National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System最新文献

Background and objectives: Beginning with the 2023 data year, the National Center for Health Statistics (NCHS) will use a different, expanded measure of perinatal mortality for standard publications. This measure, Definition III, includes fetal deaths at 20 weeks of gestation or more and infant deaths younger than 7 days. Definition III replaces Definition I (fetal deaths at 28 weeks of gestation or more and infant deaths younger than 7 days), which has been used in NCHS reports since the 1980s. This change is being made due to the implementation of national reporting of all fetal deaths at 20 weeks of gestation or more as of 2014, allowing for the use of Definition III, which more fully represents the perinatal events most likely to be affected by similar factors. This report describes the reason for this change and compares trends in perinatal mortality rates based on Definition I and Definition III from 2014 to 2022 and differences in the two measures by maternal race and Hispanic origin, age, and state of residence for 2022.

Methods: Data for perinatal mortality are derived from NCHS's National Vital Statistics System's fetal death, birth, and period linked birth/infant death files. Perinatal mortality rates for Definition III are compared with those for Definition I.

Results: In 2022, Definition III comprised 91.4% of perinatal deaths (fetal deaths at 20 weeks of gestation or more and infant deaths younger than 28 days) compared with 60.7% of perinatal deaths captured by Definition I. The perinatal mortality rate for Definition III was about 50% higher than that for Definition I (8.27 and 5.51, respectively, in 2022). Trends in perinatal mortality were similar for both measures during 2014-2022; rates were stable from 2014 through 2016 and then declined from 2016 through 2022. For 2022, patterns by maternal race and Hispanic origin and age were also similar, but more variation in patterns was observed by state.

Objectives: This report presents complete period life tables for the United States by Hispanic origin and race and sex, based on age-specific death rates in 2022.

Methods: Data used to prepare the 2022 life tables are 2022 final mortality statistics; July 1, 2022, population estimates based on the Blended Base population estimates produced by the U.S. Census Bureau; and 2022 Medicare data for people ages 66-99. The methodology used to estimate the life tables for the Hispanic population remains unchanged from that developed for the publication of life tables by Hispanic origin for data year 2006. The same methodology is used to estimate the life tables for the American Indian and Alaska Native non-Hispanic and Asian non-Hispanic populations. The methodology used to estimate the 2022 life tables for all other groups was first implemented with data year 2008.

Results: In 2022, the overall expectation of life at birth was 77.5 years, increasing 1.1 years from 76.4 in 2021. Between 2021 and 2022, life expectancy at birth increased by 1.3 year for males (from 73.5 to 74.8) and by 0.9 year for females (79.3 to 80.2). Between 2021 and 2022, life expectancy increased 2.2 years for the Hispanic (77.8 to 80.0) and the American Indian and Alaska Native non-Hispanic (65.6 to 67.8) populations. Life expectancy increased by 1.6 years for the Black non-Hispanic population (71.2 to 72.8), by 0.9 year for the Asian non-Hispanic population (83.5 to 84.4), and by 0.8 year for the White non-Hispanic population (76.7 to 77.5).

Objectives: This report presents complete period life tables for the United States by Hispanic origin and race and sex, based on age-specific death rates in 2022.

Methods: Data used to prepare the 2022 life tables are 2022 final mortality statistics; July 1, 2022, population estimates based on the Blended Base population estimates produced by the U.S. Census Bureau; and 2022 Medicare data for people ages 66-99. The methodology used to estimate the life tables for the Hispanic population remains unchanged from that developed for the publication of life tables by Hispanic origin for data year 2006. The same methodology is used to estimate the life tables for the American Indian and Alaska Native non-Hispanic and Asian non-Hispanic populations. The methodology used to estimate the 2022 life tables for all other groups was first implemented with data year 2008.

Results: In 2022, the overall expectation of life at birth was 77.5 years, increasing 1.1 years from 76.4 in 2021. Between 2021 and 2022, life expectancy at birth increased by 1.3 year for males (from 73.5 to 74.8) and by 0.9 year for females (79.3 to 80.2). Between 2021 and 2022, life expectancy increased 2.2 years for the Hispanic (77.8 to 80.0) and the American Indian and Alaska Native non-Hispanic (65.6 to 67.8) populations. Life expectancy increased by 1.6 years for the Black non-Hispanic population (71.2 to 72.8), by 0.9 year for the Asian non-Hispanic population (83.5 to 84.4), and by 0.8 year for the White non-Hispanic population (76.7 to 77.5).

Objectives: This report presents 2023 data on U.S. births by selected characteristics. Trends in fertility patterns and maternal and infant characteristics are described.

Methods: Descriptive tabulations based on birth certificates of the 3.60 million births registered in 2023 are shown for various maternal demographic and health characteristics; medical and healthcare utilization, including source of payment for the delivery; and infant health characteristics. Selected data by mother's state of residence and birth rates also are shown. Trends for 2010 to 2023 are presented for selected items, and by race and Hispanic origin for 2016-2023.

