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 % Change Number of Births81,58272,835-11%* % Foreign Born Mothers %* % Multiple Births % Teen Birth Rate (births/1000 women ages years) %* Infant Mortality Rate (IMR) (deaths per 1,000 live births) % % Preterm (<37 weeks) % % Low Birthweight (<2,500 g, 5.5 lbs) %* % Smoking During Pregnancy %* % Gestational Diabetes %* % Cesarean Deliveries %* Massachusetts Birth Indicators Since and 2010 * Statistically Significant (p≤.05)

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 4 Indicator % Change Number of Births74,96672,835-3%* % Foreign Born Mothers % Multiple Births % Teen Birth Rate (births/1000 women ages years) %* Infant Mortality Rate (IMR) (deaths per 1,000 live births) % % Preterm (<37 weeks) % % Low Birthweight (<2,500 g, 5.5 lbs) % Smoking During Pregnancy %* % Gestational Diabetes % Cesarean Deliveries % Massachusetts Birth Indicators – One Year 2009 and 2010 * Statistically Significant (p≤.05)

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 5 IndicatorMAUS Fertility Rate (births /1000 females ages yrs) 53.7*64.1 Teen Birth Rate (births/1000 females ages 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 US 1 Data 1. Births: Final Data for 2010, National Vital Statistics Reports, Volume 61, Number 1, August Provisional estimates for 2010 US, National Vital Statistics Reports - Volume 60, Number 4, January, *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: * Statistically Significant (p ≤.05) APC = Annual Percentage Change 92, % * 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 years) Massachusetts: %* APC +0.3%* APC %* APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 9 Massachusetts ,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 Massachusetts ,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: % * 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: %* 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 Percent Multiple Births Massachusetts: *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 Teen Birth Rates Massachusetts and US :

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 16 Teen Birth Rates by Race 1 and Ethnicity Massachusetts: 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 Holyoke % 2Lawrence % 3Springfield % 4Chelsea % 5Southbridge % 6New Bedford % 7Lynn % 8Lowell % 9Fall River % 10Brockton % Massachusetts3, %* ** Statistically lower (p ≤.05)

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 18 Infant Mortality Rate (IMR) Massachusetts: * Statistically Significant (p ≤.05) APC = Annual Percentage Change %* APC -0.6% APC

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 19 IMR by Race 1 & Hispanic Ethnicity Massachusetts: non-Hispanic

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 20 IMR by Race 1 & Hispanic Ethnicity Massachusetts: 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 Hispanic IMR Massachusetts: * Statistically Significant (p ≤.05) APC = Annual Percentage Change - 7.8%* APC % APC

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 22 Highest Infant Mortality Rates Among the 30 Largest Communities in Massachusetts: 2010 Rate = infant deaths per 1,000 live births * Statistically Significantly higher than state rate (p ≤.05) City/Town2010 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 Rates Among the 30 Largest Communities in Massachusetts: Rate = infant deaths per 1,000 live births * Statistically Significantly higher than the state rate (p ≤.05) City/Town Springfield 8.8 (n=63)* Pittsfield8.4 (n=13) Lowell 8.1 (n=42) * Worcester 8.0 (n=62) * Brockton 7.9 (n=35) * Taunton7.9 (n=17) MA Overall 4.7 (n=1,067)

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 24 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 Smoking During Pregnancy Massachusetts: %* 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 Low Birthweight and Preterm Massachusetts: * 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 Adequate Prenatal Care 1 Massachusetts: %* 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 Gestational Diabetes Mellitus (GDM) Massachusetts: %* 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 Deliveries Massachusetts and the US: * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation 31 Cesarean Deliveries Massachusetts: * 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 l Most Massachusetts perinatal health indicators are better than those of the US l The teen birth rate is at an all time low l Smoking during pregnancy is at an all time low l Breastfeeding and Adequate Prenatal care reached record highs l One-third of all births are to non-white mothers l 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:

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) TDD/TTY: (617) DPH Website: To access Birth data via MassCHIP (DPH’s Internet- based public health information service) Website: Telephone: MASCHIP (Mass only) (617) New blog called Commonwealth Conversations: Public Health at

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