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Objectives—This report presents 2014 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, attendant at birth, method of delivery, period of gestation, birth weight, and plurality. Birth and fertility rates are presented by age, live-birth...
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OBJECTIVES: This report presents 2013 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, attendant at birth, method of delivery, period of gestation, birthweight, and plurality. Birth and fertility rates are presented by age, live-birth...
Citations
... Over 63,000 very preterm infants, those infants delivered before 32 weeks gestational age (GA), are born annually in the United States [1]. In 2020, the rate of preterm single births was almost 65% higher for Black mothers compared to White mothers [2]. ...
Background: The birthrate of Black preterm (BPT) infant is 65% higher than White preterm (WPT) infants with BPT mortality 2.3 times higher. The incidence of culture positive sepsis is as high as 41% in preterms. This study aimed to examine infections and mortality in BPTs and WPTs. Methods: We enrolled 362 preterms born < 32 weeks gestational age (GA) between 2019-2023 in 5 neonatal intensive care unit (NICU)s to study onset of infections, and dispositions; RedCap data were analyzed for descriptive statistics. Results: 226 BPTs (63.5%) and 107 WPTs (30.8%) enrolled, with 29 other than White or Black, 50.5% female, mean GA of 27.67 weeks and 986.74 grams birthweight. Of 426 suspected infections evaluated in enrolled infants, there were 7 infants with early onset sepsis (EOS) and 39 infants with late onset sepsis (LOS). The incidence of EOS was 1.9% overall, 2.2% in BPTs vs 0.9% in WPTs. LOS incidence was 10.8% overall, 11.9% in BPTs and 9.3% in WPTs. Both BPT and WPT infants had ~ 8% gram-positive LOS events and 3% gram-negative LOS events; however, 82% of all gram-negative LOS episodes occurred in BPTs. There were 27 urinary tract infections and 78% were in BPTs. Two cerebral spinal fluid cultures were positive in BPTs. Necrotizing enterocolitis was diagnosed in 5.8% of the sample, with an incidence of 6.1% in BPTs versus 4.7% in WPTs. Death occurred in 6.0% of the enrolled infants with the rate of death being slightly higher in BPTs (7.0%) versus WPTs (5.6%). Conclusions: BPTs had a higher rate of positive cultures, double the gram-negative infections, a much higher rate of urinary tract infec-tions and a higher rate of mortality than their WPT counterparts. This study emphasizes higher risk of morbidity and mortality for BPTs.
... In United States, cesarean delivery, as prevalence of 32% from all deliveries, is one of the most common obstetric procedures. 1 Abdominal wound dehiscence as complication in obstetric procedure happens from 3.6 to 29% of all obstetrics and gynecology surgery. 2 It usually prolongs wound healing time. Several risk factors including obesity, smoking, surgical site infection, technical factors, such as inadequate hemostasis inhibit the wound healing. ...
... However, there is a growing public health concern that the prevalence of CS has been rising for all women in the world regardless of the medical condition, maternal age or gestational age [3]. Despite the WHO recommending the optimal range of CS to be between 10-15%, countries are still recording high prevalence [4] [5], although in developing countries the range varies from extremely low to high [3][6] [7] . . Nonetheless studies have revealed that this rise has not resulted in significant improvement in neonatal or maternal mortality [8] [9]. . ...
Background: Increase in cesarean section (CS) has been a source of public health concern globally. There is scanty updated information about cesarean section and associated factors in developing countries like Zambia. The aim of this study was to determine the prevalence of CS and associated factors at The University Teaching Hospital women and Newborn in Lusaka Zambia. Methodology: The study design was cross sectional. It involved retrospective collection of data from birth registers of women who gave birth at the University Teaching Hospital-Women and Newborn from 1 st January, 2018 to 31 st December 2018. The total sample size was 6,965 women (15-49 years) after the inclusion and exclusion criteria were met. Statistical analysis was conducted using Binary Logistic Regression, level of significance was 0.05 and Confidence Interval of 95%. Goodness of fit was conducted using the likelihood ratio test. Data was analyzed using STATA version 14.2.
