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Infant Birth Health in Texas

CDC, Apr 10, 2007

Births to U.S. residents occurring outside this country are not reallocated to the United States. In tabulations by place of residence, births occurring within the United States to U.S. citizens and to resident aliens are allocated to the usual place of residence of the mother in the United States, as reported on the birth certificate. Beginning in 1970 births to nonresidents of the United States occurring in the United States are excluded from these tabulations. From 1966 to 1969 births occurring in the United States to mothers who were nonresidents of the United States were considered as births to residents of the exact place of occurrence; in 1964 and 1965 all such births were allocated to `balance of county' of occurrence even if the birth occurred in a city. The change in coding beginning in 1970 to exclude births to nonresidents of the United States from residence data significantly affects the comparability of data with years before 1970 only for Texas.

Beginning in 1992, NCHS contracted with seven States with the highest API populations to code births to additional API subgroups. The API subgroups include births to Vietnamese, Asian Indian, Korean, Samoan, Guamanian, and other API women. The seven States included in this reporting area are: California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington. At least two-thirds of the U.S. population of each of these additional API groups lived in the seven-State reporting area(8). The data are available on the detailed natality tapes and CD-ROMs beginning with the 1992 data year. An analytic report based on the 1992 data year is also available upon request.

The number of births to unmarried women in Texas was underreported during the years 1989-93. As a result of legislation passed in 1989, a birth was considered to have occurred to a married woman if the mother provides any information about the father, or if a paternity affidavit has been filed. The measurement of marital status for Texas births improved beginning with the 1994 data year because a direct question on marital status was added to the Texas birth certificate. However, there is a considerable discontinuity in the data for Texas from 1993 to 1994.  The proportion of births to unmarried mothers increased from 17 to 29 percent. 

One-and 5-minute Apgar scores were added to the U.S. Standard Certificate of Live Birth in 1978 to evaluate the condition of the newborn infant at 1 and 5 minutes after birth. The Apgar score is a useful measure of the need for resuscitation and a predictor of the infant's chances of surviving the first year of life. It is a summary measure of the infant's condition based on heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each of these factors is given a score of 0, 1, or 2; the sum of these 5 values is the Apgar score, which ranges from 0 to 10. A score of 10 is optimum, and a low score raises some doubts about the survival and subsequent health of the infant. In 1994 the reporting area for the 1- and 5-minute Apgar scores was comprised of 48 States and the District of Columbia, accounting for 78 percent of all births in the United States. California and Texas did not have information on Apgar scores on their birth certificate.

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