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Paul D Sutton

Publications and source records attributed to Paul D Sutton.

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Births: final data for 2004.

OBJECTIVES: This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. RESULTS: In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise. The twinning rate increased, but the rate of triplet and higher order multiple births was down slightly.

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Birth and fertility rates for states by Hispanic origin subgroups: United States, 1990 and 2000.

OBJECTIVES: This report presents U.S. and State-level data on births, birth rates, and fertility rates for Hispanic origin subgroups for 1990 and 2000. Data for non-Hispanic whites and non-Hispanic blacks are provided for comparison. METHODS: Data are presented in detailed tables, graphs, and maps. RESULTS: Between 1990 and 2000, the total U.S. Hispanic population increased 58 percent, from 22,353,999 to 35,305,818. Over the same period of time, births to Hispanic mothers increased 37 percent, from 595,073 to 815,868. The smaller increases in births compared with the population resulted in a falling birth rate among Hispanic mothers (26.7 in 1990 to 23.1 births per 1,000 total population in 2000). Birth and fertility rates for Mexican, Puerto Rican, and Cuban mothers all fell between 1990 and 2000. Among the Hispanic subgroups, fertility rates in 2000 ranged from 105.1 births per 1,000 women aged 15-44 years for Mexican women to 49.3 for Cuban women. Differences in fertility exist not only between Hispanic subgroups but also within groups among States. For example, total fertility rates for Puerto Rican mothers, which estimates the number of children a group of 1,000 women will have in their lifetime, ranged in 2000 from 1,616.5 in New York to 2,403.0 in Pennsylvania.

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Births: preliminary data for 2004.

OBJECTIVES: This report presents preliminary data for 2004 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, tobacco use, prenatal care, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. METHODS: Data in this report are based on 99.1 percent of births for 2004. The records are weighted to independent control counts of all births received in State vital statistics offices in 2004. Comparisons are made with 2003 data. RESULTS: The crude birth rate declined 1 percent to 14.0 births per 1,000 population. The fertility rate, however, rose slightly to 66.3 births per 1,000 women aged 15-44 years. Birth rates for teenagers 15-19 years declined modestly. The rate in 2004 was 41.2 births per 1,000 females aged 15-19 years, 1 percent lower than in 2003. Rates declined 1 percent each for teenagers 15-17 and 18-19 years. The rate for 10-14 year-olds increased slightly. The birth rate for women aged 20-24 years declined 1 percent to 101.8, a record low for the Nation. The rate for women aged 25-29 years remained essentially unchanged at 115.5 per 1,000. The birth rate for women aged 30-34 years rose less than 1 percent to 95.5 per 1,000, whereas the rates for women aged 35-39 and 40-44 years increased 3 to 4 percent each. The rate for women aged 45-49 years rose to 0.6 per 1,000. Childbearing by unmarried women rose to a record high of almost 1.5 million births in 2004, a 4-percent increase from 2003. The proportion of all births to unmarried women increased to 35.7 percent. Smoking during pregnancy declined slightly in 2004, to 10.2 percent of mothers in the 40-State reporting area. There was no improvement in timely receipt of prenatal care. In 2004, 83.9 percent of mothers in the 41-State reporting area began care in the first trimester. A record high cesarean delivery rate was reported in 2004, at 29.1 percent of all births, a 6-percent increase from 2003. The primary cesarean rate rose 8 percent, whereas the rate of vaginal birth after cesarean delivery declined 13 percent. Preterm and LBW rates each increased in 2004. More than 500,000 infants were born preterm, a rate of 12.5 percent. The LBW rate increased to 8.1 percent.

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Births: final data for 2003.

OBJECTIVES: This report presents 2003 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.09 million births that occurred in 2003 are presented. Denominators for population-based rates are derived from the U.S. 2000 census. RESULTS: In 2003 there were 4,089,950 live births reported in the United States, 2 percent more than the number in 2002. The crude birth rate (CBR) and general fertility rate (GFR) rose slightly. Childbearing among teenagers declined for the 12th straight year to another historic low. Birth rates for women aged 20-24 years also declined, whereas rates for women aged 25-44 years increased 2-6 percent, reaching highs not reported since the mid- to late 1960s. All measures of unmarried childbearing increased considerably in 2003, but smoking during pregnancy continued to decline. Timely initiation of prenatal care improved slightly. The cesarean delivery rate jumped another 5 percent to another all-time high, and the rate of vaginal birth after previous cesarean dropped 16 percent, an all-time low. Key measures of birth outcome-the percentages of preterm and low birthweight (LBW) births-rose. The twinning rate increased, but the rate of triplet and higher order multiple births was essentially stable.

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Births: preliminary data for 2003.

