1. Welcome West Virginia Perinatal Partnership
Welcome to Your 2018 Summit!
Welcome to the Summit:
Many people have been instrumental in the Perinatal Partnership. Let me introduce the Steering Committee members here today.
Also, we have an group of experts who serve diligently on the Central Advisory Council. They are:

2. State of Perinatal Health total births
Year
# of Births Born in WV
# of Births Born in WV to In-State Residents
# of Births Born in WV to Out-of-State Residents
2006 (Initial Year)
21,137
18,592
2,545
2012
21,154
18,494
2,660
2013
21,127
18,410
2,717
2014
20,556
17,890
2,666
2015
20,426
17,461
2,965
2016
19,889
16,906
2,983
2017 (Preliminary)
19,256
16,356
2,900
Here is A quick over view of the State of Perinatal Health in WV.
Total Births in the state 2013
There were 21,124 WV occurrence births in 2013.
Data Source: WV Health Statistics Center, Vital Statistics System

3. Locations of WV Birth Facilities
WV has 28 birthing facilities in operational. 27 hospitals and 1 birthing center.
3 tertiary care centers and 2 level 2 NICU’s. We have Total Births in the state 2013
Locations of Level I and II obstetric services
Level III Perinatal Referral Centers

4. Trimester Prenatal Care Began West Virginia Resident Births, 2006-2017
Year
Total Births with Known Prenatal Care
First Trimester
Second Trimester
Third Trimester
No Care
Number
Percent
2006
20,450
16,669
81.5%
3,001
14.7%
639
3.1%
141
0.7%
2010
19,260
16,009
83.1%
2,609
13.5%
531
2.8%
111
0.6%
2011
20,268
16,958
83.7%
2,711
13.4%
488
2.4%
0.5%
2012
20,565
17,296
84.1%
2,653
12.9%
504
2.5%
112
2013
20,529
16,729
3,061
14.9%
607
3.0%
132
2014
19,849
15,346
77.3%
3,381
17.0%
928
4.7%
194
1.0%
2015
19,405
15,253
78.6%
3,125
16.1%
824
4.3%
203
2016
18,924
15,047
79.5%
2,851
15.1%
767
4.1%
259
1.4%
2017*
18,443
15,044
77.8%
2,900
15.7%
924
5.0%
263
The percentage of Births among unmarried women continue to increase in relation to all births % of babies born in 2013 were to unmarried women.
Data Source: WV Health Statistics Center,
Vital Statistics System
*Preliminary data

5. West Virginia Occurrence Births by Marital Status of Mother
Mother’s Marital Status
2006
2013
2014
2015
2016
2017 (Prelim.)
Married
61.0%
53.8%
55.3%
55.7%
54.6%
54.0%
Not Married
39.0%
46.2%
44.7%
44.3%
45.4%
46.0%
Data Source: WV Health Statistics Center, Vital Statistics System
The percentage of Births among unmarried women continue to increase in relation to all births % of babies born in 2013 were to unmarried women.

6. The State of Perinatal Health in West Virginia 2006-2017
Pre-Term Births (<37 Weeks Gestation) Among WV Residents
2006 – 12.4%
2011 – 11.3%
2012 – 10.7%
2013 – 10.5%
2014 – 10.8%
2015 – 11.3%
2016 – 11.8%
2017 – 12.0%
Data Source: WV Health Statistics Center, Vital Statistics System

7. The State of Perinatal Health in West Virginia 2006-2017
Low Birth Weight (<2,500 GMS) Among WV Residents
2006 – 9.7%
2011 – 9.6%
2012 – 9.2%
2013 – 9.4%
2014 – 9.1%
2015 – 9.6%
2016 – 9.7%
2017 (Preliminary) – 9.6%
Data Source: WV Health Statistics Center, Vital Statistics System

8. The State of Perinatal Health in West Virginia 2006-2017
Very Low Birth Weight (<1,500 GMS) Among WV Residents
2006 – 1.5%
2011 – 1.6%
2012 – 1.5%
2013 – 1.2%
2014 – 1.4%
2015 – 1.4%
2016 – 1.4%
2017 (Preliminary) – 1.6%
Data Source: WV Health Statistics Center, Vital Statistics System

