Decline in Perinatal Mortality in the United States, 2017–2019

2022 ◽  
Author(s):  
Claudia Valenzuela ◽  
Elizabeth Gregory ◽  
Joyce Martin
Keyword(s):  
United States ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
The United States ◽  
Mortality Trends ◽  
Early Neonatal Mortality ◽  
Hispanic Origin ◽  
Mother’S Age

This report presents trends in perinatal mortality, as well as its components, late fetal and early neonatal mortality, for 2017 through 2019. Also shown are perinatal mortality trends by mother’s age, race and Hispanic origin, and state for 2017–2019.

scholarly journals NVSR 70-6. Declines in Infant Mortality in Appalachia and the Delta, 1995-1996 and 2017-2018

2021 ◽  
Author(s):  
Anne Driscoll ◽  
Danielle Ely
Keyword(s):  
United States ◽  
Infant Mortality ◽  
The United States ◽  
Mortality Trends

This report examines infant mortality trends in each region, Appalachia, the Delta, and the rest of the United States, and compares the pattern and magnitude of change between both Appalachia and the Delta with the rest of the United States.

The Value of Postponing Pregnancy: California’s Paid Family Leave and the Timing of Pregnancies

2014 ◽  
Vol 14 (4) ◽  
pp. 1467-1499 ◽  
Author(s):  
Shirlee Lichtman-Sadot
Keyword(s):  
United States ◽  
Parental Leave ◽  
The United States ◽  
Family Status ◽  
Hispanic Origin ◽  
Monetary Benefit ◽  
Education Levels ◽  
Lower Education ◽  
Paid Parental Leave ◽  
Shed Light

Abstract Conditioning a monetary benefit on individuals’ family status can create distortions, even in individuals’ seemingly personal decisions, such as the birth of a child. Birth timing and its response to various policies has been studied by economists in several papers. However, pregnancy timing – i.e. the timing of conception – and its response to policy announcements has not been examined. This paper makes use of a 21-month lag between announcing California’s introduction of the first paid parental leave program in the United States and its scheduled implementation to evaluate whether women timed their pregnancies in order to be eligible for the expected benefit. Using natality data, documenting all births in the United States, a difference-in-differences approach compares California births to births in states outside of California before the program’s introduction and in 2004, the year California introduced paid parental leave. The results show that the distribution of California births in 2004 significantly shifted from the first half of the year to the second half of the year, immediately after the program’s implementation. While the effect is present for all population segments of new mothers, it is largest for disadvantaged mothers – with lower education levels, of Hispanic origin, younger, and not married. These results shed light on the population segments most affected by the introduction of paid parental leave and on the equitable nature of paid parental leave policies.

Perinatal Mortality in First- and Second-Born Twins in the United States

2004 ◽  
Vol 103 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Wendy Sheay ◽  
Cande V. Ananth ◽  
Wendy L. Kinzler
Keyword(s):  
United States ◽  
Perinatal Mortality ◽  
The United States

P–776 Singleton pregnancies conceived with infertility treatments and the risk of
neonatal and infant mortality

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Farley ◽  
M Sauer ◽  
J Brandt ◽  
C Ananth
Keyword(s):  
United States ◽  
Neonatal Mortality ◽  
Preterm Delivery ◽  
The United States ◽  
Infertility Treatment ◽  
Exposure Misclassification ◽  
Unmeasured Confounding ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Singleton Live Birth

