- Low Birthweight and Preterm Births
- Infant Mortality
- Prenatal Care
- Teen Births
- Why This Topic Is Important
In addition to being at higher risk of death during the first year of life, babies born weighing less than 5.5 pounds are at increased risk of long-term disabilities, including developmental delays, learning disabilities, and autism (1, 2). Cardiac and/or respiratory distress, brain hemorrhaging, and vision impairments are also problems that low birthweight infants may face (3). Women who are more likely to give birth to low birthweight babies include those with low incomes or education, smoking habits, and those under age 17 or over age 35 (1, 3).
Babies born prematurely may face adverse outcomes as low birthweight infants (4). Preterm birth is the leading cause of infant death in the U.S. (5). Some preterm babies require specialized care in a newborn intensive care unit (4). Women who are most likely to give birth preterm include those who have had a previous premature birth, those pregnant with twins, triplets, or more, and those with certain uterine abnormalities. In addition, demographic and behavioral factors can increase the risk of delivering preterm, including low socioeconomic status, being under age 17 or over age 35, receiving inadequate prenatal care, and smoking during pregnancy (6). About 1 in 9 pregnancies in the U.S. result in preterm birth (3).Sources for this narrative:
1. Child Trends Databank. (2015). Low and very low birthweight infants. Retrieved from: http://www.childtrends.org/?indicators=low-and-very-low-birthweight-infants
2. Pinto-Martin, J. A., et al. (2011). Prevalence of Autism Spectrum Disorder in adolescents born weighing <2000 grams. Pediatrics, 128(5), 883-891. Retrieved from: http://pediatrics.aappublications.org/content/128/5/883
3. March of Dimes. (2014). Low birthweight. Retrieved from: http://www.marchofdimes.com/baby/low-birthweight.aspx
4. March of Dimes. (2013). Premature babies. Retrieved from: http://www.marchofdimes.org/baby/premature-babies.aspx
5. Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2013). Preterm labor and birth: Overview. Retrieved from: http://www.nichd.nih.gov/health/topics/preterm/Pages/default.aspx
6. March of Dimes. (2014). Preterm labor and premature birth. Retrieved from: http://www.marchofdimes.org/pregnancy/preterm-labor-and-premature-birth.aspx
- How Children Are Faring
The percentage of California babies born at low birthweight increased from 6.1% in 1999 to 6.9% in 2005, and has remained fairly steady since then. At the local level, percentages range from 4.9% to 9.8% in 2013 among counties with available data. The state and all but five counties with data in 2013 met the national Healthy People 2020 objective of no more than 7.8% of infants with low birthweight. However, figures vary by demographic group. For example, California mothers age 45 and older consistently have the highest percentages of low birthweight babies (20.4% in 2013), compared to younger mothers. Among California's racial/ethnic groups with available data, African American/Black mothers consistently have the highest percentages of infants at low birthweight (11.7% in 2013).
California babies born at a very low birthweight has remained steady since 1995, hovering between 1.1% and 1.2%. The state and all but two counties with available data in 2013 met the Healthy People 2020 objective of no more than 1.4% of infants with very low birthweight.
In 2013, 8.8% of infants were born preterm, which represents a decline from the high of 11.2% in 2005. At the county-level, figures range from 6.3% to 13.6% of infants born preterm in 2013. Among counties with available data, all but two met the Healthy People 2020 objective of no more than 11.4% of infants born prematurely.
- Policy Implications
Some of the risk factors for low birthweight and preterm birth can be influenced by public and institutional policy focused on education, prevention, and treatment. These factors include smoking, drinking alcohol, or using illicit substances during pregnancy; being a teenage mother; and being overweight or underweight (1).
According to research and subject experts, policy options that could influence low birthweight and preterm births include:
For more policy ideas and research on this topic, see kidsdata.org’s Research & Links section, or visit the March of Dimes. Also see Policy Implications on kidsdata.org under the Prenatal Care, Infant Mortality, Teen Births and Teen Sexual Health topics.
