Maternal and Child Health Library

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April 20, 2007

1. REPORT HIGHLIGHTS PROGRESS TOWARD MEETING HEALTHY PEOPLE 2010 MATERNAL, INFANT, AND CHILD HEALTH OBJECTIVES

Healthy People 2010 Midcourse Review: Maternal, Infant and Child Health highlights results from an assessment of progress toward achieving the Healthy People (HP) 2010 maternal, infant, and child health goals and objectives through the first half of the decade. The purpose of the midcourse review, which was led by the Centers for Disease Control and Prevention and the Health Resources and Services Administration, is to assess data trends; consider new science and available data; and, if appropriate, revise the objectives to ensure that HP 2010 remains current, accurate, and relevant to public health priorities. Topics include modifications to objectives and sub-objectives, progress toward Healthy People 2010 targets, progress toward elimination of health disparities, opportunities and challenges, and emerging issues. References and related objectives from other focus areas are also included. The report is available at http://www.healthypeople.gov/data/midcourse/pdf/FA16.pdf.

• Among pregnant women in the United States, 21.7% reported that they smoked cigarettes and 12.4% met criteria for nicotine dependence.
• Among pregnant women who smoked cigarettes, 45.1% met criteria for at least one mental disorder; among pregnant women with nicotine dependence, 57.5% met criteria for at least one mental disorder.
• After adjustment for differences in demographic characteristics and co-morbid mental disorders, the associations between major depressive disorder, dysthymia, and panic disorder remained significantly associated with nicotine dependence among pregnant women.

• The number of prescriptions for the ages-18-and-younger group increased by a monthly average of 0.79% from April 2002 to February 2004. After February 2004, there was a decrease in the number of prescriptions by a monthly average of 4.23%. By July 2004, the market began to stabilize such that there was no significant change in prescribing trends from July 2004 to March 2005.
• In quarter February 2004, psychiatrists cared for 44% of the ages-18-and-younger group. In contrast, psychiatrists cared for 63% of this group in quarter February 2005.
• There was an increase in prescribing of non-FDA-approved antidepressants to the ages-18-and-younger group that was not observed in the ages-18-and-older groups.

• Infant mortality rates declined during the study period for all the deprivation groups.
• Between 1969 and 1984, both absolute and relative socioeconomic disparities in infant, neonatal, and postnatal mortality declined. Beginning with the 1985-1989 period, however, the risk ratios (RRs) of infant, neonatal, and postnatal mortality associated with area deprivation generally increased.
• In 1985-1989, infants in the most deprived group had, respectively, 36% and 57% higher risks of neonatal and postneonatal mortality than infants in the least deprived group. In 1995-2000, the deprivation gradient in infant mortality widened considerably, with infants in the most deprived group experiencing 43% and 96% higher RRs of neonatal and postnatal mortality, respectively, than their least-deprived counterparts.
• Between 1986 and 2001, all maternal-education groups showed substantial declines in mortality rates, but the adjusted relative educational disparities were greater in 2001 than in 1986.
• Infant, neonatal, and postnatal mortality rates show dramatic declines between 1986 and 2001 for the three birthweight strata (very-low birthweight, moderately low birthweight, and normal birthweight). The rate of decline in neonatal mortality during 1986-2001, however, was greater in all three strata in the highest educational category than in the lower educational categories.