... Advanced paternal age had been linked to an increased risk of a number of diseases in their offspring, including schizophrenia [10], autism [11], intellectual disabilities [12], achondroplasia [13], premature birth [14,15], low birth weight [16], childhood cancers [17][18][19], abortion [20], and lower success rates of assisted reproduction [6]. Congenital anomalies (CAs) had been the second most common cause of neonatal death only secondary to preterm birth [21] and contributed significantly to early childhood deaths and long-term disabilities in children [22], and the relationship between paternal age and congenital anomalies was inconclusive [23][24][25]. ...
The objective of the study was to explore the impact of paternal age on the risk of congenital anomalies and birth outcomes in infants born in the USA between 2016 and 2021. This retrospective cohort study used data from the National Vital Statistics System (NVSS) database, a data set containing information on live birth in the USA between 2016 and 2021. Newborns were divided into four groups based on their paternal age (< 25, 25–34, 35–44, and > 44 years) and using the 25–34 age group as a reference. The primary outcomes were congenital anomalies involving structural anomalies and chromosome anomalies. Secondary outcomes were preterm birth, low birth weight, severe neonatal perinatal asphyxia, and admission to neonatal intensive care units (NICU). A multivariable logistic regression model was used to analyze the association between paternal age and outcomes. Overall, 17,764,695 live births were included in the final analyses. After adjusting confounding factors, advanced paternal age > 44 years was associated with increased odds of congenital anomalies (adjusted odds ratio (aOR) = 1.17, 95%CI 1.12–1.21) compared with the 25–34 age group, mainly for the chromosomal anomalies (aOR = 1.59, 95%CI 1.40–1.78) but not the structure anomalies (aOR = 1.03, 95%CI 0.97–1.09). The risk of preterm delivery, low birth weight, and NICU hospitalization in their infants was increased by advanced parental age as well.
Conclusion: Advanced paternal age increases the risk of congenital anomalies, especially chromosomal anomalies in their offspring, implying prenatal genetic counseling is required. What is Known:
• There's a rising trend of advanced paternal age, which is associated with an increased likelihood of premature birth and low birth weight in their offspring. However, the exploration between paternal age and congenital abnormalities in offspring was limited and contradictory.
What is New:
• Infants with a paternal age > 44 years were more likely to be born with congenital anomalies, especially chromosomal anomalies.
... The birth rate among RMAA continues to be among the highest in the nation [10,22,23]. This relatively higher birth rate reflects the large population of youth exposed to potential STI transmission [24,25]. Proportionately more RMAA live in the US-Mexico border regions in which the STI diagnoses are among the highest in the US. ...
Rural America is often viewed as bereft of social problems facing urban America. Rural families, however, experience stressors due to low employment rates, fewer educational opportunities, a relatively increased incidence of poverty and limited access to mental health care. These families are at increased risk for substance use, violence and associated psychological distress that occurs when failing to cope with stress. Rural children, experiencing these stressors and affected by barriers of culture, poverty and remote access to mental health care, are at higher risk for these negative health outcomes. The need for culturally appropriate intervention tailored to the target population, rural Mexican-American adolescent women, is consistently supported by evidence. A one-size-fits-all approach most likely will not effectively impact behavior and health outcomes. The fact that few studies evaluated effects of mental health interventions on multiple outcomes including substance use, violence, unintended pregnancy and STI is problematic given previously noted associations. Evidence is needed to evaluate associations between mental health interventions and these outcomes. This manuscript presents results of preliminary studies, conducted using a multi-method research approach for development, pre-testing and feasibility testing of interventions for rural primary care settings. This methodology is appropriate when dealing with the complexity of social phenomena. It provides a look at an issue from all angles and thereby the cultural context and perspective informing intervention development. These multi-component interventions are critical for mental health promotion among Mexican-American adolescent women living in rural America.
... For example, until recently, "on-time" fertility occurred between the ages of 24 and 29 (Matthews and Hamilton 2016). However, the most recent estimates show a dramatic increase in first-time motherhood between the ages of 30 and 34 (Hamilton et al. 2015;Matthews and Hamilton 2016). The birth rate is 105.8 births per 1,000 for those 24 to 29 years old, and 100.8 births per 1,000 for those 30 to 34 years old. ...
... Importantly, relationships outside of marriage do not infer childlessness. For example, nearly half of cohabitating relationships involve a child (Daugherty and Copen 2016;Hamilton et al. 2015). Moreover, outside of marriage and cohabitation, there is evidence that young adults are selecting into parenthood in a variety of relationship types, including chosen singlehood and monogamous dating (Golombok et al. 2016). ...
