MATERNAL HEALTH

What Was Measured?
Prenatal care, low birthweight (under 5.5 lbs), infant deaths, and birth to teenage ,girls in San Mateo County from 1989 to 1992 are measured.  Adequate prenatal care was measured by the Kessler Index, which uses gestational age, number of prenatal visits, and time of prenatal care to determine adequacy of care.

Why Is This Important?
Early prenatal care is essential for preventing infant mortality, low birthweights, and illness.  Low birthweight is one of the primary causes of death for an infant in the first year of life.  A sustainable community makes certain that adequate prenatal care and access to health care is available to all women, thus providing every newborn with the opportunity to thrive and become a healthy, productive adult.  In addition, this preventative care will reduce the long term social and medical burdens placed on a community.

What Was Found?
Prenatal Care: The overall rate of prenatal care for all races improved from 77 percent in 1989 to 81.1 percent in 1992.  Nearly 91 percent of White and Asian women obtained adequate prenatal care in 1992, the highest rate for all races/ethnicities.  The lowest rates were in Hispanic and African-American women, who rated 71 percent and 69 percent, respectively.  Cumulative data for 1989 through 1992 shows that 52 percent of teens received prenatal care during their first trimester, compared to 83 percent among older women.

Low Birthweight Deliveries: Low birthweight deliveries remained constant over the four years, with an average rate of 5.45 percent of total births. Women receiving inadequate prenatal care had a higher percentage of low birthweight deliveries, with 9 percent in 1992. In contrast, women who received adequate care during that same year had a low birthweight rate of 5.45 percent. Of all races/ethnicities, African-American women had the highest rate of low birthweight deliveries, rising to 13 percent during 1992.  Low birthweight deliveries of teens were much higher than to women 18 and older, increasing from 8.8 percent in 1989 to 9.6 percent in 1992.

Infant Death Rate: The average infant death rate between 1989 and 1991 was 6.8 per 1000 births.  Both Whites and Hispanics had lower-than-average infant death rates with 5.0 and 5.8 deaths per 1000 births.  The African-American death rate was nearly triple that at 16.0 per 1000 births.

Teen Birth Rate: Births to teenagers accounted for 2.5 percent of total births, with 238 deliveries per 10,000 teens in 1989 and rising to 260 in 1992.  Over 50 percent of these births were to Hispanic teens, who averaged 37 births a year per 1000 Hispanic teenagers.  African-American teenagers followed closely with an annual birth rate of 35 per 1000, while the rate for both Whites and Asians was below 10 births per 1000 teens.

What Is The Trend?
Although the number of women receiving adequate prenatal care has risen slightly, African-Americans and Hispanics continue to have the lowest rates of timely prenatal care.  This low rate may contribute to the high number of low birthweight infants born to African-Americans, a trend that continued during the four year period.  However, Hispanics counter this correlation by having a low rate of timely prenatal care while also having one of the lowest rates of low birthweights.

Teenagers also show a similar trend of I receiving inadequate prenatal care, as well as having a high percentage of low birthweight babies.  Teens typically have lower rates of receiving early prenatal care, putting their infants at higher risk for having low birthweight and other health problems.

Source: Healthy San Mateo 2000, Health Status Indicators, Fall 1994

Researcher: Carla Bagneschi