beginning with 2001 data, codes were added for deaths due to terrorism (U01-U03). Deaths coded U01-U02 are grouped under homicides and those coded U03 are grouped under suicide.
·
Comparability
Ratio:
a number used to measure the effect of changes in classification
and coding rules between revisions of the International Classification
of Diseases (ICD). Comparability
ratios less than 1.0 result from fewer deaths being classified
to cause x under ICD-10 compared with the comparable cause under
ICD-9. Ratios greater
than 1.0 result from more deaths being classified to cause
x under ICD-10.
Preliminary comparability ratios used in this report
should not be used on data prior to 1994 and caution should
be exercised when applying the ratios to age-, race-, or sex-specific
data.
·
Fetal
Death: death prior to the
complete expulsion or extraction from its mother of a product
of conception; the fetus shows no signs of life such as breathing
or beating of the heart, pulsation of the umbilical cord,
or definite movement of voluntary muscles.
Fetal deaths are also referred to as stillbirths, miscarriages,
or abortions.
·
Infant
Death: death within the first
year of life.
·
Maternal
Death: a death in which the
certifying physician has designated a maternal condition as
the underlying cause of death.
In the Tenth Revision of the International
Statistical Classification of Diseases and Related Health
Problems, this includes only those deaths assigned to
causes related to or aggravated by pregnancy or pregnancy
management (ICD-10 codes O00-O95, O98-O99, and A34) and which
occur within 42 days after delivery or other termination of
pregnancy.
·
Neonatal
Death: death of an infant within
the first 27 days of life.
·
Postneonatal
Mortality: death
of an infant from 28 days to one year of life.
·
Underlying
Cause of Death: the
disease or injury which initiated the train of events leading
directly to death or the circumstances of the unintentional
injury or violence which produced the fatal injury.
All cause-of-death data in this report relate to the
underlying cause of death coded from the death certificate.
·
Years
of Potential Life Lost (YPLL): a measure of the number of years of life not
lived by each individual who died before reaching a predetermined
age. This measure weights deaths at younger ages
more heavily than deaths at older ages; the younger the age
at death, the greater the number of years of potential life
lost. The YPLL for a population is computed as the
sum of all the individual YPLL for individuals who died during
a specific time period. Prior
reports in this series contained tables of YPLL, but the
same
data are now available from CDC's WISQARS query system.
All
Tables in the Report
·
Not
Stated: an inclusive term used
to represent data which are missing, unknown, not available,
or not classifiable.
The presentation of
vital statistics in the form of rates and ratios facilitates
comparisons between political subdivisions with populations
of different sizes or between subgroups of a population.
Crude rates are calculated by dividing the number of
events of a type that occur to the residents of an area (e.g.,
births, deaths) by the resident population of an area or subgroup.
The events are limited to those that occur within a
specific time period, usually a year, and the population is,
in general, the mid-year estimate of the resident population
of the area, although census counts as of April 1 may be used
in decennial census years.
Crude rates are expressed in terms of occurrences within
a standard, rounded population, usually 1,000 or 100,000.
In order to compare
birth and death experiences among various ages and races or
between the sexes, rates may be computed for subgroups of
the population. These are referred to as age-, race-, or sex-specific
rates and are calculated by dividing the relevant events within
a subgroup by the population in the subgroup.
Death rates from specific causes may also be calculated,
with the numerator consisting of the deaths from the particular
cause in an area and the denominator comprised of the population
at risk of the disease or condition.
The numbers of births
and deaths in an area are directly related to the demographic
characteristics of the area's population.
In comparing rates over time or among geographic areas,
it is helpful to eliminate the effects of the differences
in the populations' demographic characteristics on the comparison.
This can be accomplished through adjustments of the
rates for the particular characteristics of interest.
The most common type of adjustment of rates is for
age. Direct adjustment
of vital statistics rates involves application of existing
rates (age-, race-, or sex-specific) to a standard population
to arrive at the theoretical number of events that would
occur in the standard population, at the rates prevailing
in the actual population. These events are then divided by the total number
of persons in the standard population to arrive at an adjusted
rate. Adjusted rates are index numbers and cannot be compared
to crude or other actual rates.
The use of adjusted rates is limited to comparison
with other adjusted rates, based on the same standard population.
The standard population used in this report is the
United States 2000 standard million, derived from the projection
of counts from the 2000 decennial census. Reports in this series prior to 1999 used the
US 1940 standard million for age-adjustment.
The definition of rates
and ratios used in this report follows.
It should be noted that alternative forms exist for
some of these statistics.
Some other states and the federal government may employ
different formulae for the computation of selected rates.
·
Crude
Birth Rate: the number of resident live births per 1,000
population.
·
General
Fertility Rate: the
number of resident live births per 1,000 females aged 15-44
years.
·
Total
Fertility Rate: age-specific
birth rates of women in five-year age groups multiplied by
five and summed to form a total for all ages.
This rate indicates the number of children a cohort
of 1,000 women would bear if they experienced the existing
age-specific birth rates throughout their childbearing years.
·
Age-Specific
Birth Rate: the number of resident live births to females
in a specific age group per 1,000 females in the age group.
·
Crude
Death Rate: the
number of resident deaths per 100,000 population.
·
Age-Adjusted
Death Rate: Direct
Method-the elimination of the effect of age on the crude death
rates for purposes of comparison with other rates by applying
actual age-specific rates to a standard population.
The resulting death rate in the standard population
is age-adjusted and can be compared to other death rates age-adjusted
to the same standard population.
·
Cause-Specific
Death Rate: the
number of resident deaths from a specific cause per 100,000
population.
·
Infant
Death Rate: the number of resident deaths under one year
of age per 1,000 population.
·
Infant
Mortality Rate: the
ratio of the number of deaths to children less than one year
of age in a given y
