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1 Massachusetts Births 2010 Bureau of Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology Registry of Vital Records & Statistics Bureau of Family Health and Nutrition March 2013 Massachusetts Department of Public Health
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Page 1: Massachusetts Births 2010

1

Massachusetts Births 2010

Bureau of Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology

Registry of Vital Records & Statistics

Bureau of Family Health and Nutrition

March 2013

Massachusetts Department of Public Health

Page 2: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 2

Topics

• Overview and trends

• Changing demographics

• Diversity and disparities

• Selected Topics–Preterm and Low Birthweight–Smoking during pregnancy–Gestational Diabetes–Cesarean Deliveries–Adequacy of Prenatal Care

• Summary

Page 3: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 3

Indicator 2000 2010 % ChangeNumber of Births 81,582 72,835 -11%*

% Foreign Born Mothers 20.8 27.4 32%*

% Multiple Births 4.3 4.6 7%

Teen Birth Rate (births/1000 women ages 15-19 years) 25.9 17.1 -34%*

Infant Mortality Rate (IMR) (deaths per 1,000 live births)

4.6 4.4 -4%

% Preterm (<37 weeks) 8.3 8.6 4%

% Low Birthweight (<2,500 g, 5.5 lbs) 7.1 7.8 10%*

% Smoking During Pregnancy 9.7 6.3 -35%*

% Gestational Diabetes 2.8 4.7 68%*

% Cesarean Deliveries 23.4 33.3 42%*

Massachusetts Birth Indicators Since 20002000 and 2010

* Statistically Significant (p≤.05)

Page 4: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 4

Indicator 2009 2010 % ChangeNumber of Births 74,966 72,835 -3%*

% Foreign Born Mothers 27.4 27.4 --

% Multiple Births 4.7 4.6 -2%

Teen Birth Rate (births/1000 women ages 15-19 years) 19.5 17.1 -12%*

Infant Mortality Rate (IMR) (deaths per 1,000 live births)

4.9 4.4 -10%

% Preterm (<37 weeks) 8.7 8.6 -1%

% Low Birthweight (<2,500 g, 5.5 lbs) 7.8 7.8 --

% Smoking During Pregnancy 6.8 6.3 -7%*

% Gestational Diabetes 4.7 4.7 --

% Cesarean Deliveries 33.6 33.3 -1%

Massachusetts Birth Indicators – One Year2009 and 2010

* Statistically Significant (p≤.05)

Page 5: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 5

Indicator MA US

Fertility Rate (births /1000 females ages 15-44 yrs) 53.7* 64.1

Teen Birth Rate (births/1000 females ages 15-19 yrs) 17.1* 34.3

% Low Birthweight (< 2,500 g, 5.5 lbs) 7.8* 8.2

% Unmarried mothers 34.6* 40.8

% Cesarean deliveries 33.3* 32.8

Infant Mortality Rate (IMR) 4.4* 6.1

A Comparison of 2010 Massachusetts Birth Indicators

with US1 Data

1. Births: Final Data for 2010, National Vital Statistics Reports, Volume 61, Number 1, August 2012.

2. Provisional estimates for 2010 US, National Vital Statistics Reports - Volume 60, Number 4, January, 2012.

*Statistically Significant difference with US (p ≤ .05)

2

Page 6: Massachusetts Births 2010

6

Changing Demographics

Page 7: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 7

Trend in the Number of Births Massachusetts: 1990-2010

72,83570

75

80

85

90

95

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Year

Nu

mb

er

of

Bir

ths

in

10

00

s

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

92,461

-2.2%* APC

-0.8%* APC

-2.4% APC

Page 8: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 8

Fertility Birth Rate(per 1,000 females ages 15-44 years)

Massachusetts: 1990-2010

53.7

62.1

48

50

52

54

56

58

60

62

64

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Bir

th p

er

1,0

00

Fe

ma

les

Ag

es

15

-44

-2.2%* APC

+0.3%* APC1995

2007

-1.9%* APC

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Page 9: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 9

Asian6%

Hispanic11%

Black7%

Other3%

White74%

Massachusetts 2000 81,582 Births

Massachusetts Births by Race and Hispanic Ethnicity: 2000

White, Black, Asian, and Other are Non-Hispanic

Other Groups

26%

Page 10: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 10

Asian8%

Hispanic15%

Black9%

Other2%

White67%

Massachusetts 2010 72,835 Births

Massachusetts Births by Race and Hispanic Ethnicity: 2010

White, Black, Asian, and Other are Non-Hispanic

Other Groups

33%

Page 11: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 11

Percent Foreign Born Mothers Massachusetts: 1990-2010

27.4%

14.7%

0%

10%

20%

30%

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

of

Bir

ths

5.5%* APC

1.1% APC

0.6% APC

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Page 12: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 12

