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New Jersey Health Statistics, 2002

TECHNICAL NOTES

Definitions | Rates | Cause of Death Rankings | Race/Ethnicity | Data Sources | Data Quality | Residence/Occurrence

 

DEFINITIONS

Births

·       Abnormal Conditions of the Newborn (Martin, et al., 2003):

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., 2003):

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., 2003):

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., 2003):

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., 2003):

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 2002 was the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, (ICD-10) sponsored by the World Health Organization. Reports in this series prior to 1999 used the ninth revision (ICD-9). 

·         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.  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.