Abstract Study question Is maternal infertility treatment associated with an increased risk of neonatal and infant mortality when compared to natural conception? Summary answer Infertility treatment is associated with a 70% increased adjusted risk of neonatal mortality. This association is strongly mediated by preterm delivery. What is known already The number of assisted reproduction technology (ART) cycles performed in the United States (US) increased by 39% from 142,435 cycles in 2007 to 197,737 in 2016. Within this growing experience, several studies described an increased risk of preterm delivery, low birth weight, congenital malformations, neonatal intensive care unit admission, stillbirth, and perinatal mortality among singletons conceived through ART compared to those conceived naturally. Experts have called for ART patients to be advised of potential increased risk for adverse perinatal outcomes and for obstetricians to manage these pregnancies as high risk. Study design, size, duration This is a cross-sectional study of 11,289,466 pregnancies in the United States (US) from 2015–2017 that resulted in a non-malformed singleton live birth. The exposure group includes births resulting from any infertility treatment method, including ART and fertility-enhancing drugs. The control group includes births resulting from natural conceptions. The primary outcomes measured were neonatal (within 1 month), post-neonatal (1 month to a year), and infant (up to 1 year) mortality. Participants/materials, setting, methods Pregnancies (n = 11,289,466) resulting in a non-malformed singleton live birth in the US from 2015–2017. Associations were estimated from log-linear Poisson regression models with robust variance. Risk ratio (RR) and 95% confidence interval (CI) were derived as the effect measure with adjustments for confounders. The impact of exposure misclassification and unmeasured confounding biases were assessed. A causal mediation analysis of the infertility treatment-mortality association with preterm delivery (<37 weeks) was performed. Main results and the role of chance Any infertility treatment was documented in 1.3% (n = 142,215) of singleton live births during the study period. Any infertility treatment was associated with a 70% increased adjusted risk of neonatal mortality (RR 1.70, 95% CI 1.54–1.88), with an even higher risk for early neonatal (RR 1.82, 95% CI 1.63–2.05) than late neonatal (RR 1.37, 95% CI 1.11–1.69) mortality. These risks were similar among pregnancies conceived through ART and treatment with fertility-enhancing drugs. The mediation analysis showed that 68% (95% CI 59–81) of the total effect of infertility treatment on neonatal mortality was mediated through preterm delivery. In a sensitivity analysis, following corrections for exposure misclassification and unmeasured confounding biases, these risks were higher for early neonatal (bias-corrected RR [RRbc] 2.94 95% CIbc 2.16–4.01), but not for late neonatal (RRbc 1.04, 95% CIbc 0.68–1.59) mortality. Limitations, reasons for caution Limitations of the study include the potential underreporting of infertility treatment on birth certificates and potential confounding from sociodemographic characteristics that were not accounted for in this study. Wider implications of the findings: Pregnancies conceived with infertility treatment are associated with increased neonatal mortality and this association is mediated by the increased risk of preterm delivery. Knowledge of this risk should be shared with prospective couples consulting for fertility care in order to best provide adequate informed consent. Trial registration number Not applicable

Abstract MP38: Intracerebral Hemorrhage Across the United States: Incidence and Mortality Trends From 1990 to 2017

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Augustin DeLago ◽  
Harpreet Singh ◽  
Arashdeep Rupal ◽  
Chinmay Jani ◽  
Arshi Parvez ◽  
...  
Keyword(s):  
United States ◽  
Intracerebral Hemorrhage ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
The United States ◽  
Mortality Trends ◽  
Reversal Agents ◽  
Incidence And Mortality ◽  
The Us

Background: Intracerebral Hemorrhage (ICH) accounts for 10% of strokes annually in the United States (US). Up-to-date trends in disease burden and regional variation remain unknown; especially after a dramatic increase in the use of direct oral anticoagulants (DOACs) since 2010. Our study reports updated incidence, mortality and mortality to incidence ratio (MIR) data related to ICH across the US. Methods: This observational study utilized the Global Burden of Disease database to determine age-standardized incidence (ASIR), death (ASDR) and MIR rates for ICH overall and for each state in the US from 1990-2017. All analyses were stratified by sex. Trends were analyzed using Joinpoint regression analysis, with presentation of estimated annual percentage changes (EAPCs) in ASIRs, ASDRs and MIRs over the observation period. Results: We observed an overall decrease in ASIRs, ASDRs and MIRs in both genders from 1990-2017, apart from female ASIRs and ASDRs in West Virginia and Kentucky. In 2017, the mean ASIR per 100,000 population for men was 25.67 and 19.17 for women. The 2017 mean ASDRs per 100,000 population for men and women were 13.96 and 11.35, respectively. The District of Columbia had the greatest decreases in ASIR EAPCs for males at -41.25% and females at -40.58%, and the greatest decreases in ASDR EAPCs for both males and females at -55.38% and -48.51%, respectively. The overall MIR during the study period decreased in males by -12.12% and females by -7.43%. However, MIR increased in males from 2014-2017 (EAPC +2.2% [95% CI +0.9%-+3.5%]) and in females from 2011-2017 (EAPC +1.0% [CI +0.7%-+1.4%]). Conclusion: This report reveals overall decreasing trends in incidence, mortality and MIR from 1990-2017. Notably, no significant change in mortality was found in the last 6 years of the study period, and MIR worsened in males from 2014-2017 and in females from 2011-2017, suggesting decreased ICH related survival lately. The substitution of vitamin K antagonists with DOACs is one possible explanation for a downtrend in incidence despite an aging population and increased use of anticoagulants. Limited access to reversal agents for DOACs is a potential reason for increase in MIR, however concrete deductions cannot be made owing to the observational nature of the study.

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