Number of Births by Mother’s Age Massachusetts: 1990-2010

37,049

39,531

55,411

33,287

20,000

30,000

40,000

50,000

60,000

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Ages 30+

Ages < 30

-5.4%* APC

-2.0%* APC

+1.9%* APC

-1.8%* APC

-3.1%* APC

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Page 13: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 13

4.6%

2.6%

0.0

1.0

2.0

3.0

4.0

5.0

6.0

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

of

Bir

ths

Percent Multiple Births Massachusetts: 1990-2010

*Statistically Significant (p ≤.05) APC = Annual Percentage Change

5.4%* APC

-0.9% APC

2002

Page 14: Massachusetts Births 2010

14

Diversity and Disparities

Page 15: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 15

34.3

59.9

17.1

35.4

0

10

20

30

40

50

60

70

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Bir

ths

pe

r 1

,00

0 W

om

en

Ag

es

15

-19

United States

Massachusetts

Teen Birth RatesMassachusetts and US : 1990-2010

Page 16: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 16

49.3

120.8

25.8

89.2

32.8

8.310.424.0

0

20

40

60

80

100

120

140

160

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Bir

ths

pe

r 1

,00

0 W

om

en

Ag

es

15

-19

Hispanic

Black

Asian

White

Teen Birth Rates by Race1 and EthnicityMassachusetts: 1990-2010

1 non-Hispanic

Page 17: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 17

Teen Birth Rates Ranked by Teen Rate(Among Communities with Highest # of Teen Births in 2010)

City Number of Births

Birth Rate Change 2009 to

2010

1 Holyoke 126 83.6 -14%

2 Lawrence 193 56.8 -19%

3 Springfield 371 54.3 -15%

4 Chelsea 62 51.8 -18%

5 Southbridge 28 49.0 -10%

6 New Bedford 144 47.4 -17%

7 Lynn 149 46.2 -13%

8 Lowell 184 44.7 -12%

9 Fall River 124 44.6 -4%10 Brockton 119 35.5 -13%

Massachusetts 3,907 17.1 -12%*

** Statistically lower (p ≤.05)

Page 18: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 18

5.0

4.4

7.0

3.5

4.5

5.5

6.5

7.5

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Year

IMR

(#

dea

ths/

1,00

0 liv

e b

irth

s)Infant Mortality Rate (IMR)Massachusetts: 1990-2010

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

1996

-5.3%* APC

-0.6% APC

Page 19: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 19

6.1

3.1

8.2

13.7

6.1

9.1

0

2

4

6

8

10

12

14

16

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

IMR

(#

de

ath

s/1

,00

0 li

ve

bir

ths

)

WhiteBlackHispanic

IMR by Race1 & Hispanic Ethnicity Massachusetts: 1990-2010

1 non-Hispanic

Page 20: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 20

6.1

3.1

8.2

13.7

6.1

9.1

0

2

4

6

8

10

12

14

16

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

IMR

(#

de

ath

s/1

,00

0 li

ve

bir

ths

)

WhiteBlackHispanic

IMR by Race1 & Hispanic Ethnicity Massachusetts: 1990-2010

1 non-Hispanic * Statistically Significant (p ≤.05) APC = Annual Percentage Change

-2.1%* APC

-2.2%* APC

Page 21: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 21

5.1

9.1

6.1

0

2

4

6

8

10

12

14

16

18

20

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Year

IMR

(#

de

ath

s/1

,00

0 li

ve

bir

ths

)Hispanic IMR

Massachusetts: 1990-2010

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

- 7.8%* APC

19961.0% APC

Page 22: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 22

Highest Infant Mortality RatesAmong the 30 Largest Communities

in Massachusetts: 2010

Rate = infant deaths per 1,000 live births* Statistically Significantly higher than state rate (p ≤.05)

City/Town 2010

Pittsfield 11.8 (n=6)

Springfield 9.2* (n=21)

Lowell 8.9 (n=15)

Brockton 7.1 (n=10)

Lawrence 5.8 (n=8)

Worcester 5.7 (n=14)

MA Overall 4.4 (n=319)

Page 23: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 23

Highest Infant Mortality RatesAmong the 30 Largest Communities

in Massachusetts: 2008-2010

Rate = infant deaths per 1,000 live births* Statistically Significantly higher than the state rate (p ≤.05)

City/Town 2008-2010

Springfield 8.8 (n=63)*

Pittsfield 8.4 (n=13)