Solidifying a strong personal sense of mastery or control over life is a key developmental task in young adulthood. We investigate the extent to which intimate relationship status (i.e., marriage, cohabitation, monogamous dating, and singlehood) and parenthood simultaneously shape mastery for a longitudinal sample of 18- to 34-year-olds. We further investigate whether age qualifies the effects of relationship-parenthood status on the sense of mastery similarly for men and women. Regardless of parenthood and gender, marriage and cohabitation are related to higher mastery than monogamous dating and singlehood. On average, single fathers and mothers have the lowest mastery. As individuals age from their late twenties into their early thirties, married and monogamously dating men without children have the highest levels of mastery, while cohabiting men without children and monogamously dating mothers have the lowest levels of mastery.
... Preterm birth (PTB) is a serious complication of pregnancy and is used as a predictor of neonatal mortality (Rocha et al. 2022). Due to the imperfect development of various body systems, premature infants are prone to severe multiple systems diseases, and high mortality and disability (Hamilton et al. 2015;McCormick et al. 2011). In the past 20 years, the incidence of PTB is increasing worldwide, making PTB a global problem in public health. ...
Accumulating evidence suggested that the risk of preterm births (PTBs) following prenatal exposure to air pollution was inconclusive. The aim of this study is to investigate the relationship between air pollution exposure in the days before delivery and PTB and assess the threshold effect of short-term prenatal exposure to air pollution on PTB. This study collected data including meteorological factors, air pollutants, and information in Birth Certificate System from 9 districts during 2015–2020 in Chongqing, China. Generalized additive models (GAMs) with the distributed lag non-linear models were conducted to assess the acute impact of air pollutants on the daily counts of PTB, after controlling for potential confounding factors. We observed that PM2.5 was related to increased occurrence of PTB on lag 0–3 and lag 10–21 days, with the strongest on the first day (RR = 1.017, 95%CI: 1.000–1.034) and then decreasing. The thresholds of PM2.5 for lag 1–7 and 1–30 days were 100 μg/m³ and 50 μg/m³, respectively. The lag effect of PM10 on PTB was very similar to that of PM2.5. In addition, the lagged and cumulative exposure of SO2 and NO2 was also associated with the increased risk of PTB. The lag relative risk and cumulative relative risk of CO exposure were the strongest, with a maximum RR at lag 0 (RR = 1.044, 95%CI: 1.018, 1.069). Importantly, the exposure–response curve of CO showed that RR increased rapidly when the concentration exceeded 1000 μg/m³. This study indicated significant associations between air pollution and PTB. The relative risk decreases with day lag, while the cumulative effect increases. Thus, pregnant women should understand the risk of air pollution and try to avoid high concentration exposure.
Supplementary Information
The online version contains supplementary material available at 10.1007/s11356-023-25624-2.
... Despite the decrease in the number of births in the United States between 2006 and 2014, this study found an increase in HG and NVP ED visits. 30,31 Although the reasons for this increase remain unknown, we believe that the following could help explain this trend: reduced capacity at outpatient infusion service, payer restrictions on admission for outpatient services, increased use of observation status, and reduced capacity of obstetrical services over time. 32 Similarly, a possible explanation for the 65% increase in the average cost of a HG ED visit but a 110% increase in the aggregate cost of HG ED visits is that the cost burden of treating HG is shifted to the ED instead of being charged to the inpatient. ...
Background:
Hyperemesis gravidarum is the most severe form of nausea and vomiting of pregnancy, potentially affecting both maternal and pregnancy health. Hyperemesis gravidarum often results in emergency department visits, although the exact frequency and costs associated with these visits have not been well studied.
Objective:
This study aimed to analyze the trends in hyperemesis gravidarum emergency department visits, inpatient admissions, and the associated costs between 2006 and 2014.
Study design:
Patients were identified from the 2006 and 2014 Nationwide Emergency Department Sample database files using International Classification of Diseases, Ninth Revision diagnosis codes. Patients with a primary diagnosis of hyperemesis gravidarum, nausea and vomiting of pregnancy, and all nondelivery pregnancy-related diagnoses (all antepartum visits) were identified. All groups were analyzed; trends in demographics, number of emergency department visits, and visit costs were compared. Costs were inflation-adjusted to 2021 US dollars.