Results: A total of 3,596,017 births occurred in the United States in 2023, down 2% from 2022. The general fertility rate declined 3% from 2022 to 54.5 births per 1,000 females ages 15-44 in 2023. The birth rate for females ages 15-19 declined 4% from 2022 to 2023; birth rates rose less than 1% for women ages 20-24, fell 1% to 3% for women ages 25-44, and were unchanged for females ages 10-14 and women ages 45-49. The total fertility rate declined 2% to 1,621.0 births per 1,000 women in 2023. Birth rates declined for both unmarried and married women from 2022 to 2023. Prenatal care beginning in the first trimester declined to 76.1% in 2023; the percentage of women who smoked during pregnancy declined to 3.0%. The cesarean delivery rate increased 1% in 2023 to 32.3%; Medicaid was the source of payment for 41.5% of births, an increase from 2022 (41.3%). The preterm birth rate (10.41%) and the low birthweight rate for 2023 (8.58%) were essentially unchanged from 2022. The twin birth rate declined 2% in 2023 to 30.7 per 1,000 births; the triplet and higher-order multiple birth rate decreased 6% to 73.8 per 100,000 births.

Objectives: This report examines the role of age-specific trends in fertility rates in the decline in the number of births and of general fertility rates (GFRs) and total fertility rates (TFRs).

Methods: Data are from the National Center for Health Statistics' National Vital Statistics System birth data files from 1990 through 2023. To estimate the role of changes in age-specific fertility rates on total births, GFRs, and TFRs from 1990 through 2023, 1990 rates for each maternal age category were kept constant and applied to all subsequent years to produce adjusted totals and rates.

Results: The actual number of U.S. births declined 14% from 1990 to 2023, the GFR declined 23%, and the TFR declined 22%. Due to declines in birth rates among females younger than age 30, holding their 1990 birth rates constant resulted in higher adjusted GFRs, TFRs, and number of births in 2023 than the actual rates and numbers. Due to increases in birth rates to women age 30 and older, holding their 1990 birth rates constant would have led to lower adjusted GFRs, TFRs, and number of births in 2023 than the actual rates and numbers. The magnitude of the decrease in birth rates among females younger than 30 was greater than the magnitude of the increase in rates among women 30 and older, resulting in declining overall fertility rates. These age-specific changes in birth rates resulted in changing maternal age distributions-in 1990, females younger than 30 accounted for 7 in 10 births (69.8%), while in 2023, they accounted for less than 1 in 2 (48.6%).

Summary: The decline in fertility rates over the past few decades results from declining rates among females younger than 30 coupled with smaller increases in rates among older women.

Objectives: This report presents final 2021 data on U.S. deaths, death rates, life expectancy, infant and maternal mortality, and trends by selected characteristics such as age, sex, Hispanic origin and race, state of residence, and cause of death.

Methods: Information reported on death certificates is presented in descriptive tabulations. The original records are filed in state registration offices. Statistical information is compiled in a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics. Causes of death are processed according to the International Classification of Diseases, 10th Revision . Beginning in 2018, all states and the District of Columbia were using the 2003 revised certificate of death for the entire year, which includes the 1997 Office of Management and Budget revised standards for race. Data based on these revised standards are not completely comparable to previous years.

Results: In 2021, a total of 3,464,231 deaths were reported in the United States. The age-adjusted death rate was 879.7 deaths per 100,000 U.S. standard population, an increase of 5.3% from the 2020 rate. Life expectancy at birth was 76.4 years, a decrease of 0.6 year from 2020. Age-specific death rates increased from 2020 to 2021 for every age group. In 2021, 9 of the 10 leading causes of death remained the same as in 2020. Heart disease remained the top leading cause, followed by cancer and COVID-19. The infant mortality rate of 5.44 infant deaths per 1,000 live births in 2021 did not change significantly from the rate in 2020 (5.42).

Conclusions: In 2021, the age-adjusted death rate increased and life expectancy at birth decreased for the total, male, and female populations, primarily due to the influence of deaths from COVID-19.

Objectives: This report presents 2022 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined.

Methods: Descriptive tabulations of data are presented and interpreted for all fetal deaths reported for the United States for 2022 with a stated or presumed period of gestation of 20 weeks or more. Cause-of-fetal-death data only are restricted to residents of the 43 states and District of Columbia where cause of death was based on the 2003 fetal death report revision and less than 50% of deaths were attributed to Fetal death of unspecified cause (P95).

