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Background Widespread increases in facility delivery have not substantially reduced neonatal mortality in sub-Saharan Africa and South Asia over the past 2 decades. This may be due to poor quality care available in widely used primary care clinics. In this study, we examine the association between hospital delivery and neonatal mortality. Methods and findings We used an ecological study design to assess cross-sectional associations between the share of hospital delivery and neonatal mortality across country regions. Data were from the Demographic and Health Surveys from 2009 to 2018, covering 682,239 births across all regions. We assess the association between the share of facility births in a region that occurred in hospitals (versus lower-level clinics) and early (0 to 7 days) neonatal mortality per 1,000 births, controlling for potential confounders including the share of facility births, small at birth, maternal age, maternal education, urbanicity, antenatal care visits, income, region, and survey year. We examined changes in this association in different contexts of country income, global region, and urbanicity using interaction models. Across the 1,143 regions from 37 countries in sub-Saharan Africa and South Asia, 42%, 29%, and 28% of births took place in a hospital, clinic, and at home, respectively. A 10-percentage point higher share of facility deliveries occurring in hospitals was associated with 1.2 per 1,000 fewer deaths (p-value < 0.01; 95% CI: 0.82 to 1.60), relative to mean mortality of 22. Associations were strongest in South Asian countries, middle-income countries, and urban regions. The study's limitations include the inability to control for all confounding factors given the ecological and cross-sectional design and potential misclassification of facility levels in our data. Conclusions Regions with more hospital deliveries than clinic deliveries have reduced neonatal mortality. Increasing delivery in hospitals while improving quality across the health system may help to reduce high neonatal mortality., Author(s): Anna D. Gage 1,*, Günther Fink 2,3, John E. Ataguba 4,5, Margaret E. Kruk 1 Introduction Despite substantial increases in facility delivery in the past 2 decades, global declines [...]

North Carolina health statistics are often tabulated by race as a means of measuring health disparities. Many of North Carolina's racial minority groups have worse outcomes than the majority white […]

Recent trends in birth statistics in England and Wales with a focus on births in 1999 and conceptions in 1998, are summarized.

OBJECTIVE: To investigate trends in the birth rate for teenagers in Queensland, stratified by geographic remoteness and economic disadvantage. METHOD: This was an analysis of routine data for the period 1988 to 1997. The number of births were obtained from the Queensland Perinatal Data Collection. Population data (the denominators for the rates) were obtained from the Australian Bureau of Statistics. Economic disadvantage was based on place of usual residence of the mother. Because of differences in physical, social and psychological development, the data were analysed in three age groups: 13 to 14 years, 15 to 17 years and 18 to 19 years. RESULTS: Birth rates to teenagers who live in disadvantaged areas were 2 to 4 times higher than the rates for all of Queensland and 10 to 20 times higher than the rates in affluent areas. The trend analysis showed that the rates are decreasing in urban-affluent areas (about 2.5% per year), while they have remained stable, but extremely high in disadvantaged-remote areas, and are increasing (about 5% per year)in disadvantaged-urban areas. CONCLUSIONS: The relatively low and stable rates for all of Queensland have hidden marked variations in the trends for areas defined according to economic disadvantage and remoteness. The rates were especially high and showed no improvement over time in remote disadvantaged areas, which have a large Indigenous population. IMPLICATIONS: In some areas of Queensland births to teenagers is a pressing problem, especially because it can perpetuate a cycle of limited educational opportunities, social isolation and reliance on welfare.

The number of births in England and Wales totalled 636,000 in 1998, against 642,000 in 1997. Some 38% of births in 1998 were registered outside marriage, with 61% of these births being registered jointly by co-habiting partners. There were 800,000 conceptions in the region during 1997, down 2% from 1996, with 70% resulting in maternity.

Research presented concerns Russia's population and demographic potential. Topics discussed include 20th-century population transitions, negative natural population growth, mortality and birthrate, and forecasts of Russia's life potential.

Research presented concerns Russia's seven-year decline in population, and the population dynamics of reproduction and migration. Topics addressed include the changes in population from 1951-95, the low birth rates and high mortality rates responsible for decline, the age breakdown of the population, and forecasts of population growth.

