Missouri Resident Infant Health Profile

Morbidity

Preterm Births (less than 37 Weeks Gestation)

Number of resident infants born alive prior to the 37th completed week of gestation. The rate is per 100 resident live births with known gestational age.

Early Preterm Births (less than 34 Weeks Gestation)

Number of resident infants born alive prior to the 34th completed week of gestation. The rate is per 100 resident live births with known gestational age.

Low Birth Weight

A live birth of less than 2,500 grams (five and one-half pounds). The rate of this number is per 100 resident live births with known birth weight.

Low Birth Weight and Term

Number of resident low birth weight infants (less than 2,500 grams) born after the 37th completed week of gestation. The rate is per 100 resident live births with known birth weight and gestational age.

Very Low Birth Weight

Resident live births of less than 1,500 grams (three pounds and 5 ounces). The rate is per 100 resident live births with known birth weight.

Small for Gestational Age

The number of resident singleton infants whose birth weight is below the 10th percentile for their gender and gestational age. Tenth percentile cut points were acquired from the 1991 United States National Reference for Fetal Growth (Alexander GR et al., Obst & Gyn. Vol. 87, No. 2, Feb. 1996 p. 167). The rate is per 100 resident live births with known gestational age.

NICU Admission

The number of resident live births that were sent to the Neonatal Intensive Care Unit (NICU) after birth. The rate is per 100 resident live births.

Birth Defects per 10,000

Number of resident infants born with birth defects diagnosed within the first year of life. Rate is per 10,000 live births for the noted time period. Birth defects are congenital defects of body structure or function, likely to result in mental or physical handicap or death. Specific condition included are those listed in the 740-759 Congenital Anomalies section of the International Classifications of Diseases – 9th Revision or the Q00-Q99 Congenital malformations, deformations and chromosomal abnormalities of the International Classification of Diseases – 10th Revision. Certain conditions of little or no medical or cosmetic significance, such as supernumerary digits, common birth marks, tongue tie, and undescended testicle in preterm infants, also ICD-9 codes 743.65, 744.1, 750.0, 755.0, 757.3, 757.9 and 747.0 or 752.5 in preterm infants and ICD-10 codes Q10.6, Q17.0, Q69, Q38.1, Q82.8, Q84.9, and Q25.0 or Q53 are excluded. The information is acquired from the following files to ascertain cases: birth certificates, death certificates, newborn inpatient abstract system, pediatric in- and outpatient abstracts.

Neural Tube Defects (NTD) per 10,000

Resident live births with neural tube defect(s) noted from the following files to ascertain cases: birth certificates, death certificates, newborn inpatient abstract system, pediatric in- and outpatient abstracts. Neural tube defects include 1) anencephaly, the congenital absence of most or all of the brain, a uniformly fatal defect; and/or 2) spina bifida, the congenital closure of the spinal column with profusion of the spinal cord, resulting in varying degrees of disability, including bowl and bladder control difficulties and paralysis. The rate is per 10,000 live births for the noted time period.

Critical Congenital Heart Disease (CCHD) per 10,000

Resident live births diagnosed with critical congenital heart disease noted from the following files to ascertain cases: birth certificates, death certificates, newborn inpatient abstract system, pediatric in- and outpatient abstracts. Critical congenital heart disease includes common truncus, transposition of great vessels, tetralogy of fallot, hypoplastic left heart syndrome, tricuspid valve atresia and stenosis, and aortic valve stenosis. The rate is per 10,000 live births for the noted time period.

Oral Clefts per 10,000

Resident live births with oral clefts noted from the following files to ascertain cases: birth certificates, death certificates, newborn inpatient abstract system, pediatric in- and outpatient abstracts. Oral clefts include cleft palate only, cleft lip with or without cleft palate, and choanal atresia. The rate is per 10,000 live births for the noted time period.

Limb Defects per 10,000

Resident live births with limb defect(s) noted from the following files to ascertain cases: birth certificates, death certificates, newborn inpatient abstract system, pediatric in- and outpatient abstracts. Limb defects include clubfoot, reduction deformity of the upper limb, and reduction deformity of the lower limb. The rate is per 10,000 live births for the noted time period.

Chromosomal Defects per 10,000

Resident live births with chromosomal defect(s) noted from the following files to ascertain cases: birth certificates, death certificates, newborn inpatient abstract system, pediatric in- and outpatient abstracts. Chromosomal defects include trisomy 21 (Down syndrome), trisomy 13 (Patau syndrome), trisomy 18 (Edwards syndrome), and other chromosomal anomalies. The rate is per 10,000 live births for the noted time period.

Utilization

Very Low Birth Weight Delivered in Level III Centers

Resident very low birth weight infants (less than 1,500 grams) delivered in Level III perinatal care centers. The rate is per 100 very low birth weight infants to Missouri residents recorded in Missouri facilities.

Infants Participating in WIC

The number of Missouri infants certified in the WIC infant program during the specified data year. The rate is the percent of Missouri infants certified in WIC out of all Missouri resident infants. Residents are eligible for the WIC Infant program from birth to their first birthday. WIC participation is acquired from the WIC Certification data sets. WIC data could be undercounted for any given county due to problems in identifying county of residency from the WIC Certification data sets. Percent (rate) for any given county may exceed 100 due to in-migration to that geographic area.

Breastfeeding Initiation in Hospital

Live births where the mother breastfed, or attempted to breastfeed, the baby prior to discharge from the birthing facility. This does not imply that the breastfeeding was successful or that the mother intends to continue breastfeeding after discharge. The rate is per 100 resident live births.

WIC Infants – Ever Breastfed

Ever breastfed refers to infants participating in the WIC program that were breastfed sometime in their infancy, without regard to duration. The rate is the percent of Missouri WIC infants ever breastfed out of all infants participating in WIC (prior to their first birthday) with known breastfeeding status.

Infants on Medicaid

Number of resident infants (less than one year of age) eligible for Medicaid (having a Medicaid card -unduplicative count) on December 31 of given year and the percent this number is of total resident live births for calendar year. Medicaid status is acquired from Department of Social Services files. Percent may be over 100 due to in migration to geographic area.

Mortality

Neonatal Deaths per 1,000

The total number of resident deaths to babies born alive and dying during the first 27 days of life. The rate is per 1,000 resident births for the noted eleven-year period.

Perinatal Deaths per 1,000

The total number of resident fetal deaths with a gestational age of 20 or more weeks plus neonatal deaths. The rate is per 1,000 resident fetal deaths and live births for the noted eleven-year period.

Postneonatal Deaths per 1,000

The total number of resident deaths to babies born alive and dying after 27 days of life and before one year of age. The rate is per 1,000 resident live births for the noted eleven-year period.

Infant Deaths per 1,000

The total number of resident deaths to babies born alive and dying before their first birthday. The rate is per 1,000 resident live births during the noted eleven-year period.

Sudden Infant Death Syndrome (SIDS) per 1,000

The total number of resident deaths to babies born alive and dying during infancy before their first birthday with Sudden Infant Death Syndrome (ICD-10 code R95) noted as the underlying cause of death. The rate is per 1,000 live births during the noted eleven-year period. SIDS is defined as the sudden death of an infant less than one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. The number may not agree with the Death MICA because the Death MICA includes SIDS above the age of one.