OBJECTIVES: This report presents preliminary data for 2003 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, tobacco use, prenatal care, cesarean delivery, preterm births, and low birthweight are also presented. METHODS: Data in this report are based on nearly 99 percent of births for 2003. The records are weighted to independent control counts of all births received in State vital statistics offices in 2003. Comparisons are made with 2002 final data. RESULTS: The crude birth rate rose to 14.1 births per 1000 population in 2003, an increase of 1 percent from 2002 (13.9). The fertility rate also rose in 2003 by 2 percent to 66.1 births per 1000 women aged 15-44 years. Since 1994, the rate has ranged from 63.6 to 66.1. The birth rate for teenagers continued to decline in 2003 to 41.7 births per 1000 women aged 15-19 years, 3 percent lower than in 2002. Rates fell for teenagers in all race and Hispanic origin groups, in many cases marking new record lows for the Nation. Birth rates for teenagers 15-17 and 18-19 years continued to steadily decline. The rate for ages 15-17 was 22.4 per 1000 in 2003, down 3 percent from 2002 and 42 percent from 1991, the recent peak. The rate for older teenagers 18-19 years in 2003 was 70.8 per 1000, also 3 percent lower than in 2002 and 25 percent lower than in 1991. The birth rates for women in their twenties were 102.6 per 1000 for women aged 20-24 years and 115.7 for women aged 25-29 years, a decrease of 1 percent and an increase of 2 percent, respectively, compared with 2002. The birth rate for women aged 30-34 years increased 4 percent to 95.2 births per 1000 women compared with 2002. The rate rose 6 percent for women aged 35-39 years, between 2002 and 2003, and 5 percent for women aged 40-44 years. The rate for women aged 45-49 years remained unchanged. The birth rate for unmarried women increased by 3 percent in 2003, from 43.7 to 44.9 per 1000 unmarried women aged 15-44 years. The proportion of births to unmarried women also increased in 2003 to 34.6 percent, compared with 34.0 percent in 2002. The proportion of mothers smoking during pregnancy continued to steadily decline in 2003, from 11.4 percent in 2002 to 11.0 percent. The percent of women who received prenatal care within the first 3 months of pregnancy edged upward for 2003, to 84.1 percent, compared with 83.7 percent in 2002. In 2003, 27.6 percent of all births were delivered by cesarean delivery, a marked rise of 6 percent over the 2002 level, and one-third higher than that for 1996. The primary cesarean rate also rose 6 percent between 2002 and 2003 while the rate of vaginal birth after previous cesarean (VBAC) dropped by 16 percent. Preterm and low birthweight rates both rose between 2002 and 2003. The preterm rate increased from 12.1 to 12.3 and low birthweight rate rose from 7.8 to 7.9 percent.

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Trends in characteristics of births by State: United States, 1990, 1995, and 2000-2002.

OBJECTIVE: This report presents U.S. and State-level data on births, birth rates, fertility rates, sex ratio, marital status, and educational attainment by race and Hispanic origin for 1990, 1995, and 2000-2002. METHODS: Data are presented in detailed tables, summary tables, maps, and graphs. RESULTS: In 2002 there were 4,021,726 live births in the United States, 136,486 fewer than in 1990. Despite a slight decline in the number of births nationwide, a few States witnessed significant increases in the number of live births with most of these States located in the western United States. Some of the westward shift in number of births is attributable to a growing population and some to the age and race composition of the individual States. However, real differences in fertility by State persist even when the effects of age structure and race and ethnic composition of the States' population are taken into account. This report also presents data on sex ratios, percentage unmarried, and educational attainment of mothers. Several observations from these data are noteworthy. The proportion of births to unmarried mothers increased nationally and in every State between 1990 and 2002. Nationally the percentage of mothers with fewer than 12 years of education fell, and the percentage with 16 or more years increased for all racial and ethnic groups. However, at the State level, the percentage of women with fewer than 12 years of education increased for nearly a quarter of the States, despite near universal increases in the percentage of women with 16 or more years of education.

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Births: final data for 2002.

OBJECTIVES: This report presents 2002 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.022 million births that occurred in 2002 are presented. Denominators for population-based rates are derived from the 2000 U.S. census. Rates for 1991-2001 may differ from those published previously based on the 1990 U.S. census. RESULTS: There were 4,021,726 live births in 2002, essentially unchanged from 2001. The birth rate, fertility rate, and total fertility rates all declined 1 percent in 2002. The teenage birth rate dropped 5 percent, reaching another record low. The birth rates for women 20-24 years declined, whereas the rate for women 25-29 years was stable. The birth rate for women 30-34 years declined, but the rate for women 35-44 years continued to rise. Births to unmarried women changed very little. Smoking during pregnancy was down again. The timeliness of prenatal care continued to improve. The cesarean delivery rate climbed to the highest level ever reported in the United States (26.1 percent) and the rate of vaginal birth after previous cesarean plummeted 23 percent to 12.6 percent. Preterm and low birthweight levels both rose for 2002. The twin birth rate continued to climb, but the rate of triplet/+ births was down slightly.

