Births: Preliminary Data for 2009 - CDC report

Births: Preliminary Data for 2009 

by Brady E. Hamilton, Ph.D.; Joyce A. Martin, M.P.H.; and Stephanie J. Ventura, M.A.; 

Division of Vital Statistic

Births: Preliminary Data for 2009 

Brady E. Hamilton, Ph.D.; Joyce A. Martin, M.P.H.; and Stephanie J. Ventura, M.A.; 

Division of Vital Statistics

Abstract

Objectives—This report presents preliminary data for 2009 on births in the United States.  

U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother.  Data on marital status, cesarean delivery, preterm births, and low birthweight are also presented. 

Methods—Data in this report are based on 99.95 percent of births for 2009.  The records are weighted to independent control counts of all births received in state vital statistics offices in 2009.  Comparisons are made with final 2008 data.

Results— The 2009 preliminary number of  US births declined 3 percent from 2008,  to 4,131,019; the 2009 general fertility rate  (66.7 per 1,000 women) and  the  total fertility rate ( 2,007.5 births per 1,000)   declined (3-4 percent).  The number of births  and rates declined for all race and Hispanic origin groups in 2009. 

• The birth rate for US teenagers 15-19 fell 6 percent to 39.1 per 1,000, a  record low for the Nation. 

•  Birth rates for younger and older teenagers and for Hispanic, non-Hispanic white, non-Hispanic black, American Indian or Alaska Native, and Asian or Pacific Islander teenagers all reached historic lows in 2009. 

• The birth rates for women in their early twenties fell (7 percent, the largest percentage decline for this age group since 1973) as did the rates for women in their late twenties and thirties; the birth rate for women in their early forties increased in 2009. 

• The birth rate for unmarried women declined almost 4 percent to 50.6 per 1,000 aged 15-44. The number of nonmarital births fell 2 percent to 1,693,850 in 2009, the first decline since 1996 -1997. 

• The percentage of  births to unmarried women, however, continued to increase in 2009. 

• The cesarean delivery rate rose to 32.9 percent in 2009, another record high. 

• The preterm birth rate declined for the third straight year to 12.18 percent of all births. 

• The low birth weight rate was essentially unchanged between 2008 and 2009 at 8.16 percent in 2009, but is down from 2006. 

Introduction

This report from the Centers for Disease Control and  Prevention’s National Center for Health Statistics (NCHS) presents preliminary data on births and birth rates and selected maternal and infant health characteristics for the United States in 2009.  The findings are based on 99.95 percent of registered vital records occurring in calendar year 2009, which were received and processed by NCHS as of October 14, 2010.  Trends in the preliminary reports for 1995 -2008  births were confirmed by the final vital statistics for each year [1,2].  Comparisons are based on the final data for 2008 and earlier years [2].

State-specific detailed tables for 2009 births, based on preliminary data —  showing the 

percentages of  births to women under age 20 years, to unmarried women, delivered by cesarean, born preterm, and low birthweight — are available on the NCHS website (see internet tables I-1-I-5). 

Keywords: births ? birth rates ? maternal and infant health ? vital statistics

Results

Births and birth rates

Key findings are listed below and presented in Tables 1-7 and Figures 1-3: 

• The  2009  preliminary estimate of registered births for the United States was 4,131,019, 3  percent less than  2008 (4,247,694)  (Tables 1-3  and Figure  1)  [2].  

Births declined for all race and Hispanic origin groups, down 4 percent for Hispanic women, 2 percent for non-Hispanic white, non-Hispanic black and American Indian or Alaska Native (AIAN) women, and 1 percent for Asian or  Pacific Islander (API) women.  Early birth counts through June 2010 suggest continued decline [3].     

• The  2009  preliminary  crude birth rate (CBR) was  13.5  births per 1,000 total population, 4 percent below the rate in 2008 (14.0), and the lowest rate ever recorded for the United States (Table 1) [4].  The 2009 general fertility rate (GFR) was 66.7 births per 1,000 women age 15-44 years, a 3 percent decline from the rate in 2008 (68.6) (Table 1, 2 and 3 and Figure 1) and reversing the increases from 2006 to 2008 [2].  The rates declined for all race and Hispanic origin groups, down 2-3 percent for non-Hispanic white, no n-Hispanic black, and AIAN women, 4 percent for  API women, and 6 percent for Hispanic women.  Rates based on early birth counts through June 2010 suggest continued decline [3].  

• The  birth rate for U.S. teenagers fell 6 percent in 2009  according to preliminary data, the lowest level ever recorded in nearly seven decades of tracking teenage childbearing (since 1940) [2,4].  The number of births to teenagers under age 20 also fell 6 percent (Table 2).

