Maternal & Child Health - Birth Definitions

• Measures
• Demography

Measures:

Note: all percent measures are "valid percents" - this means that any records with unknown values are excluded from the denominator.

Births Breastfed and Percent Births Breastfed

The number of live births reported to be breastfed upon discharge, per 100 total live births. Formula = [Number of live births breastfed / Number of live births] * 100. Records with unknown values for this selected measure are excluded from the denominator.

Birth Rate

The number of live births occurring to females in an age group per 1,000 females in the same age group. Formula = [Number of Live Births in an age group / Female population in same age group] * 1,000. If no age chosen, then birth rate will equal All Live Births / Female Population 10-55 years of age * 1,000 (which will differ from the General Fertility Rate).

Births to Females with < 12^th Grade Education & Percent

The number of live births to females with < 12^th grade education, per 100 total live births. Formula = [Number of live births to females with < 12^th grade education / Number of live births] * 100. Records with unknown values for this selected measure are excluded from the denominator. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection.

Births to Unmarried Mothers & Percent

The number of live births to females who are not legally married at the time of conception and did not marry during the time between conception and delivery, per 100 live births. Formula = [Number of live births to unmarried females / Number of live births] * 100. Records with unknown values for this selected measure are excluded from the denominator. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection.

Births to Women who reported drinking Alcohol during Pregnancy & Percent

The number of births to women who reported drinking alcohol during pregnancy per 100 live births. Formula = [Number of Births to Women who reported Drinking Alcohol during Pregnancy / Total Number of Live Births] * 100. Records with unknown values for this selected measure are excluded from the denominator.

Births to Women who reported using Tobacco during Pregnancy & Percent

The number of births to women who reported using Tobacco during pregnancy per 100 live births. Formula = [Number of Births to Women who reported using Tobacco during Pregnancy / Total Number of Live Births] * 100. Records with unknown values for this selected measure are excluded from the denominator.

Births with Less Than 2 year Birth Interval & Percent

Women who delivered a live birth, where the time between the current live birth and previous live birth was less than 2 years. First and unknown birth order births are excluded from the denominator. Multiple births are treated as 1 birth.
Formula - [Number of women who delivered a live birth with less than 2 year birth interval / Number of women who experienced a previous live birth (repeat births)] * 100. Records with unknown values for this selected measure are excluded from the denominator.

Birthweight

Infant's weight recorded at the time of birth.

First Births & Percent First Births

The number of births that are the first birth to the women.
Formula = [Number of first births]/[Number of live births]*100.
Records with unknown values for this selected measure are excluded from the denominator.

General Fertility Rate (GFR)

The number of live births to women of any age per 1,000 females 15-44 years of age. Formula = [Number of live births / Female population 15-44 years of age] * 1,000. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection. Rates that use Census Population Estimates in the denominator are unable to be calculated when the selected population is Unknown.

Inadequate Kotelchuck Index & Percent

The Kotelchuck measure is an index of adequacy of prenatal care based upon month of entry, number of prenatal visits and gestational age of infant at birth. It uses American College of Obstetricians and Gynecologists standards for number of visits. The number of births by the "inadequate" value from the Kotelchuck Index, per 100 live births. Formula = [Number of Live Births with Inadequate Kotelchuck Value / Number of Live Births] * 100. Records with unknown values for this selected measure are excluded from the denominator. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection.

Late or No Prenatal Care Births & Percent

Births where the mother received prenatal care after the 2nd trimester, or not at all.
Formula = [Number of live births where the mother received prenatal care after 2nd trimester, or not at all / Number of live births] * 100. Records with unknown values for this selected measure are excluded from the denominator.

Less Than 5 Prenatal Care Visit Births & Percent

The number of births where mother had less than 5 prenatal care visits, per 100 live births. Formula = [Number of live births with less than 5 prenatal care visits / Number of live births] * 100. Records with unknown values for this selected measure are excluded from the denominator. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection.

Live Birth

The complete expulsion or extraction of a product of conception from its mother, irrespective of the duration of the pregnancy, which after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.

Low Birthweight Births & Percent

Live births of a birthweight less than 2500 grams (5lbs. 8oz.) per 100 live births. Formula = [Number of live births under 2,500 grams / Number of live births] * 100. Records with unknown values for this selected measure are excluded from the denominator. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection.

Number of Births

Number of Births count the number of live births not pregnancies. Thus, a pregnancy resulting in the delivery of twins is counted as two births.