9. Percentage of Very Low Birth Weight Infants (450-1,499 grams) by Place of Birth, WV Occurrences
The national CDC goal is to have only 10% of very low birth weight infants born outside of tertiary care hospitals.
Very low birth weight infants have a better chance of survival if the mother transferred prior to delivery and the infant is born in a tertiary care center, rather than being transferred after delivery.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentage of all births weighing 450-1,499 grams

10. Percentage of Elective Inductions Among Nulliparous Births, Weeks Gestation West Virginia Occurrences
ACOG recommendations is to limit inductions prior to 41 weeks to cases where the cervix meets standards to be ripe for delivery. It appears that most of the inductions are being conducted between 39 and 41 weeks. The c section rate has not decreased at a significate rate, as we would have anticipated.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentages of all Nulliparous births weeks gestation.
*Preliminary data.
Note: From , elective inductions are defined as those having no medical risk factors or congenital anomalies.

11. Percentage of Elective Inductions Among Nulliparous Births, 41+ Weeks Gestation West Virginia Occurrences
ACOG recommendations is to limit inductions prior to 41 weeks to cases where the cervix meets standards to be ripe for delivery. It appears that most of the inductions are being conducted between 39 and 41 weeks. The c section rate has not decreased at a significate rate, as we would have anticipated.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentages of all Nulliparous births 41+ weeks gestation.
*Preliminary data.
Note: From , elective inductions are defined as those having no medical risk factors or congenital anomalies.

12. Percentage of C-Sections Among Nulliparous Births, <39 Weeks Gestation West Virginia Occurrences
ACOG recommendations is to limit inductions prior to 41 weeks to cases where the cervix meets standards to be ripe for delivery. It appears that most of the inductions are being conducted between 39 and 41 weeks. The c section rate has not decreased at a significate rate, as we would have anticipated.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentages of all Nulliparous births <39 weeks gestation.
*Preliminary data.

13. Percentage of C-Sections Among Nulliparous Births, Weeks Gestation West Virginia Occurrences
ACOG recommendations is to limit inductions prior to 41 weeks to cases where the cervix meets standards to be ripe for delivery. It appears that most of the inductions are being conducted between 39 and 41 weeks. The c section rate has not decreased at a significate rate, as we would have anticipated.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentages of all Nulliparous births weeks gestation.
*Preliminary data.

14. Percentage of C-Sections Among Nulliparous Births, 41+ Weeks Gestation West Virginia Occurrences
ACOG recommendations is to limit inductions prior to 41 weeks to cases where the cervix meets standards to be ripe for delivery. It appears that most of the inductions are being conducted between 39 and 41 weeks. The c section rate has not decreased at a significate rate, as we would have anticipated.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentages of all Nulliparous births 41+ weeks gestation.
*Preliminary data.

15. Number and Percentage of C-Section and VBAC
Among WV Occurrence Births,
Year
Total Births with Known Method of Delivery
Number of C-Sections
Number of Vaginal after Previous C-Section
Number
Percent
2006
21,134
7,277
34.4%
139
0.7%
2010
20,758
7,412
35.7%
153
2011
20,958
7,709
36.8%
155
2012
21,152
7,606
36.0%
150
2013
21,126
7,632
36.1%
130
0.6%
2014
20,556
7,266
35.3%
243
1.2%
2015
20,425
7,148
35.0%
207
1.0%
2016
19,888
7,005
35.2%
263
1.3%
2017 (Preliminary)
19,255
6,783
293
1.5%
The percentage of Births among unmarried women continue to increase in relation to all births % of babies born in 2013 were to unmarried women.
Data Source: WV Health Statistics Center,
Vital Statistics System