- Providing access to early and regular high-quality prenatal care, including ensuring that pregnant women get appropriate nutrition and avoid increased risks of delivering early due to overweight and obesity (1, 2)
- Ensuring that health care systems train clinicians on identifying smokers among pregnant women, and that evidence-based tobacco cessation services are available to pregnant women and reimbursed by insurance (1)
- Sustaining adequate funding for universal screening for substance use among pregnant women, and for treatment services specifically designed for pregnant women who use alcohol or illicit drugs (3)
- Addressing depression and depressive symptoms in pregnant women as depression has been found to have an impact on the incidence of preterm labor and low birthweight (4)
- Supporting a comprehensive approach to women’s health (1), including integration of reproductive planning into women’s routine health care by ensuring access to medical and dental services; included in this approach should be a focus on increasing interpregnancy intervals (at least 12 months), recognizing that short intervals are associated with increased risk for preterm birth (5)
Sources for this narrative:
1. Shore, R., & Shore, B. (2009). Preventing low birthweight (KIDS COUNT Indicator Brief). Annie E. Casey Foundation. Retrieved from: http://www.aecf.org/resources/kids-count-indicator-brief-preventing-low-birthweight/
2. McDonald, S. D., et al. (2010). Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: Systematic review and meta-analyses. British Medical Journal, 341, c3248. Retrieved from: http://www.bmj.com/content/341/bmj.c3428
3. Chasnoff, I. J., et al. (2008). Perinatal substance use screening in California. NTI Upstream. Retrieved from: http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Documents/MO-ChasnoffPerinatalSubstanceUseScreeningReport-10-24-08.pdf
4. Grote, N. K., et al. (2010). A meta-analysis of depression during pregnancy and the risk of preterm, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67(10), 1012-1024. Retrieved from: http://archpsyc.jamanetwork.com/article.aspx?articleid=210887
5. Wise, P. H. (2008). Transforming preconceptional, prenatal, and interconceptional care into a comprehensive commitment to women's health. Women’s Health Issues, 18(Suppl. 6), S13-S18. Retrieved from: http://www.whijournal.com/article/S1049-3867(08)00109-6/fulltext
- Websites with Related Information
- California Dept. of Public Health: Maternal, Child and Adolescent Health Division
- California Maternal Quality Care Collaborative
- California Perinatal Quality Care Collaborative
- CityMatCH, National Organization of Urban Maternal Child Health Leaders
- March of Dimes
- National Institute for Children's Health Quality
- Preterm (Premature) Labor and Birth, American College of Obstetricians and Gynecologists
- Preterm Birth, Centers for Disease Control and Prevention, Division of Reproductive Health
- U.S. Dept. of Health and Human Services: Maternal and Child Health Bureau
- Key Reports and Research
- Health Equity and Birth Outcomes, 2017, March of Dimes
- Infant Mortality Statistics from the 2013 Period Linked Birth/Infant Death Data Set, 2015, National Vital Statistics Reports, Mathews, T. J., et al.
- Maternity Care in California: Delivering the Data, 2016, California Health Care Foundation
- Nonmedically Indicated Early-Term Deliveries, 2017, American College of Obstetricians and Gynecologists, Committee on Obstetric Practice
- Playbook for the Successful Elimination of Early Elective Deliveries, 2015, National Quality Forum
- Policies to Promote Child Health, 2015, The Future of Children
- Premature Birth Report Cards, March of Dimes
- Preterm Birth and Low Birthweight, 2017, Federal Interagency Forum on Child and Family Statistics, America's Children: Key National Indicators of Well-Being
- Preterm Birth Fact Sheet, 2017, World Health Organization
- The Outcomes of Very Preterm Infants: Is It Time to Ask Different Questions?, 2017, Pediatrics, McCormick, M. C., & Litt, J. S.
- Trends in Infant Mortality in the United States, 2005–2014, 2017, National Center for Health Statistics, Mathews, T. J., & Driscoll, A. K.
- Worry About Racial Discrimination: A Missing Piece of the Puzzle of Black-White Disparities in Preterm Birth?, 2017, PLoS ONE, Braveman P., et al.
- County/Regional Reports
- Community Health Assessment and Community Health Improvement Plan, Los Angeles County Dept. of Public Health
- Fresno Community Scorecard
- Full-Term and Normal-Weight Births by Region in Los Angeles County: Recent Progress and Why It Matters, 2017, Children’s Data Network, USC Suzanne Dworak-Peck School of Social Work, McCroskey, J., et al.
- Key Indicators of Health by Service Planning Area, 2017, Los Angeles County Dept. of Public Health
- San Diego County Report Card on Children and Families, 2015, The Children's Initiative & Live Well San Diego
- Santa Monica Youth Wellbeing Report Card, Santa Monica Cradle to Career
- The 23rd Annual Report on the Conditions of Children in Orange County, 2017, Orange County Children's Partnership
- More Data Sources For Low Birthweight and Preterm Births
- 2018 KIDS COUNT Data Book, Annie E. Casey Foundation
- CDC WONDER, Centers for Disease Control and Prevention
- FastStats: Infant Health, National Center for Health Statistics
- Maternal and Child Health Bureau: National Survey Publications and Chartbooks, U.S. Dept. of Health and Human Services
- Maternal and Infant Health Assessment (MIHA), California Dept. of Public Health & University of California, San Francisco
- PeriStats, March of Dimes
- Pregnancy Risk Assessment Monitoring System (PRAMS), Centers for Disease Control and Prevention
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