Results: A total of 20,202 fetal deaths at 20 weeks of gestation or more were reported in the United States in 2022. The 2022 U.S. fetal mortality rate was 5.48 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, 4% lower than in 2021 (5.73) and a new historic low for the United States. The fetal mortality rate in 2022 for deaths occurring at 20-27 weeks of gestation was 2.79, a 5% decline from 2021 (2.95). For deaths occurring at 28 weeks of gestation or more, the rate in 2022 was 2.71, a 3% decline from 2021 (2.80). In 2022, the fetal mortality rate was highest for Native Hawaiian or Other Pacific Islander non-Hispanic (10.36) and Black non-Hispanic (10.05) females and lowest for Asian non-Hispanic females (3.70). Fetal mortality rates were highest for women ages 40 and older, for women who smoked during pregnancy, and for women with multiple gestation pregnancies. Five selected causes accounted for 90.0% of fetal deaths in the 43-state and District of Columbia reporting area.

Objectives: This report presents complete period life tables for each of the 50 states and the District of Columbia by sex based on age-specific death rates in 2021.

Methods: Data used to prepare the 2021 state-specific life tables include: 2021 final mortality statistics; July 1, 2021, population estimates based on the Blended Base population estimates produced by the U.S. Census Bureau; and 2021 Medicare data for people ages 66-99. The methodology used to estimate the state-specific life tables is the same as that used to estimate the 2021 national life tables, with some modifications.

Results: Among the 50 states and District of Columbia, Hawaii had the highest life expectancy at birth, 79.9 years in 2021, and Mississippi had the lowest, 70.9 years. From 2020 to 2021, life expectancy at birth declined for 39 states, increased for 11 states, and remained unchanged for the District of Columbia. In 2021, life expectancy at age 65 ranged from 16.1 years in Mississippi to 20.6 years in Hawaii. Life expectancy at birth was higher for females in all states and the District of Columbia. The difference in life expectancy between females and males ranged from 3.9 years in Utah to 7.6 years in New Mexico.

Objectives: This report presents final 2022 infant mortality statistics by age at death, maternal race and Hispanic origin, maternal age, gestational age, leading causes of death, and maternal state of residence. Trends in infant mortality are also examined.

Methods: Descriptive tabulations of data are presented and interpreted for infant deaths and infant mortality rates using the 2022 period linked birth/infant death file. The linked birth/infant death file is based on birth and death certificates registered in all 50 states and the District of Columbia.

Results: A total of 20,577 infant deaths were reported in the United States in 2022, up 3% from 2021. The U.S. infant mortality rate was 5.61 infant deaths per 1,000 live births, a 3% increase from the rate of 5.44 in 2021. The neonatal mortality rate increased 3% from 3.49 in 2021 to 3.59 in 2022, and the postneonatal mortality rate increased 4% from 1.95 to 2.02. The overall infant mortality rate increased for infants of American Indian and Alaska Native non-Hispanic, White non-Hispanic, and Dominican women in 2022 compared with 2021; changes in rates for the other race and Hispanic-origin groups were not significant. Infants of Black non-Hispanic women had the highest mortality rate (10.90) in 2022, followed by infants of American Indian and Alaska Native non-Hispanic and Native Hawaiian or Other Pacific Islander non-Hispanic (9.06 and 8.50, respectively), Hispanic (4.89), White non-Hispanic (4.52), and Asian non-Hispanic (3.51) women. Mortality rates increased from 2021 to 2022 among preterm (less than 37 weeks of gestation) infants (33.59 to 34.78) and for infants born term (37 to 41 weeks of gestation) (2.08 to 2.18). The five leading causes of infant death in 2022 were the same as in 2021. Infant mortality rates by state for 2022 ranged from a low of 3.32 in Massachusetts to a high of 9.11 in Mississippi.

Objectives: This study examines trends in the numbers, percentages, and rates of first and second and higher-order births to teenagers younger than age 20 and for those ages 15-17 and 18-19 by race and Hispanic origin.

Methods: Data for this analysis are from the National Vital Statistics System birth data files from 2000 and 2022. Analyses are limited to births to females younger than age 20. Changes in the numbers, percentages, and rates of total, first, and second and higher-order teen births from 2000 to 2022 were calculated for all teenagers and for non-Hispanic American Indian and Alaska Native, non-Hispanic Black, non-Hispanic White, and Hispanic teenagers.

Results: The number of first teen births declined 67% and the number of second and higher-order teen births declined 79%, while the population of female teenagers increased 7% from 2000 to 2022. The declines were greater for younger teenagers compared with older teenagers. First and second and higher-order teen birth rates declined 69% and 80%, respectively. Similar declines were found for each race and Hispanic-origin group. In 2000 and 2022, first and second and higher-order birth rates were lowest among White teenagers. First birth rates were highest among Hispanic teenagers in 2000 and for Hispanic and non-Hispanic American Indian and Alaska Native teenagers in 2022. In 2000, second and higher-order birth rates were highest for non-Hispanic Black and Hispanic teenagers; second and higher-order birth rates were more similar by race and Hispanic-origin group in 2022.