• The rate in 2009 was 39.1 births per 1,000 teenagers 15-19 years, down from 41.5 in 2008  and 8 percent lower than in 2007  (42.5) ( see Tables  2-5 and Figures 2  and 3).   The 2007-2009 decline reverses two consecutive years of increase ( 2005-2007) that interrupted the 34 -precent decline extending from the peak in 1991 to 2005  [2,4].  The rate for 2009 was 37 percent lower than in 1991 (61.8 per 1,000).   

• Rates declined for all age groups under 20 years.   The rate for the youngest teenagers, 10 -14 years, fell from 0.6 to 0.5 per 1,000, the lowest level ever reported.

• The birth rate for teenagers 15-17 years declined 7 percent to 20.1 per 1,000. 

This rate dropped 9 percent from 2007 ( 22.1) to 2009, and was 48 percent lower than the rate reported in 1991 (38.6 per 1,000).  

• The birth rate for older teenagers dropped 6 percent in 2009, to 66.2 per 1,000 aged 18-19 years.  The rate fell 10 percent from 2007 to 2009.  The 2009 rate  was 30 percent lower than in 1991 (94.0 per 1,000). 

• Rates fell significantly for all race and Hispanic origin groups between 2008 and 2009, with declines ranging from 4 to 6 percent (for non-Hispanic white, non-Hispanic black, and AIAN teenagers).   The rate for Hispanic teenagers aged 15 -19 fell 10 percent in 2009 to 70.1 births per 1,000, the lowest rate ever reported for this group in the two decades for which rates for Hispanic teenagers are available.  The rate for API teenagers dropped 10 percent. Rates for all groups reached historic lows [2]. 

• Teenage birth rates by state a re not  yet available for 2009 from the preliminary file.  Recently published  teen  birth rates by state for 2008, moreover, indicated declines were widespread geographically [5].

• The  birth rate for women aged 2 0–24 years declined 7 percent in 2009, to 96.3 births per 1,000 women from 103.0 in 2008 (Tables 2-4 and Figure 3), the largest decline in this rate since 1973 [4].  The number of births to women in this group also declined in 2009  (4 percent) (Tables 2-4).   The rate for women aged 25–29 years declined in 2009 as well, down 4 percent to 110.5 births per 1,000 women from 115.1 in 2008.  The number of births to women aged 25–29 years decreased by 2 percent in 2009. 

• The birth rate for women aged 30–34 years declined 2 percent in 2009 to 97.7 births per 1,000 women from 99.3 in 2008 (Figure 3).   The  number of births to women in this age group declined slightly in 2009.  The rate for women aged 35-39 years also declined in 2009, down 1 percent  to 46.6 births per 1,000, from 46.9  in 2008.  This  marks a  two year decline in the rate for this group which had been increasing since  1978 [2,4].   The  number of births to women aged 35-39 years decreased 3 percent in 2009. 

• The birth rate for women aged 40–44 years rose in 2009, the only age group to do so, up 3 percent from 9.8 births per 1,000 women in 2008 to 10.1, the highest rate since 196 7 (10.6) [2,4].  The  rate for women aged 45 –49 years (which includes births to women aged 5 0 years and over) was unchanged in 2009 at 0.7 births per 1,000 women (Tables 2-4).  The number of  births to women  aged 4 0-44 years decreased slightly in 2009 whereas births to women aged 50 years and over increased by 4 percent. 

• The 2009 preliminary total fertility rate (TFR) was 2,007.5 births per 1,000 women, 4 percent below the rate in 2008 (2,084.5) (Table 1).  This is the largest decline in the rate since 1973.  The TFR estimates the number of births that a hypothetical group of 1,000 women would have over their lifetimes, based on the age-specific birth rates in a given year.

• The TFR for the United States was below replacement for the second year in 2009, after being above in 2006 and 2007.  Replacement is the rate at which a given generation can exactly replace itself, generally considered to be  2,100 births per 1,000 women.  The rate was below replacement from 1972 to 2005. 

• The total fertility rate declined for all race and Hispanic origin groups in 2009, down 3-4 percent for non-Hispanic white, non-Hispanic back and A IAN women, 5 percent for API women, and 6 percent for Hispanic women.    

• The 2009 preliminary first birth rate was 27.0  births per 1,000 women age 15 -44 years, 3 percent below the rate in 2008 (27.7) (Table 4) [2].  First-birth rates declined for women aged 10-34 years (decreases ranging from 1 to 6 percent for women aged 15-34 years) and were unchanged for women aged 35-49 years.  Second-, third-, and fourth and higher-order birth rates for women aged 15-44 years also declined in 2009. 

• Preliminary 2009  General fertility rates  (GFR) for states decreased for 4 0 states and Puerto Rico an d were essentially unchanged ( i.e., not statistically different) for the remaining states (Iowa, Kansas, Maine, Nebraska, New Hampshire, New York, North Dakota, South Dakota, Vermont, and West Virginia) and the District of Columbia, as  well as  Guam, American Samoa, and Northern Marianas.  Rates by state continued to vary considerably, ranging from 50.8 births per 1,000 women age 15-44 years in Vermont to 88.4 in Utah (Table  6).