The authors examines seasonal implications of low birth weight and pre-term births among Australian aborigines. Topics include intrauterine retardation, births statistics, and underlying causes.

The birth rate in China has declined from 33.43 per 1,000, to 16.98; while the death rate has declined slightly from 7.60 to 6.56. However, it is argued that birth and infant mortality statistics in China are underreported. The one-child policy, which was implemented in 1979 to slow population growth and which offers rewards and penalties, is partly responsible for underreporting.

The percentage of male births seems to be declining in many countries but the reasons are not known. Normally, about 106 males are born for every 100 females, for a ratio of 1.06. Another way of saying this is that 106 out of 206 births, or 51.5% are male. An analysis of births in Denmark, the Netherlands, Canada and the US reveals a significant decline in the percentage of males born, from 51.6% in 1950 to 51.3% in 1994 in the Netherlands. Similar declines were seen in Denmark, Canada and the US.

Using Current Population Survey data, Vital and Health Statistics data, photoperiod data and temperature data, this article attempts to provide an interdisciplinary explanation of monthly (N = 243) variation in the dependent variable representing the birth rate (the rate of conceptions that become live births) for white women 20-24 years of age. Among the selected explanatory variables, four were found to play significant roles in accounting for the variation of the birth rate. They were rates of female absence from the labor market (nonparticipation plus unemployment), male employment rates, length-of-night variations and the days in the month of conception. Rainwater's concept of 'validating activities' (1974) and recent quality of life research regarding domains serve as a basis for development of the concepts 'compensatory validation' and 'contextual compatibility'. Research and policy implications are discussed. KEY WORDS: birth rate, seasonality of births, birth rate and employment, photoperiod and births, compensatory validation, contextual compatability

Data from the Panel Study of Income Dynamics were used to study the economic situation of non-teenage single mothers. The economic variables considered include involvement in the labor force, use of welfare and family income before and after giving birth. The economic status of older, single childbearers was found to be closer to the condition of teenage mothers compared to married mothers of the same age, with white, 25 years and older single mothers having better conditions.

In 1997, the number of live births in England and Wales fell 1.1% to 642,000, compared to the previous year. Of total births, 37% were born out of wedlock. The average age of women at first marriage rose to 27.2 years in 1996, from 22.8 in 1976; with the average age at first birth up over two years to 28.8. Of the 816,000 conceptions in 1996, 21% were aborted, up 1% on 1995.

