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BIRTHS

In 1998, 6,569 babies were born to Vermont residents. This represents a decrease of 33 births from 1997. The number of babies born to Vermont residents has declined every year since 1989. The crude birth rate in 1998 was 11.1 per 1,000 Vermont residents, compared to 11.2 in 1997 and 11.5 in 1996. The preliminary U.S. white birthrate was 14.0 in 1998. Comparisons are made to the U.S. white rate because 96.8 percent of Vermont resident births were to white mothers in 1998. The Vermont birth rate peaked in 1955 at 24 per 1,000 residents, then dropped for two decades, remained relatively stable from the late 1970's through the 1980's, and has been slowly and steadily decreasing since 1989.

FERTILITY

Although the crude birth rate reflects the relationship between the total resident live births and the total resident population, a more exact method for measuring changing birth patterns is the fertility rate which relates the number of live births to the population of women ages 15 through 44. The birth rate and the fertility rate are both based on the number of live births.

The 1998 Vermont fertility rate was 48.9 per 1,000 women ages 15 through 44, down from 49.5 in 1997. The 1998 rate is the lowest ever recorded in Vermont. The preliminary U.S. white fertility rate was 64.7 in 1998. The fertility rate in Vermont peaked in 1960 at 126, declined through the 1960's and 1970's, leveled off slightly in the 1980's and has declined through the 1990's. In recent years, the age-specific fertility rates have declined in the youngest age group, and fluctuated in the other age groups.

FIGURE 5

AGE-SPECIFIC FERTILITY RATES, SELECTED YEARS 1980-1998

AGES/ YEAR

1980

1990

1997

1998

TOTAL

63.3

60.5

49.5

48.9

15 - 19

38.5

34.1

26.9

24.4

20 - 24

102.4

93.9

86.1

85.1

25 - 29

113.0

114.6

86.2

88.3

30 - 34

60.2

79.5

76.0

77.0

35 - 44

12.5

19.6

19.7

19.1

Slightly more than half of all births (51.1%) in 1998 were to women in their twenties, down from 66.2 percent in 1980. Women age 30 and over accounted for 41.0 percent of births, up from 21 percent in 1980. Women age 15 through 19 accounted for 7.8 percent of births, down from 12.7 percent in 1980.

BIRTH WEIGHT

A subgroup of major importance are low birth weight babies, those weighing less than 2,500 grams (5 pounds 8 ounces) at birth. These infants are more likely to die in the first month of life and are at significantly greater risk of growth problems and developmental delays.

In 1998, 6.6 percent of Vermont resident births were low birth weight and 1.4 percent were very low birth weight (less than 1,500 grams or 3 pounds 5 ounces). The preliminary U.S. white low birth weight rate for 1998 was 6.5 percent. In Vermont in 1998, low birth weight babies comprised 9.4 percent of births to women under age 20, compared to 6.6 percent of births to women age 20-29 and 6.1 percent of births to women age 30 or greater. The Vermont low birth weight rate remains well above the Healthy Vermonters 2000 goal of 5.0 percent.

PRENATAL CARE

In 1998, 87.3 percent of the babies were born to mothers who began prenatal care in the first three months of pregnancy. The percentage of women receiving first trimester prenatal care has been increasing, slowly but steadily since 1987. Preliminary data for 1998 show that 84.8 percent of U.S. white births were to women who began prenatal care in the first trimester.

The proportion of births in 1998 to Vermont mothers who delayed care to the third trimester or received no prenatal care was 2.0 percent, the same as in 1997. The preliminary proportion of women receiving late or no prenatal care in 1998 was 3.3 percent for U.S. white mothers. As in previous years, the age of the mother is closely associated with the time of entry to prenatal care with young women seeking care later than older women.

RISK FACTORS

Smoking during pregnancy was reported in 17.9 percent of all births, and for 29.3 percent of the low birth weight babies. Alcohol use during pregnancy was reported by .9 percent of women. (Since smoking and alcohol use during pregnancy are not always reported, these underestimate smoking and alcohol use. It should also be noted that there may be inconsistencies in reporting among hospitals.)

Of the births in 1998, 75.3 percent of mothers had no reported medical risk factors for pregnancy. Of those with medical risk factors reported, the most common were pregnancy-associated hypertension, diabetes, previous preterm or small-for-gestational-age infant, anemia, uterine bleeding, and acute or chronic lung disease. In 1998, 62.7 percent of births had no complications of labor and/or delivery reported. Of those with complications, the most common complications of labor and/or delivery were meconium, dysfunctional labor, prolonged labor, fetal distress, and premature rupture of membrane.

DELIVERIES

Of babies born in Vermont hospitals in 1998, 17.3 percent were delivered by cesarean section compared to a preliminary cesarean section rate of 21.0 percent for U.S. white women in 1998. The primary cesarean section rate was 13.1 percent in Vermont for 1998, compared to 14.5 percent for white mothers nationally in 1997. Of mothers delivering in Vermont hospitals in 1998 who had a previous delivery by cesarean section, 39.1 percent had vaginal births, compared to 27.4 percent for white mothers nationally in 1997.

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