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
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
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)
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)
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
6
Changing Demographics
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
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
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%
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%
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
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
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
14
Diversity and Disparities
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
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
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)
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
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
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
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
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)
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)
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.
25
Selected Topics
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
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
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.
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
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
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
32
Summary
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
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
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
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
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 37
Thank You