Lowell 8.1 (n=42) *

Worcester 8.0 (n=62) *

Brockton 7.9 (n=35) *

Taunton 7.9 (n=17)

MA Overall 4.7 (n=1,067)

Page 24: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 24

9.1

91.8 89.7

2.6

71.9

17.6

74.2

29.0

86.0

6.9

0.6

7.4

35.3

6.1

0

20

40

60

80

100

LBW Smoking PubliclyFinanced

C-Section MultipleBirths

Breastfeed AdequatePrenatal

Care

Per

cen

t (%

)

Less than high school (age 20+ only) College graduate or higher

Birth Characteristics by Maternal Education Massachusetts: 2010

**All indicators are significantly different for the two groups.

Page 25: Massachusetts Births 2010

25

Selected Topics

Page 26: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 26

6.3%

19.4%

0

5

10

15

20

25

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Mo

the

rs R

ep

ort

ing

Sm

ok

ing

Du

rin

g P

reg

na

nc

y (

%)

Smoking During Pregnancy Massachusetts: 1990-2010

- 2.4%* APC

- 6.2%* APC

- 9.6%* APC

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Page 27: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 27

8.6%

6.5%

5.8%

7.8%

5

6

7

8

9

10

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Per

cen

t L

BW

/Pre

term

% Preterm

% LBW

Low Birthweight and Preterm Massachusetts: 1990-2010

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Low birthweight: less than 2,500 grams or 5.5 pounds. Preterm: < 37 weeks gestation.

+2.1%* APC

-0.4% APC

-0.9% APC

+3.8%* APC

+3.4%* APC

Page 28: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 28

84.9%

79.5%

70

80

90

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

wit

h A

de

qu

ate

Pre

na

tal C

are

(K

ote

lch

uc

k)

Adequate Prenatal Care1

Massachusetts: 1990-2010

+0.2%* APC

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

1 Based on Adequacy of Prenatal Care Utilization (APNCU) Index.

Page 29: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 29

2.8%

4.7%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

5.0%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

wit

h G

es

tati

on

al

Dia

be

tes

Gestational Diabetes Mellitus (GDM) Massachusetts: 2000-2010

+5.1%* APC

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Page 30: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 30

Cesarean DeliveriesMassachusetts and the US: 1990-2010

22.2%

32.8%

22.5%

33.3%

18

22

26

30

34

38

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

US Massachusetts

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

Page 31: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 31

Cesarean DeliveriesMassachusetts: 1990-2010

22.5%

33.3%

18

22

26

30

34

38

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

* Statistically Significant (p ≤.05) APC = Annual Percentage Change

4.5%* APC

- 2.1%* APC

-0.1% APC

7.0%* APC

Page 32: Massachusetts Births 2010

32

Summary

Page 33: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 33

Summary Most Massachusetts perinatal health indicators are

better than those of the US

The teen birth rate is at an all time low

Smoking during pregnancy is at an all time low

Breastfeeding and Adequate Prenatal care reached record highs

One-third of all births are to non-white mothers

Cesarean delivery rate remains stable: one-third of all births are delivered by Cesarean section

Page 34: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 34

• The infant mortality rate (IMR) for Blacks is more than twice

as high as the IMR for Whites

• The Hispanic teen birth rate is almost 5 times that of Whites

• Less educated mothers have poorer birth indicators than more

educated mothers

• Mothers with their prenatal care paid through

Medicaid/MassHealth were almost 6 times more likely to

report smoking during pregnancy than those with their

prenatal care paid by private sources

Disparities Persist by Race, Ethnicity Geography, and SES

Page 35: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 35

Infant Mortality Rate Massachusetts: 1842-2010

0

50

100

150

200

250

1842

1848

1854

1860

1866

1872

1878

1884

1890

1896

1902

1908

1914

1920

1926

1932

1938

1944

1950

1956

1962

1968

1974

1980

1986

1992

1998

2004

2010

Year

De

ath

s p

er

1,0

00

liv

e b

irth

s

Page 36: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 36

How to Access the Births Report and Data

To access hard copies of the 2010 Report, call•Voice: (617) 740-2670•TDD/TTY: (617) 624-6001•DPH Website:

http://www.mass.gov/eohhs/docs/dph/research-epi/birth-report-2010.pdf

To access Birth data via MassCHIP (DPH’s Internet- based public health information service)

•Website: http://masschip.state.ma.us•Telephone: 1-888-MASCHIP (Mass only)

(617) 624-5629

New blog called Commonwealth Conversations: Public Health at http://publichealth.blog.state.ma.us

Page 37: Massachusetts Births 2010

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 37

Thank You


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