The 1996 annual survey of vital statistics in the US shows several enduring trends. Infant mortality continued to decline to the lowest rate recorded, at 7.2 deaths/l,000 births, but remained high in international comparisons. The increase in life expectancy at birth persisted, with a new high of 76.1 years. The death rate of children between 1 and 19 declined once again, with accidental deaths down almost 50% since 1979, mostly due to preventative measures such as car seats and smoke alarms. However, accidental injuries remained the leading cause of death for all children., Several recent trends in the vital statistics of the United States continued in 1996, including an increase in life expectancy and declines in infant mortality, births to teenage mothers, age-adjusted death rates, and death rates for children and adolescents. In 1996, there were an estimated 3 914 953 births in the United States. The preliminary birth rate remained unchanged at 14.8 births per 1000 population, and the fertility rate, births per 1000 women 15 to 44 years of age, was essentially the same at 65.7. Fertility rates rose slightly for most racial and ethnic groups except black women, for whom the rate hit a historic low of 70.8. Overall, fertility remains particularly high for Hispanic women, although there is considerable variation within this heterogenous group. For the fifth consecutive year, birth rates dropped for teenagers. Birth rates for women [is greater than or equal to] 30 years of age continued to increase. The birth rate for unmarried women declined 1% in 1996 to 44.6 births per 1000 unmarried women, continuing the decline noted in 1995 for the first time in 2 decades. The percentage of women who began prenatal care in the first trimester rose in 1996 to 81.8%, whereas the percentage with late (third trimester) or no care dropped to 4.1%. The rise in timely prenatal care was greatest for black and Hispanic women. The percentage of low birth weight (LBW) infants reached 7.4% in 1996, its highest level since 1975. The very low birth weight rate remained unchanged at 1.4%. The rise in LBW occurred primarily among white women, whereas the LBW rate for black women dropped to 13.0%, the lowest rate reported since 1987. The rise among white women is only partially a result of increases in multiple births, because LBW rates have also risen among white singleton births. The multiple birth ratio rose again in 1996 by 2%, as it has since 1980. The rise was particularly large for higher-order multiple births. Infant mortality reached an all time low level of 7.2 deaths per 1000 births, based on preliminary 1996 data. Neonatal and postneonatal rates declined, as did rates for both black and white infants. National birth weight specific mortality rates are reported here for the first time. In 1995, 63% of infant deaths occurred to the 7.3% of the population that was born LBW. The four leading cause of infant death were congenital anomalies, disorders relating to short gestation and unspecified birth weight, sudden infant death syndrome, and respiratory distress syndrome, accounting for more than half of infant deaths in 1996. Despite the declines in infant mortality, the United States continues to rank poorly in international comparisons of infant mortality. Expectation of life at birth reached a new high in 1996 of 76.1 years for all gender and race groups combined. Age-adjusted mortality rates declined in 1996 for diseases of the heart, malignant neoplasms, cerebrovascular diseases, accidents and adverse effects, chronic liver disease and cirrhosis, and suicide. They rose, as in the past several years, for chronic obstructive pulmonary diseases, diabetes mellitus, and pneumonia and influenza. For the first time since human immunodeficiency virus infection was created as a special cause-of-death category in 1987, death rates for human immunodeficiency virus infection declined from 15.6 in 1995 to 11.6 in 1996. The homicide rate also declined, as it has since 1991. Death rates for children between 1 and 19 years of age declined in 1996, with an estimated 29 183 deaths to children. Unintentional injury mortality has dropped by ~50% among children and adolescents since 1979, although it remains the leading cause of death for all age groups of children from 1 to 19 years. Homicide was the fourth leading cause of death for children 1 to 4 and 5 to 9 years of age, the third leading cause for children 10 to 14, and the second leading cause for 15 to 19 year olds. Pediatrics 1997;100:905-918; birth, death, infant mortality, low birth weight., ABBREVIATIONS. IMR, infant mortality rate; HIV, human immunodeficiency virus; NCHS, National Center for Health Statistics; LBW, low birth weight; VLBW, very low birth weight; NMR, neonatal mortality rate; PNMR, postneonatal [...]

The author analyzes William H. James' article criticising conclusions in 1994 study of the Havasupai Indians. Explanations detailing his conclusions on hormonal controls, parental factors, and secondary sex ratios are provided.

This author reexamines John F. Martin's 1994 study of the sex ratio and birth order of the Havasupai Indians of northwestern Arizona. Excerpts from the original report, limitations of the conclusions, and other possible theories are examined.

The welfare debate in Maryland centers on births while on public assistance. Differentials in the incidence of births while on welfare were studied using Quality Control data for the 1991-1992 period. The results show that around one-quarter of recipient children were born on welfare and that there were higher rates of such births amongst young mothers with less than high-school education, who had never married, and were Baltimore residents.

The continuance of low birth rates in most European countries is expected to affect the direction of population change in Europe. From high fertility levels after the Second World War, birth rates have been falling drastically since the early 1970s. This second demographic transition is characterized by a population move from a state of low birth rates and low death rates, with the former exceeding the latter in such a way that birth rates are permanently below death rates and the population slowly decreases. The consequences of a further continuance of this trend, as well as the directions that societies must take, are discussed.

Extreme summer temperatures are related to below-normal conceptions in all populations. However, conceptions are unaffected by extreme cold. This may be explained in terms of photoperiod, since the seasonal patterns least related to temperature are observed in places with the most extreme seasonal variation in day lengths. Despite controlling for temperature changes, seasonality in births in northern Europe remain unexplained. This suggests the role of factors other than photoperiod in explaining seasonal variations in births.

