Pregnancy Health Article

PREGNANCY

A great deal of public health resources is spent on pregnancy. It is clear that prenatal and neonatal health play a large role in determining the health of a population, and in fact, pregnancy outcomes are often used as an indicator of a nation's health.

EPIDEMIOLOGY OF PREGNANCY

Globally, there are approximately 240 million pregnancies annually. These pregnancies result in 134 million births and 50 million induced abortions, 20 million of which are performed under unsafe conditions. Approximately 6 to 7 million of these 240 million pregnancies occur each year in the United States. These result in about 4 million liveborn babies, over 1 million induced abortions, at least 1 million spontaneous abortions (miscarriages), nearly 100,000 ectopic pregnancies (a pregnancy in which the fetus develops outside the uterus), and about 30,000 fetal deaths.

Of the 4 million babies born in the United States in 1999, 12 percent were born to women under 20 years of age. Approximately 4.5 percent of white teens (ages 15 to 19), 8.1 percent of African-American teens, and 9.3 percent of Hispanic teens gave birth. Since 1991, the teenage birth rate has been declining in the United States, particularly among African Americans, largely because of an increased use of effective contraception.

In 1999, 13 percent of the babies born in the United States were born to women 35 years old and older. The birth rate among this age group increased during the last three decades of the twentieth century, despite the fact that older women have an increased risk for having babies with chromosomal abnormalities (the risk is approximately 1 in 1,000 at age 25, 1 in 200 at age 35, and 1 in 20 at age 45).

About half of all pregnancies are unintended or unplanned, and one in three babies are born to single or unmarried mothers. (Nearly 70% of African-American babies and over 40% of Hispanic babies are born to unmarried mothers.)

Four out of five women who gave birth in 1999 started prenatal care in the first trimester, though this percentage was lower among African-American and Hispanic women. Despite an overall improvement in prenatal care utilization, the proportion of low birthweight (LBW) births and preterm births have been increasing gradually since the mid-1980s. This increase is accounted for, in part, an increase in multiple gestations and the growing number of infants born to women older than 35 years of age.

Of the 1.2 million legal induced abortions performed in 1999, 20 percent were obtained by women less than 20 years old, 60 percent by white women, and 80 percent by unmarried women.