Trends in the Well-Being of America's Children and Youth, 2000. HC 2.1 Healthy Births

01/01/2000

A healthy birth is defined here as a birth with the following characteristics: a 5-minute Apgar score of 7 or more out of 10,20 weight at birth of at least 2,500 grams (5 lbs. 8oz.), a gestational age of at least 37 weeks, and maternal receipt of prenatal care within the first trimester.

Table HC 2.1.A reports the percentage of all births qualifying as healthy births, by race and Hispanic origin, according to the above criteria in 1998. The table shows non-Hispanic black newborns scored lower on all four measures of healthiness than non-Hispanic white and Hispanic newborns. For example, 86.8 percent of non-Hispanic black infants were born weighing 2,500 grams or more, while the comparable numbers for Hispanic and nonHispanic white newborns were 93.6 and 93.4 percent respectively

Apgar Score. The Apgar score is a numerical expression of the physical condition of an infant shortly after delivery and is used to predict the newborn’s chance of survival. The score considers five characteristics of the baby—heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each of these characteristics is assessed and assigned a value between 0 and 2. The total score is the sum of the scores of the five components and thus ranges between 1 and 10. Ninety-nine percent of all births were rated with an Apgar score at 5 minutes after birth of 7 or more in 1998 (See Table HC 2.1.A). These numbers were nearly the same for all racial/ethnic groups except non-Hispanic blacks. In 1998, 97.6 of all births to this group were rated as healthy according to the Apgar criteria.

Birthweight. The risks for infants born weighing less than 2,500 grams (5lb. 8oz.) is discussed in the following indicator, HC 2.2. As stated in that section, the percentage of infants born at low birthweight has increased steadily since 1985 to 7.6 percent in 1999 (See Table HC 2.2.A). In contrast, the percentage of children born weighing more than 2,500 in 1998 was 92.4. Hispanic and non-Hispanic whites had similarly high percentages with 93.6 and 93.4 percent respectively. The percentage of infants born to non-Hispanic black mothers weighing over 2,500 grams was much lower however, at 86.8 percent (See Table HC 2.1A).

Period of Gestation. Preterm birth, defined as infants that are born prior to 37 weeks of gestation, is a major cause of infant mortality and has been associated with long-term neurodevelopment and respiratory disorders. The percentage of births that are preterm has risen steadily over the past decade. In 1989, 10.6 of all births were preterm, and this percentage had risen to 11.6 in 1998 (See Table HC 2.1.B). It appears that the rising number of preterm infants born to white non-Hispanic mothers account for much of this increase. This percentage has risen from 8.4 in 1989 to 10.2 percent in 1998. In comparison, the percentage of preterm infants born to black non-Hispanic mothers has decreased (from 19 percent in 1989 to 17.6 percent in 1998), and the percentage of preterm Hispanic infants has increased only slightly, from 11.1 to 11.4 in the same time period.

Prenatal care. Early prenatal care (especially within the first trimester of pregnancy) can promote healthier births by detecting and managing preexisting medical conditions, and by providing health advice to the mother.21 In 1998, nearly 88 percent of all non-Hispanic white mothers received prenatal care sometime during their first trimester of pregnancy. The percentages for non-Hispanic blacks and Hispanic mothers were considerably lower at 73 and 74 percent respectively (See Table HC 2.1.A). This topic is discussed in greater detail in section HC 3.2.

Table HC 2.1.A Percentage of all births in the United States defined as healthy, by mother’s race: 1998

  Gestational age 37 weeks + Birthweight 2,500 grams + Apgar score 7 or above Prenatal care 1st trimester
All 88.4 92.4 98.6 82.8
White 89.8 93.4 98.7 87.9
Black 82.4 86.8 97.6 73.3
Hispanic 88.6 93.6 98.8 74.3

Source: Special tabulations for 1998 birth data by Sally C. Curtin, National Center for Health Statistics.


Table HC 2.1.B Percentage of preterma live births by race and Hispanic origin of mother: 1989-1998 

  1989b 1990c 1991d 1992d 1993 1994 1995 1996 1997 1998
All 10.6 10.6 10.8 10.7 11.0 11.0 11.0 11.0 11.4 11.6
White 8.4 8.5 8.7 8.7 9.1 9.3 9.4 9.5 9.9 10.2
Black 19.0 18.9 19.0 18.5 18.6 18.2 17.8 17.5 17.6 17.6
Hispanic 11.1 11.0 11.0 10.7 11.0 10.9 10.9 10.9 11.2 11.4

a Infants born prior to 37 weeks of gestation.

b Data by Hispanic origin exclude New Hampshire, Oklahoma, and Louisiana, which did not report Hispanic origin.

c Data by Hispanic origin exclude New Hampshire and Oklahoma, which did not report Hispanic origin.

d Data by Hispanic origin exclude New Hampshire which did not report Hispanic origin.

Sources: Ventura, et al., 2000. Births.


20 The Apgar score is a numerical expression of the physical condition of an infant shortly after delivery. The infant is rated 0, 1, or 2 on color, heart rate, reflex irritability, muscle tone, and breathing. The maximum score is 10, and a score of 4 or less indicates examination and treatment are warranted. As defined in Apgar, V., Holiday, D.A., James, L.S., Weisbrot, I.N., & Berrien, C. 1953. Evaluation of the Newborn Infant-2nd Report. Current Researchers in Anesthesia and Analgesia, 32: 260-267.

21 Ibid.

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