16. Smoking Status During Pregnancy
West Virginia Resident Births,
Year
Total Births with Known Smoking Status
Mothers Who Reported Smoking During Pregnancy
Mothers Who Did Not Smoke During Pregnancy
Number
Percent
2006
20,815
5,696
27.4%
15,119
72.6%
2010
20,402
5,361
26.3%
15,041
73.7%
2011
20,640
5,389
26.1%
15,251
73.9%
2012
20,779
5,481
26.4%
15,298
73.6%
2013
20,763
5,320
25.6%
15,443
74.4%
2014
20,189
5,602
27.7%
14,587
72.3%
2015
19,714
4.949
25.1%
14,765
74.9%
2016
18,999
4.798
25.3%
14,201
74.7%
2017*
18,628
4,599
24.7%
14,029
75.3%
The percentage of Births among unmarried women continue to increase in relation to all births % of babies born in 2013 were to unmarried women.
Data Source: WV Health Statistics Center,
Vital Statistics System
*Preliminary data

17. Smoking and 2nd Hand Exposure During Pregnancy
West Virginia Occurrence Births,
Year
Mothers Who Reported Smoking During Pregnancy
Mothers Exposed to 2nd Hand Smoke During Pregnancy
Number
Percent
2006
5,912
28.1%
N/A
2010
5,559
26.8%
2011
5,641
26.9%
2012
5,670
2013
5,445
25.8%
2014
5,820
28.4%
3,877
19.1%
2015
5,259
3,267
16.2%
2016
5,101
25.7%
2,940
14.9%
2017*
4,898
25.5%
2,627
13.7%
The percentage of Births among unmarried women continue to increase in relation to all births % of babies born in 2013 were to unmarried women.
Data Source: WV Health Statistics Center,
Vital Statistics System
*Preliminary data
Note: 2nd hand smoke exposure data came into effect beginning in 2014.

18. Smoking in Pregnancy by Medicaid Status 2000-2017
Percentage of West Virginia Resident Births to Mothers Who Smoked During Pregnancy Among Those with Medicaid or Other Healthcare Coverage
Medicaid covered pregnant women smoke at a higher rate than women who are not covered by Medicaid.
Even with the decreases in smoking rates, WV still has the highest rate of smoking among pregnant women.
Nationally less that 10 % of pregnant women smoke.
Data Source: WV Health Statistics Center, Vital Statistics System
Percentages are calculated excluding unknown smoking status
* Preliminary data
** Cumulative and unedited data

19. Infant Mortality Rates West Virginia and United States Residents, 1970-2016
Data Source: WV Health Statistics Center, Vital Statistics System
Note: data is preliminary

20. Infant Mortality Rates
Mortality Rates by Cause,
*Some causes were not reportable (n<10) and incorporated into the all other cause category; labels contain proportions of mortality by cause for categories contributing 5% or more.
Bold=Significantly higher than U.S. Total, p<0.05
Source: Region III Infant Mortality Data Infant Mortality Collaborative Improvement and Innovation Network, NICHQ
Source: CDC Wonder

21. Maternal Deaths to West Virginia Residents, 2010-2017
*CDC defines maternal death as one who has died within one year after giving birth

22. Teen Pregnancy Rate Ages 15-19 Rates per 1,000 Females Ages 15-19
By County of Residence
WV Rate: 32.9
Lowest – Monongalia County (11.2)
Rates per 1,000 Females Ages 15-19
40.1 – 63.4
33.0 – 40.0
26.7 – 32.9
11.2 – 26.6
Highest –
Mingo County (63.4)
Source: West Virginia Health Statistics Center, Vital Statistics System

23. Maternal Drug Use - Known or self-reported maternal non-prescribed and/or illicit drug use during pregnancy
2014 – 5.2%
2015 – 5.9%
2016 – 7.7%
2017 – 8.3%*
Source: West Virginia Health Statistics Center, Vital Statistics System
* Preliminary data

24. Neonatal Abstinence Syndrome (NAS)
2014 – 2.7%
2015 – 3.0%
2016 – 4.6%
2017 – 4.6%*
Source: West Virginia Health Statistics Center, Vital Statistics System
* Preliminary data

27. Hepatitis C Infection During Pregnancy
2014 – 2.3%
2015 – 2.8%
2016 – 3.4%
*2017– 3.6%
Source: West Virginia Health Statistics Center, Vital Statistics System
* Preliminary data