Pregnancy and birth rates among teenage girls are the highest of any developing country and it appears likely that the trend will continue. Pregnancy rates in 15- to 19-year-old girls increased 9% between 1980 and 1990 to reach 95.9 per 1,000 girls. The actual number of pregnancies declined because the number of teenage girls in that age group fell 16% during the same time period. Among sexually active girls the pregnancy rates fell 8%, and the decline was greater in girls 17 or younger. Abortion rates remained stable during the decade. Abortion rates among sexually active girls declined during this time. Birth rates, which fell during the first half of the decade, rose 18% during the last half to reach 59.9 births per 1,000 girls. Black teens had birth rates twice as high as white teens. Among girls younger than 15, birth rates increased 30% during the decade and the rate was seven times higher in blacks than in whites.

The distribution of birth years of physicists involved in the development of quantum mechanics shows a striking periodicity, with a period of about seven years. Although an obvious explanation of the phenomenon is lacking, a preference of humans to cooperate with persons who differ from their own age by an integral multiple of about 7 years could be a possible mediating mechanism.

Analysis of U.S. vital statistics from 1993 and projections for 1994 reveal that an estimated 3,979,000 people were born in 1994, the lowest since 1989. In 1993, fertility rates declined, although rates among Hispanic and black women exceeded rates among white women. 1994 birth rates among women 30 and older continued to rise while rates among 15- to 19-year-olds leveled off. Ninety-nine percent of births occurred in hospitals. In 1993, the number of births attended by midwives rose to 4.8%, the overall cesarean rate fell to 21.8%, the first-time cesarean rate fell to 15.3%, and the vaginal birth rate after cesarean rose to 24.3%. Less than 5% of mothers had no or late prenatal care. Smoking during pregnancy declined to 15.8%. The incidence of low birth weight rose to 7.2%, mostly due to an increase in multiple births. Among black women it was 13.3%. Because birth rates exceeded death rates, 1,693,000 persons were added to the population. The infant death rate fell to 7.9 per thousand, the lowest ever. Because nonwhite and Hispanic races have higher fertility rates, their proportion among children is expected to grow. The proportion of elderly is expected to increase markedly while the proportion of children declines., SPECIAL NOTE FROM THE AUTHORS Since 1950,[1] Myron Wegman has authored this series of reports of the vital statistics of the United States, a record of achievement that few of us will ever,equal, and this calls for special comment. Over the years, his articles have informed, enlightened, and entertained readers. Dr Wegman, a master teacher, has never been shy about expressing his strongly-held views in these articles! The new authors will attempt to maintain this tradition of independent thinking and critical commentary. In addition, we hope over the next few years to introduce some new features and new data sets. The devotees of this annual Wegman paper will note that it now takes four of us to replace one giant! The article is now a collaboration between academics from a school of public health and professionals from a federal agency, recognizing the importance of cooperation between our institutions. The National Center for Health Statistics (NCHS) is the source of the data presented in the paper and assures its accuracy and timeliness. In last year&apos;s report,l Dr Wegman explained the sources of the vital statistical data, the different NCHS reports that are used, and the timing of their availability. The shift in authorship from the University of Michigan to Johns Hopkins and NCHS reflects Dr Wegman&apos;s long association with these institutions. We wish to request comments and reactions from readers. Please tell us which parts of the article are the most useful and what additional information you would like us to report. Finally, the authors wish to thank the American Academy of Pediatrics and the Editors of Pediatrics for having the confidence in us to pass the baton our way. Recent trends in the vital statistics of the United States continued in 1994, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate. Life expectancy increased slightly to 75.7 years. Only marriages reversed the recent trend with a slight increase in 1994. An estimated 3 979 000 infants were born during 1994, a decline of, ars. Prenatal care utilization improved in 1993; 79% of women initiated care in the first trimester and ABBREVIATIONS. US, United States; LBW, low birth weight; VLBW, very low birth weight; [...]

Statistics indicate that births outside marriage have risen sharply during the past two decades, with the majority of births registered by both parents, who were living together. Births outside marriage are more likely to occur in women from a manual class background, who also had the highest low birthweight rates. Half of the women who were not married at their first birth were married at the time of their second birth.