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Revised birth and fertility rates for the 1990s and new rates for Hispanic populations, 2000 and 2001: United States.

OBJECTIVES: This report presents revised birth and fertility rates for 1991-99, as well as previously published revised rates for 2000-2001, based on populations consistent with the April 1, 2000, census. Revised rates for Hispanic subgroups (Mexican, Cuban, Puerto Rican, and other Hispanic) are also included in this report. Rates are presented by age, race, and Hispanic origin of mother; by age, race, Hispanic origin, and marital status of mother; by age and race of father; and by age of mother and by State. This report also presents new rates by age and Hispanic origin (subgroups) of mother for 2000 and 2001. The revised rates are compared with previously published rates that used July 1 population estimates based on the 1990 census. METHODS: Populations for most rates were produced for the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) under a collaborative arrangement with the U.S. Census Bureau. Populations for teenage subgroups 15-17 and 18-19 years by race and Hispanic subgroups were produced by NCHS. The populations reflect the results of the 2000 census. This census allowed people to report more than one race for themselves and their household members, and also separated the category for Asian or Pacific Islander persons into two groups (Asian and Native Hawaiian or Other Pacific Islander). These changes reflected the Office of Management and Budget's (OMB) 1997 revisions to the standards for the classification of Federal data on race and ethnicity. Because only one race is currently reported in birth certificate data, the 2000 census populations were "bridged" to the single race categories specified in OMB's 1977 guidelines for race and ethnic statistics in Federal reporting, which are still in use in the collection of vital statistics data. RESULTS: Revised population-based birth and fertility rates from 1991 to 1999, based on the 2000 census, are with few exceptions lower than the rates previously published based on populations projected from the 1990 census. As expected, the differences in rates for American Indians, Hispanics, and Asian or Pacific Islanders were considerable. However, revised rates for most other population subgroups (i.e., non-Hispanic whites and blacks) differed little from those previously published. Regardless of the magnitude, the differences between the 2000-based and 1990-based rates progressively diverged through time so that previously published trends were generally retained but lower. Because of this shift, especially for Hispanic women, the differentials in fertility among population subgroups remain, but were somewhat reduced.

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Births: preliminary data for 2002.

OBJECTIVES: This report presents preliminary data for 2002 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, prenatal care, cesarean delivery, preterm births, and low birthweight are also presented. METHODS: Data in this report are based on nearly 98 percent of births for 2002. The records are weighted to independent control counts of all births received in State vital statistics offices in 2002. Comparisons are made with 2001 final data. RESULTS: The crude birth rate was 13.9 per 1,000 population in 2002, a decrease of 1 percent from 2001 (14.1). This is the lowest birth rate reported for the United States since national data have been available. The fertility rate was also down 1 percent in 2002 to 64.8 births per 1,000 women aged 15-44 years. Since 1990, this rate has declined 9 percent. The birth rate for teenagers continued to decline in 2002, dropping 5 percent to 42.9 births per 1,000 women aged 15-19 years. The teenage birth rate has dropped 28 percent since 1990. The rate for younger teenagers 15-17 years fell 6 percent from 24.7 per 1,000 in 2001 to 23.2 in 2002. The rate for older teenagers 18-19 years declined 4 percent from 76.1 per 1,000 in 2001 to 72.7 in 2002. Since 1990, the rate for teenagers 15-17 years has fallen 38 percent and the rate for teenagers 18-19 years, 18 percent. The birth rate for women aged 20-24 years declined by 3 percent to 103.5 per 1,000 in 2002 compared with 2001, whereas the rate for women aged 25-29 years was essentially unchanged (113.6). The birth rate for women aged 30-34 years decreased slightly from 91.9 per 1,000 in 2001 to 91.6 in 2002. Birth rates for women aged 35-39 years and 40-44 years continued to rise, increasing 2 percent for both. Childbearing among women over 45 years of age was unchanged. The birth rate for unmarried women was down slightly in 2002 to 43.6 births per 1,000 unmarried women aged 15-44 years. The number of births to unmarried women increased by 1 percent in 2002; however births to unmarried teenagers declined by 4 percent. Prenatal care utilization continued to slowly but steadily improve; 83.8 percent of women began prenatal care in the first trimester of pregnancy in 2002 compared with 83.4 in 2001. More than one fourth of all births (26.1 percent) were cesarean deliveries in 2002, the highest rate ever reported in the United States; the primary cesarean rate jumped 7 percent to 18 percent and the rate of vaginal births after previous cesarean delivery plummeted 23 percent to 12.7 percent (figure 1). Preterm (12.0 percent) and low birthweight (7.8 percent) rates were up slightly for 2002. The low birthweight rate is the highest reported in more than three decades.

