Low Birth Weight
Infants who weigh less than twenty-five hundred grams (or five pounds, eight ounces) at birth are
FIGURE 5.2 Spina bifida rates and number of live births with spina bifida, 1991–2003
FIGURE 5.2 Spina bifida rates and number of live births with spina bifida, 1991–2003
| FIGURE 5.2 | |||
|---|---|---|---|
| Spina bifida rates and number of live births with spina bifida, 1991–2003 | |||
| Year | Spina bifida cases | Total live births | Rate |
| Note: Excludes data for Maryland, New Mexico, and New York, which did not require reporting for spina bifida for some years. | |||
| SOURCE: Adapted from "Figure 1. Spina Bifida Rates, 1991–2002," and "Table 1. Number of Live Births and Spina Bifida Cases and Rates per 100,000 Live Births for the United States, 1991–2002," Trends in Spina Bifida and Anencephalus in the United States, 1991–2002, Centers for Disease Control and Prevention, National Center for Health Statistics, 2004, http://www.cdc.gov/nchs/products/pubs/pubd/hestats/spine_anen.htm (accessed December 1, 2005). Data for 2003 are unpublished from the National Vital Statistics System, NCHS, CDC, December 1, 2005. | |||
| 2003 | 702 | 3,715,577 | 18.89 |
| 2002 | 734 | 3,645,770 | 20.13 |
| 2001 | 730 | 3,640,555 | 20.05 |
| 2000 | 759 | 3,640,367 | 20.85 |
| 1999 | 732 | 3,533,565 | 20.72 |
| 1998 | 790 | 3,519,240 | 22.45 |
| 1997 | 857 | 3,469,667 | 24.70 |
| 1996 | 917 | 3,478,723 | 26.36 |
| 1995 | 975 | 3,484,539 | 27.98 |
| 1994 | 900 | 3,527,482 | 25.51 |
| 1993 | 896 | 3,562,723 | 25.15 |
| 1992 | 816 | 3,572,890 | 22.84 |
| 1991 | 887 | 3,564,453 | 24.88 |
considered to be of low birth weight. Those born weighing less than fifteen hundred grams (three pounds, four ounces) have very low birth weight. Low birth weight may result from various causes, including premature birth, poor maternal nutrition, teen pregnancy, drug and alcohol use, smoking, or sexually transmitted diseases.
In 2003, 7.9% of the more than four million live births that year were low-birth-weight infants, the highest level reported in more than two decades. About 1.4% were very-low-birth-weight infants. African-American mothers were about twice as likely as white and Hispanic mothers to have low-birth-weight babies (13.6% of children born to non-Hispanic African-American birth mothers had low birth weight compared with 7% and 6.7%, respectively, born to non-Hispanic white and Hispanic mothers). (See Table 5.6 and Table 5.7.) The highest percentages of low-birth weight babies
TABLE 5.5 Estimated prevalence and lifetime economic costs for certain developmental disabilities, by cost category, 2003
| TABLE 5.5 | ||||||
|---|---|---|---|---|---|---|
| Estimated prevalence and lifetime economic costs for certain developmental disabilities, by cost category, 2003 | ||||||
| Developmenta disability | Ratea | Direct medical costsb (millions) | Direct nonmedical costsc (millions) | Indirect costsd (millions) | Total costs (millions) | Average costs per person |
| Note: Lifutime economic costs are present value estimates, in 2003 dollars, of lifetime costs for persons born in 2000, based on a 3% discount rate | ||||||
| aPer 1,000 children aged 5-10 years, on the basis of Metropolitan Atlanta Developmental Disabilities Surveillance Program data for 1991–1994. | ||||||
| bIncludes physician visits, prescription medications, hospital inpatient stays, assistive devices, therapy and rehabilitation (for persons aged <18 years), and long-term care (for persons aged 18-76 years), adjusted for age-specific survival. | ||||||
| cIncludes costs of home and vehicle modifications for persons aged < 76 years and costs of special education for persons aged 3-17 years. | ||||||
| dIncludes productivity losses from increased morbidity (i.e., inability to work or limitation in the amount or type of work performed) and premature mortality for persons aged ≤ 35 years with mental retardation, aged ≤ 25 years with cerebral palsy, and aged ≤ 17 years with hearing loss and vision impairment. | ||||||
| SOURCE: A. Honeycutt, et al., "Table. Estimated Prevalence and Lifetime Economic Costs for Mental Retardation, Cerebral Palsy, Hearing Loss, and Vision Impairment, by Cost Category—United States, 2003," in "Economic Costs Associated with Mental Retardation, Cerebral Palsy, Hearing Loss, and Vision Impairment—United States, 2003," Morbidity & Mortality Weekly Report, vol. 53, no. 3, January 30, 2004, http://www.cdc.gov/mmwr/PDF/wk/mm5303.pdf (accessed December 5, 2005) | ||||||
| Mental retardation | 12.0 | $7,061 | $5,249 | $38,927 | $51,237 | $1,014,000 |
| Cerebral palsy | 3.0 | 1,175 | 1,054 | 9,241 | 11,470 | 921,000 |
| Hearing loss | 1.2 | 132 | 640 | 1,330 | 2,102 | 417,000 |
| Vision impairment | 1.1 | 159 | 409 | 1,915 | 2,484 | 566,000 |
are born to teenage mothers and to women over forty years of age. (See Table 5.7.)
Like the proportion of low-birth-weight babies, the proportion of very-low-birth-weight babies has also been increasing since the 1980s, although rates stabilized from the late 1990s through 2003. (See Table 5.8.) The increase in low- and very-low-birth-weight babies during the 1990s is attributed to the increase in the multiple birth rate. Babies born as part of a multiple birth are at much greater risk of low birth weight than babies born as a single birth.
Prematurity
The usual length of human pregnancy is forty weeks. Infants born before thirty-seven weeks of pregnancy are considered premature. A premature infant does not have fully formed organ systems. If the premature infant is born with a birth weight comparable to a full-term baby and has organ systems only slightly undeveloped, the chances of survival are great. Premature infants of very low birth weight are susceptible to numerous risks and are less likely to survive than full-term infants. If they survive, they may suffer from mental retardation and other abnormalities of the nervous system.
A severe medical condition called hyaline membrane disease, or respiratory distress syndrome (RDS), commonly affects premature infants. It is caused by the inability of the immature lungs to function properly. Occurring right after birth, it may cause infant death within hours. Intensive care includes the use of a mechanical ventilator to facilitate breathing. Also, premature infants' immature gastrointestinal systems preclude them from taking in nourishment properly. Unable to suck and swallow, they must be fed through a stomach tube.
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