A statistical model of the dynamic intrafamily relationships and factors that influence the well-being of children born to teenage mothers is developed. Using its estimates, several estimation techniques for deriving the determinants of human capital are evaluated. These are 'generalized least squares, instrumental-variables, fixed-effects based on the children of sisters, fixed-effects based on siblings, and sibling fixed-effects with instrumental variables.' The results show that giving birth at a younger age raises the birthweight and fetal growth.

Analysis of the fertility decline in Bulgaria shows that the perception of Bulgaria as an 'anomaly' in terms of its demographic development is based on a conservative interpretation of the demographic transition theory. The features that distinguish Bulgaria from the western European countries (faster decline, persistence of early and universal marriages, etc.) are generally accounted for by the specific social, economic, cultural, and political conditions. These findings suggest that the speed of the fertility decline and the means through which it is achieved are affected by a complex interaction between cultural and economic factors that are often difficult to distinguish in terms of primacy., Bulgaria has long been perceived as a peculiar case in terms of its demographic development. In the second volume of The Balance of Births and Deaths, Robert Kuczynski noted that [...]

Martens, Kelly, and Saklofske in 1988 examined 21 studies considering the possible relationship between lunar periodicities and birthrate. They reported that the majority of studies uncovered no relationship and that the positive studies were inconsistent in their findings. The present update reports on six additional studies on birthrate and lunar periodicities from five different countries. None of these studies produced evidence of lunar periodicities consistent with folklore or some previous studies.

A method is presented for unravelling the demographic equation for structured populations. A solution to the McKendrick-von Foerster equation is constructed using spline functions and this is fitted to stage-structured population data in such a way that the solution is smooth, positive, and does not imply negative death rates. The smoothness of the surface, and hence the complexity of the population model, is determined in a statistically optimum manner using cross validation. Time- and age-dependent death rates can be obtained as well as time-dependent birth rates. Confidence intervals are obtained for population size and death rates that give a 95% probability that the true population dynamics are within the intervals. Practical application of the method is demonstrated, and comparison made with three alternative methods. The method requires estimates of stage populations at a series of times and estimates of the durations of those stages, or age ranges covered by the stages. The stage durations may vary with time.

In 1992, the number of live births in England and Wales fell 1.4% to 689,700. The total period fertility rate dropped to 1.80, from 1.82 in 1991. The average age at childbirth is rising slowing, and in 1992 it totalled 27.9, compared to 27.7 in 1991, and 27.5 in 1990. For every 100 female births, 105.3 were male, compared to 105.2 in 1991, and 31.2% of all births were outside marriage, up from 30.2% in 1991.

In 1991, the number of conceptions per 1,000 teenagers in England and Wales fell 3.9% from 69.0 in 1990. Teenage abortions have been rising steadily since the Abortion Act of 1968, to total 24.6 per 1,000 in 1990, compared to 14.3 in 1971. The number of live births to teenagers totalled 52,000 in 1991, down from 57,000 in 1981, of which in 1991, teenage marital births made up 17%, compared to 53% in 1981.

The infant mortality rate declined throughout the world in 1992. The number of births, marriages and deaths also was lower in 1992 than in 1991. Researchers summarized the vital statistics for 1992. The US infant mortality rate decreased by 5% between 1991 and 1992. The difference grew between the infant mortality rates for blacks and whites despite a decline for both races. Fewer births, marriages and deaths occurred throughout the world in 1992, but the divorce rate increased. More children were born to single women in 1992, and the proportion of newborns with a low birth weight increased. The world population rose by a smaller percentage in 1992 than in previous years. In the US, the average life expectancy at birth rose to 76 years for infants born in 1992. Women still have a longer life expectancy than men in industrialized countries.

A failure to report the birth of females and determining the sex of the child prior to birth to induce sex-selective abortion are the main causes of increase in the birth of males in China. Female infanticide and abandonment also contribute to the increase in the birth of males, but the frequency of such illegal practices have decreased because of the expenses and the psychological and moral consequences. The increase in the birth of males has led to rapid population growth, hindering development in China. Various kinds of family planning programs such as contraceptive use, reduction of unplanned pregnancies, abortion, one-child policy, research on social, cultural, ethical issues and effective data collection have been implemented to counteract the issue of increase in birth of males in China.

information on population statistics, including, life expectation, marriage and divorce, abortions, deaths and international migration, is provided in table form.