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Revised birth and fertility rates for the United States, 2000 and 2001.

OBJECTIVES: This report presents revised birth and fertility rates for 2000 and 2001, based on populations consistent with the April 1, 2000, census. Rates are presented by age, race, and Hispanic origin of mother; by age, race, and Hispanic origin of mother for unmarried women; and by age and race of father. To put the rates for 2000 and 2001 into context, rates are also shown for 1990. METHODS: Populations were produced for the Centers for Disease Control and Prevention's National Center for Health Statistics under a collaborative arrangement with the U.S. Census Bureau. The populations reflect the results of the 2000 census. This census allowed people to report more than one race for themselves and their household members, and also separated the category for Asian or Pacific Islander persons into two groups (Asian; Native Hawaiian or Other Pacific Islander). These changes reflected the Office of Management and Budgets 1997 revisions to the standards for the classification of Federal data on race and ethnicity. Because only one race is currently reported in birth certificate data, the 2000 census populations were "bridged" to the single race categories specified in the Office of Management and Budget's 1977 guidelines for race and ethnic statistics in Federal reporting, which are still in use in the collection of vital statistics data. RESULTS: Population-based birth and fertility rates for 2000 and 2001, based on the 2000 census, are somewhat lower for Hispanics (11 percent for the fertility rate in 2001) and Asian or Pacific Islanders (7 percent) and considerably lower for American Indians (18 percent) than the rates previously published based on populations projected from the 1990 census. Rates for most other population subgroups differ little from those previously published. Because of these patterns, the differentials in fertility among population subgroups remain, but are somewhat reduced. Between 1990 and 2001, teenage birth rates declined, rates for women in their twenties changed little, and rates for women in their thirties and forties rose.

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Births: final data for 2001.

OBJECTIVES: This report presents 2001 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.026 million births that occurred in 2001 are presented. Denominators for population-based rates are derived from the 1990 U.S. census. As a result, rates are generally larger than would be the case if 2000-based estimates were used. The magnitude of the overestimate will vary by population subgroup; overestimates are likely greatest for those of Hispanic origin. RESULTS: The number of births, the birth rate, fertility rate, and total fertility rates all declined 1 percent in 2001. The teenage birth rate reached another historic low. Birth rates for women in their twenties declined slightly, whereas rates for women aged 30 to 44 years continued to rise. Births to unmarried women changed very little. Smoking by pregnant women was down again. Women were more likely to begin care in the first trimester of pregnancy (83.4 percent). The cesarean delivery rate rose for the fifth consecutive year to 24.4 percent; the primary cesarean rate was up 5 percent and the rate of vaginal births after a previous cesarean fell 20 percent. Preterm and low birthweight levels both rose for 2001. The twin birth rate continued to climb, and following 2 years of decline, the rate of triplet/+ births also increased.

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Births: preliminary data for 2001.

OBJECTIVES: This report presents preliminary data for 2001 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. METHODS: Data in this report are based on more than 96 percent of births for 2001. The records are weighted to independent control counts of all births received in State vital statistics offices in 2001. Comparisons are made with 2000 final data. RESULTS: The number of births, the crude birth rate, and the fertility rate all declined slightly between 2000 and 2001. The number of births was down by less than 1 percent, the crude birth rate declined 1 percent to 14.5 per 1,000 population, and the fertility rate was down slightly to 67.2 births per 1,000 women aged 15-44 years. Teenagers were less likely to give birth in 2001; the teen birth rate continued to fall, dropping 5 percent between 2000 and 2001 to 45.9 births per 1,000 females aged 15-19 years, another record low. The teen birth rate has fallen 26 percent since 1991. The birth rate for teenagers 15-17 years fell 8 percent, and the rate for teenagers 18-19 years was down 4 percent for 2000-2001. Since 1991 rates have fallen 35 percent for teenagers 15-17 years, and 20 percent for teenagers 18-19 years. Birth rates for women aged 20-24 declined by 2 percent, whereas rates for women 25-44 years increased. Childbearing among women aged 40-54 years was stable. The birth rate for unmarried women decreased modestly to 44.9 births per 1,000 unmarried women 15-44 years in 2001, still remaining below the peak reached in 1994. The number of births to unmarried women was up very slightly, but births to unmarried teens were down. The proportion of women who began prenatal care in the first trimester of pregnancy improved slightly to 83.4 percent, but the rate of low birthweight held at 7.6 percent. The total cesarean delivery rate jumped 7 percent between 2000 and 2001 to 24.4 percent of all births, the highest level ever reported from this data source; the primary rate of cesarean deliveries rose 5 percent, and the rate of vaginal births after previous cesarean delivery tumbled 20 percent.

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