28. Syphilis Infection During Pregnancy
2014 – 0.02%
2015 – 0.01%
2016 – 0.04%
2017 – 0.11%*
Source: West Virginia Health Statistics Center, Vital Statistics System
* Preliminary data

29. Mother’s Pre-Pregnancy BMI Percentage of WV Resident Births 2014-2017
The national CDC goal is to have only 10% of very low birth weight infants born outside of tertiary care hospitals.
Very low birth weight infants have a better chance of survival if the mother transferred prior to delivery and the infant is born in a tertiary care center, rather than being transferred after delivery.
Data Source: WV Health Statistics Center, Vital Statistics System
2017 data is preliminary

30. Hepatitis Immunization Percentage of WV Resident Births 2014-2017
The national CDC goal is to have only 10% of very low birth weight infants born outside of tertiary care hospitals.
Very low birth weight infants have a better chance of survival if the mother transferred prior to delivery and the infant is born in a tertiary care center, rather than being transferred after delivery.
Data Source: WV Health Statistics Center, Vital Statistics System
2017 data is preliminary

31. Number of Home Births West Virginia, 2000-2017
Medicaid covered pregnant women smoke at a higher rate than women who are not covered by Medicaid.
Even with the decreases in smoking rates, WV still has the highest rate of smoking among pregnant women.
Nationally less that 10 % of pregnant women smoke.
Data Source: WV Health Statistics Center, Vital Statistics System
*Preliminary data

32. Intentionality of Home Births Percentage of WV Home Births 2014-2017
The national CDC goal is to have only 10% of very low birth weight infants born outside of tertiary care hospitals.
Very low birth weight infants have a better chance of survival if the mother transferred prior to delivery and the infant is born in a tertiary care center, rather than being transferred after delivery.
Data Source: WV Health Statistics Center, Vital Statistics System
Preliminary data

33. Number of Home West Virginia Births, 2006-2017 Mother Had a Previous C-Section
Medicaid covered pregnant women smoke at a higher rate than women who are not covered by Medicaid.
Even with the decreases in smoking rates, WV still has the highest rate of smoking among pregnant women.
Nationally less that 10 % of pregnant women smoke.
Data Source: WV Health Statistics Center, Vital Statistics System
*Preliminary data

34. Intentionality of VBAC Home Births Percentage of WV VBAC Home Births 2014-2017
The national CDC goal is to have only 10% of very low birth weight infants born outside of tertiary care hospitals.
Very low birth weight infants have a better chance of survival if the mother transferred prior to delivery and the infant is born in a tertiary care center, rather than being transferred after delivery.
Data Source: WV Health Statistics Center, Vital Statistics System
Preliminary data

35. WV Resident Birth Outcome Rankings, 2017*
U.S.
WV Rank
Cesarean Delivery
35.3%
32.0%
5th
Preterm Births
12.0%
9.9%
4th
Low Birth Weight
9.6%
8.3%
7th
Very Low Birth Weight
1.6%
1.4%
9th
Teen Birth Rate (Age 15-19)
27.1 per 1,000
18.8 per 1,000
8th
Data Source: WV – West Virginia Health Statistics Center, Vital Statistics System
US – CDC Wonder
*Preliminary data

36. INITIATIVES AIM Patient Safety Bundles (WV ACOG)
Long Acting Reversible Contraceptives
Help2Quit – Tobacco Cessation Training Project
Continuing Zika Education
Breastfeeding – WVBFA + CLC training
Maternal Risk Screening
Bereavement Support
Childbirth Instructor Training
Oral Health Care
Preterm Birth Prevention
Substance Use in Pregnancy – DFMB programs and NAS Education
Fetal Monitoring
Hospital Guidelines and Levels of Care Self Assessment
Maternity Care Provider Shortage

37. Amy Tolliver, MS Director, WV Perinatal Partnership
1018 Kanawha Boulevard East Charleston, WV 25301
(304) ext. 5
Coordinated by the West Virginia Higher Education Policy Commission, Division of Health Sciences