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The State of Perinatal
Health in NCPerinatal Quality Collaborative of NC
May 2015
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118,983 live births Mom’s ae rane from 11 to !lus "5# years ol$ Most %omen %ere aes 25&29 '$u(ation level
◦ 1)* less than hih s(hool
◦ 22+"* ih -(hool or .'/
◦ 31+* some (ollee
◦ 18+)* ba(helor’s $eree
◦ 9+8* Masters or Ph/ 58+* %ere marrie$ 33+8* rst (hil$ 19+* fourth or reater (hil$
NC Births - 2013
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Racial Distribution ofNorth Carolina Live Births 2013
!!ro4imately 2"* of live births in NorthCarolina %ere to fri(an meri(ans, 1*
meri(an n$ians, 5* to 6hites, 15*is!ani(, an$ "* to other ra(es 7non&is!ani(
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-our(e -tate Center for ealth -tatisti(s
)0*
21*
5* 2* 2*
2013 NC Resi!ent Births" Tri#ester Prenatal Care Be$an
1st :rimester
2n$ :rimester
3r$ :rimester
No Care
;n
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%nfant &ortalit' Rate
Number of /eaths =rom ll
Causes in the 1st >ear of ?ife
M@ A &&&&&&&&&&&&&&&&&&&&&&&&&&&&& 4 1000
Number of ?ive Births
?o% birth%eiht is $ene$ as a baby born%eihin less than 2500 rams 75+5 lbs+
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%nfant &ortalit' Rates"1()*-2013
19)5 1980 1985 1990 1995 2000 2001 2002 2003 200" 2005 200 200) 2008 2009 2010 2011 2012 2013
0+0
2+0
"+0
+0
8+0
10+0
12+0
1"+0
1+0
18+0
20+0
-our(e -tate Center for ealth -tatisti(s C/CDNational Center for ealth -tatisti(s
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-our(e -tate Center for ealth -tatisti(s C/CDNational Center for ealth -tatisti(s
2011 +,S, %nfant &ortalit' RateRanin$s
Ran State
1 Mississi!!i
2 /ela%are
3 ?ouisiana
" labama
5 Ehio
n$iana
) /istri(t of Columbia
8 -outh Carolina
9 7tie r
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Why is infant ortality i!ortant"
Infant mortality is not ust about death
◦ Seen as a measure of a society!s commitment to its
most "ulnerable members # our babies
◦ Pro$y measure for the broader issue of infant morbidity
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#reter $irth 1999 %2009
North Carolina
Preterm is less than %& completed wee's gestation Source *ational Center for +ealth Statistics,
final natality data -etrie"ed .uly /&, /01/, from wwwmarchofdimescom2peristats
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1134 of all births were preterm
Preterm birth rates were higher among 5frican
5merican women
#reter &irth - 2013
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6eighing less than 33 lbs (/300 grams)
774 of babies were born low birthweight
Low birthweight rates were higher among 5frican
5merican women
Lo' &irth'eight - 2013
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Lo' $irth Weight Con(erns
Mental -etardation
Learning Disabilities
8ision Loss
+earing Loss
Cerebral Palsy
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$irth Weight )rends
Percentage of li"e births that are low birth weight
has increased steadily, but mortality rates in each
birth weight category ha"e decreased dramatically
until recently
9he greatest increase in low birthweight has been
for babies born under 300 grams: steady for /01%
for a rate of /4
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8aginal # ;%4)
Method of *eli+ery - 2013
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Infants born 301=1300 grams born in *C hospitals
◦ Le"el III # 7074
◦ ?ther # 1
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2011 2012 2013
0*
5*
10*
15*
20*
25*
30*
35*
"0*
"5*
50*/o#en a$e 10 to 2ho too- a #ultivita#in .renatal vita#in or a folic aci! su..le#ent ever' !a'
ll 6hite Bla(< ,is!ani(
0
1020
30
"0
50
0
)0
80
90
)2+2 9+"
80+"
9+5
/o#en a$e 1 to ho ha! a routine chec-u. in the .ast 'earNC 2012
-our(e -tate Center for ealth -tatisti(sDBehavioral @is< =a(tor -urveillan(e -ystem 7B@=--
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+ninsure! Po.ulation 2012
-our(e ;rban nstitute an$ Faiser Commission on Me$i(ai$ an$ the ;ninsure$ estimates base$ on theCensus BureauGs Mar(h 2012 an$ 2013 Current Po!ulation -urvey 7CP- nnual -o(ial an$ '(onomi(
04
104
/04
%04
>04
304
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-obert 6ood .ohnson Aoundation Commission on +ealth
wwwcommissiononhealthorg
H6here %e live, learn, %or< an$!lay has a reater im!a(t on
ho% lon an$ ho% %ell %e livethan me$i(al (are+I
http://www.commissiononhealth.org/http://www.commissiononhealth.org/
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Life Course ..roach
'arly
Prorammin Cumulative Path%ays
E!timal ?ife :raJe(tory
?ife :raJe(tory Ke(te$by neLuity
H
e a l t h
p o t e n t i a l
i h i i $
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6ith 'Luity, in!uts may nee$to be $iKerent to a(hieve eLual
out(omes
:his is 'LuityM/C, ealth 'Luity ?earnin ?abs 2013, !rovi$e$ by oan, +, @o%ley, /+, Berthiaume, @+ an$ :hom!son,
>, ;niversity of North Carolina at Cha!el ill+ $a!te$ from
http://indianfunnypicture.com/search/equality+doesn't+mean+justice
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Socio-4colo$ical &o!el
%n!ivi!ualFno%le$e, attitu$es
an$ s
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So /hat Do /e 7no8
;ninten$e$ !renan(ies result in !oorerbirth out(omes+
ealthy %omen ten$ to have healthier
!renan(ies+ Pre(on(e!tion health is (ru(ial+ E!timal !renatal (are is essential+ Community involvement is ne(essary
most of health is outsi$e the (lini(alsettin+
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Collaborative m!rovement an$ nnovationNet%or< 7CoN to m!rove nfant Mortality◦ nter(on(e!tionD!re(on(e!tion health
◦ Perinatal reionaliOation
◦ -o(ial /eterminants of ealth
MCP Birth Eut(omes nitiative◦ =o(us on Perinatal ealth /is!arities
National 9ocus
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Belin$a Pettifor$
Belin$a+!ettifor$$hhs+n(+ov919&)0)&599
:uestions8
mailto:Belinda.pettiford@dhhs.nc.govmailto:Belinda.pettiford@dhhs.nc.gov