Results:
Emergency department visits for hyperemesis gravidarum increased by 28% from 2006 to 2014; however, the proportion of those who were subsequently admitted to the hospital decreased. The average cost of an emergency department visit for hyperemesis gravidarum increased by 65% ($2156 to $3549), as opposed to an increase of 60% for all antepartum visits ($2218 to $3543). The aggregate cost for all hyperemesis gravidarum visits increased by 110% ($383,681,346 to $806,696,513) from 2006 to 2014, which was similar to the increase observed for all antepartum emergency department visits.
Conclusion:
From 2006 to 2014, emergency department visits for hyperemesis gravidarum increased by 28%, with associated costs increasing by 110%, whereas the number of admissions from the emergency department for hyperemesis gravidarum decreased by 42%.
... In modern obstetric practices, induction of labor (IOL) is one of the most widespread procedures, and the rates are increasing in most western countries [5]. In Canada, one in five pregnant women have their labor induced [6]; In the USA, the induction rate has more than doubled to 23.8% [7]; In polish, approximately 20% of women who give birth vaginally are affected by IOL [8]. ...
Objective:
To identify whether infection, cervical laceration and perineal laceration are associated with postpartum hemorrhage in the setting of vaginal delivery induced by Cook balloon catheter.
Materials and methods:
The retrospective study included 362 women who gave birth vaginally at or beyond 37 weeks of gestation with a diagnosis of postpartum hemorrhage between February 2021 to May 2022, of which including 216 women with induction of labor (Cook balloon catheter followed by oxytocin or oxytocin) and 146 women with spontaneous delivery. Risk factors for postpartum hemorrhage were collected and compared.
Results:
362 women were divided into three groups, group 1 with spontaneous delivery, group 2 with oxytocin, group 3 with Cook balloon catheter followed by oxytocin. There was no significant difference in incidence of infection within three groups (P > 0.05). The rate of cervical laceration and perineal laceration was significantly higher in group 3 compared with groups 2 and 1 (P < 0.05); Multivariate logistic regression analysis found that compared with group 1, either group 3 or group 2 was associated with increased risks of cervical laceration and perineal laceration (P < 0.05), and compared with group 2, group 3 was not associated with increased risks of cervical laceration and perineal laceration (P > 0.05).
Conclusion:
Infection, cervical laceration and perineal laceration are identified not to be independent risk factors for postpartum hemorrhage for women undergoing labor with Cook balloon catheter; Cervical laceration and perineal laceration increase the risk of postpartum hemorrhage in women with labor induction.
... 22 Cesarean section is one of the most performed obstetric surgical procedures. 23 Global rates of cesarean section have been increasing progressively over the past few decades, but vary widely between countries; from 15.5% of births in Finland to 53.1% in Turkey in 2015, 24 whereas rates are reported as 32% in the USA 25 and Australia, 26 and 41% in China. 27 In England, cesarean section rates were just 9% of deliveries in 1980, but more than tripled to 30% in 2018-2019. ...
Objective
To reduce average surgical‐site infection (SSI) rates to less than 7.5%, as well as other complications by incrementally implementing an SSI prevention care bundle in maternity: (1) ChloraPrep; (2) PICO dressings, performing elective cesarean sections in a main theater rather than a labor ward and warming blankets; (3) vaginal cleansing; and (4) Hibiscrub.
Methods
In this prospective cohort study, the association between categorical variables was assessed by χ² tests, temporal trends in the monthly percentage change of SSI were measured using the Joinpoint Regression Program v4.7.0.0.
Results
In all, 1682 women (mean age 33.1 ± 5.2 years) underwent either elective (53.9%) or emergency (46.1%) cesarean section. After a small initial increase (10.0%–11.8%), SSI progressively declined to 4.4% (χ² = 22.1, P < 0.001), as did sepsis, reoperation or readmission for SSI: from 12.5% to 0.5% (χ² = 90.1, P < 0.001). The rates of SSI fell progressively with the cumulative introduction care bundle components. The average monthly percentage change was −14.0% (95% confidence interval −21.8% to −5.4%, P = 0.004), and the average SSI rate was kept below 7.5% for the last 12 months of the study.
Conclusion
The maternal SSI prevention care bundle is simple and inexpensive; it effectively reduces SSI after a cesarean section and should be offered routinely to women undergoing cesarean section.