• The birth rate for unmarried women declined almost 4 percent from 2008 to 2009.

The rate per 1,000 unmarried women aged 15-44 years was 50.6 in 2009 compared with 52.5 in 2008 (data not shown) [2].  The decline in the rate found for 2008-2009 was the first reported since a slight decline 2001-02.   The rate h ad increased 20 percent from 2002 (43.7) to 2008 (52.5), following several years of relative stability. 

• The  total number of births to unmarried women declined for the first time since 1996-1997, falling about 2 percent from 1,726,566 in 2008 to 1,693,850 in 2009 (Table 7).  Increases in births to unmarried women during 2008-2009 were limited to age groups 30 years and older.  Nonmarital births declined for teenagers and women in their twenties, the principal age groups for out -of-wedlock births. 

• The proportion of all births to unmarried women increased to 41.0 percent in 2009, up from 40.6 percent in 2008. This proportion increased for all race and Hispanic origin population groups except for AIAN women (Tables 1 and 7).

• Teenagers accounted for 21 percent of  all nonmarital births in 2009, continuing a steady decline measured over the last several decades.  In 1975, teenaged mothers comprised 52 percent of nonmarital births [6,7].

• The percentage of  nonmarital births increased significantly in 16 states and declined in three areas (District of Columbia, Utah, and Washington); changes in other states were not significant.   See Table I-2  for 2008 and 2009 percentage of nonmarital births by state.  

Maternal and Infant Health Birth Characteristics

Key findings are listed below and presented in Tables 8 and 9 and Figure 4: 

• The cesarean delivery rate rose to 32.9 percent in 2009, an increase of 2 percent and another  record U.S. high.  T he percentage of  births delivered by cesarean has been rising steadily for over a decade, and is up nearly 60% since 1996 ( see Table 8) [2].  

Between 2008 and 2009 cesarean delivery rates rose among women of all age groups 20 years and older, and all race and ethnicity groups.  The largest increase was among non-Hispanic black women ( up 3 percent); rates rose 1 -2 percent among non - Hispanic white, Hispanic, AIAN and API women.  In 2009, women 4 0 years and older were as likely to have a cesarean as a vaginal delivery, that is, ½ of all births to women in this age group were in a cesarean delivery (data not tabulated).  

• The preterm birth rate declined in 2009 for the third straight year to 12.18 percent of all births, from 12.33 percent  in 2008 (Table 8).  T he percentage of  infants born preterm (less than 37 completed weeks of gestation) had risen by more than 1/3 from 1981 to 2006, but i s down 5 percent  from 2006 ( Table 9 and Figure  4) [2].   The lower preterm rate for 2009 marks the first sustained (more than 2 consecutive years) decline in this rate since 1 981 when national gestational age data first became available.   

• The 2008-2009 decline in preterm births was among infants born early preterm (less than 34 w eeks),  and late preterm ( 34-36 w eeks) ( Table 9 ).   The early preterm rate decreased from 3.56 percent to 3.51 percent and the late preterm rate from 8.77 percent  to 8.66 percent.   The late preterm rate has declined 5 percent since 2006. 

• Preterm birth rates were down among non -Hispanic  white ( 11.14 percent  to 10.92) and Hispanic infants (12.10 percent to 11.97) from 2008 to 2009; the small decline observed  for non-Hispanic black births (17.54 percent  to 17.47) was not statistically significant (Table 8).  rate s for all 3 groups are down significantly since 2006 [2].   See also Table I-4 for 2008 and 2009 preterm birth rates by state. 

• The  low birthweight rate ( LBW) w as 8 .16 percent  in 2009, compared with 8.18 percent  in 2008 ( Table 8 ).  T he LBW rate  ( the percentage of infants born at less than 2,500 grams  or  5 lb, 8 oz  per 100 births) increased more than 20 percent  from 1980s through 2006, but is down very slightly since (8.26 percent in 2006) (Figure 4) [2]. 

•  The 2009 rate of very low birthweight rate (less than 1,500 grams or 3 lb, 4 oz), was  1.45 percent, not statistically changed from 2008 (Table 8).  The VLBW rate had declined between 2007 and 2008, following several decades of fairly steady increases [2].   

•  LBW levels in 2009 were not significantly different from 2008 for the 3 largest race and Hispanic origin groups, non-Hispanic white (7.19  percent  in 2009), non-Hispanic black (13.61) and Hispanic (6.94).  Rates for non-Hispanic white and non-Hispanic black newborns are down 2-3  percent  from  2006, however (Table 8) [2].  See Table I-5 for 2008 and 2009 low birthweight rate by state.  

(References and others omitted)

Published in National Vital Statistics Reports Vol 59, Num 3, Dec 21, 2010, originally published on the website of the Centers for Disease Control and prevention