There is limited information about women's social class as traditionally this has been determined by the class of their male partner. In the 1911 Census it was recommended that the wife's occupation should be recorded, and analysis of that data revealed that the death rate for young children whose mothers were employed was higher than those whose mothers remained at home. The method of recording mother's occupations needs improvement and analysis of a mother's social class in relation to fertility and infant death rates needs to be developed.

There were equal numbers of first and second births inside marriage in both 1980 and 1990, but in births outside marriage more than a half were first births, with second births less than a quarter. Live births in England and Wales rose 8% between 1980 and 1990 with third and higher order births increasing by 13 per cent. Total births and births of each order are affected by the age distribution of women and changing numbers of women.

The 1978 World Fertility Survey (WFS) and the 1986 Demographic and Health Survey (DHS) data are used to examine the relative contributions of three proximate determinants (nuptiality or marriage, contraception and post-partum infecundability) to fertility change in Senegal. The aim is to identify the important variables that is amenable for policy towards fertility reduction. Analysis shows that there are increases in the absolute measures of all three determinants. The magnitude of change is greatest in contraceptive use, moderate in marriage but least in duration of breast-feeding. However, the index of contraceptive use exerts the least impact on fertility reduction while that of post-partum infecundability makes the strongest impact on fertility. The impact of the nuptiality index on fertility change lies in-between contraception and breast-feeding.

Nearly all West Indian islands initiated marked fertility declines sometime between 1960 and 1970. Family planning programs have not played an important role in these declines. Neither have other variables that conventional social theory tells us should promote reduced family sizes, like education and rising standards of living. The historical experience of Barbados and Antigua, which reached replacement-level fertility in the 1980s, suggests that West Indian fertility declines reflect structural changes in national economies that created job opportunities for women. Family planning programs need to be evaluated with reference to the distinctive health and human rights goals other than fertility transition that they can effectively reach.

Research determined the relationship between a woman's educational attainment and the reproductive process. An analysis of data from the Central Population Register of Norway and the 1988 National Survey of Families and Households revealed the positive relationship between a mother's educational level and the rates of third births in the family. Results showed that Norwegian women who had received 12 years of schooling gave birth to a third child more often compared to women who received minimum education. Replication of these studies in American women revealed similar results.

An overview is given of parliamentary constituency boundaries and the current review Bill, conception data 1990, birth data 1991, health and deprivation in Scotland, 1991 Census results and recent UK Office of Population Censuses and Surveys (OPCS) publications. Publications listed include 1991 Census County Reports, recent 1991 Census County Monitors and recent OPCS Monitors. Birth data reveals that live births in Wales and England fell 1% to 699,000 in 1991 vs 1990. Conceptions in 1990 in the same regions rose 1% to about 872,000 in 1990 vs 1989.

Seasonal patterns of birth differ between Canada and the northern United States. Canadian births peak in April to May while US births have a trough then. While human conception and climatic temperature have an inverse relation in both countries, the different birth patterns cannot be explained by temperature variations alone.

The paper presents the dynamics of childbearing indices in the twentieth century for 23 developing and 35 developed countries. The childbearing process over time is measured by projected ages at first and last birth, and length of reproductive life span, using the model derived by Home, El-Khorazaty, and Suchindran (1990). A time series for each of the three childbearing indices for each country is obtained, using only data on age-specific fertility rates. Two distinct general patterns characterizing child-bearing transition are identified, according to variations over time of each index, which simultaneously reflect changes in fertility levels. Future childbearing behavior is forecasted to the year 2000 using ARIMA time series modeling.

Recent shifts in economic and social conditions have put young women who begin their childbearing as teenagers in an increasingly precarious economic position. In this article, I use a nationally representative data set to examine how the effect of teenage childbearing on women's economic well-being changed during the period 1968-87. A review of the literature on the consequences of teenage childbearing and changing economic conditions provides a framework in which to interpret the results.