Payor

Payor is the primary entity responsible for payment of services. Values for Payor include:

• Medicaid, based on Title XIX of the Social Security Act, is a Federal-State matching entitlement program that pays for medical assistance for certain vulnerable and needy individuals and families with low incomes and resources;
• PeachCare for Kids (Georgia's State Child Health Insurance Program (SCHIP)) is a program that provides comprehensive health care insurance for children through the age of 18 who do not qualify for Medicaid and live in households with incomes at or below the federal poverty level;
• Medicare is a health insurance program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant);
• Private Insurance includes Blue Cross / Blue Shield, HMO/Managed Care, Commercial Insurance, Other non-specified Managed Care, PPO (Preferred Provider Organization), POS (Point of Service Provider),State Health Benefit Plan (SHBP); and
• Self Pay includes patients with no proof of insurance, patients filing their own insurance claims, patients paying their own bills, Hill-Burton cases, charity cases, etc.; and
• Other (All other plans)
• Unknown Payor

Percent Births by Mother's Age

If an age group is chosen, this is the percent of births represented by the selected age group of all births in the geographic area displayed.
Formula = [The number of births in a cluster, county, or district for a selected age group / The number of births in a cluster, county, or district for all age groups] *100. Records with unknown values for this selected measure are excluded from the denominator.

Percent Births Within State

The percent of births a cluster, county or district contributes to Georgia births.
Formula = [The number of births in a cluster, county, or district / The number of births in Georgia] *100. Records with unknown values for this selected measure are excluded from the denominator.

Percent State Population

The percent of Georgia's female population represented by the cluster, county, or district.

Premature Live Births & Percent

The number of live births with a gestational age less than 37 weeks, per 100 live births. Gestational age is expressed in completed weeks. Note: Gestational age up to and including 2007 is the elapsed time since the first day of the last normal menstrual period (LMP). With the release of 2014 birth data, we implemented the new national standard for calculating gestational age per NCHS that uses the Obstetric Estimate instead of the LMP-based calculation (National Vital Statistics Reports, Vol. 64, No.5, Measuring Gestational Age in Vital Statistics Data: Transitioning to the Obstetric Estimate. June 1, 2015) . This has the effect of lowering rates of Prematurity by roughly 2 percentage points. Further, we retroactively updated the prematurity numbers and rates back to year 2008 in order to provide trendable figures. You will therefore notice a marked drop in Prematurity rates from 2007. Records with unknown values for this selected measure are excluded from the denominator.
Formula = [Number of live births with gestational age less than 37 weeks / Number of live births] * 100. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection.

Repeat Births & Percent Repeat Births

The number of births to women who previously had at least one birth.
Formula = [Number of repeat births]/[Number of births]*100. Records with unknown values for this selected measure are excluded from the denominator.

Very Low Birthweight Births & Percent

Live births with a birthweight less than 1,500 grams (3lbs. 5oz.) / Number live births] * 100. If a race, age or ethnicity is chosen, both the numerator and denominator are filtered by that selection. Records with unknown values for this selected measure are excluded from the denominator.

Demography:

Mother's Education

The last grade of formal education completed. A sample calculation is Percentage of Live Births to Females with Less than High School Education - The total number of live births to females with less than a high school education, per 100 total live births. Formula = [Total Number of Live Births to Females with Less than High School Education / Total Number of Live Births] * 100. Please note that sometimes the individual levels will not equal the total. This is due to records with Unknown Education Level.

Mother's Ethnicity

Hispanic or Latino includes persons of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. Non-Hispanic + Hispanic may not equal the total number of events due to persons of unknown ethnicity.

Mother's Race

Per the Federal Office of Management and Budget, Directive 15 (1997),

• White is a person having origins in any of the original peoples of Europe, the Middle East or North Africa;
• Black or African-American is a person having origins in any of the black racial groups of Africa;
• Asian is a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam;
• American Indian/Alaska Native is a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment;
• Native Hawaiian or Other Pacific Islander is a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands;
• Multiracial is a person declaring 2 or more of these races.

Note: Rates for years prior to year 2000 use population estimates for the denominator that adhere to a different Federal standard for race: White, Black, Asian or Other Pacific Islander, American Indian and Alaska Native. So, unlike years 2000 and after, Multiracial is not included. Also, Asian by itself is not available because it was grouped with Pacific Islander (After 1999 Asian is separate from Native Hawaiian or Other Pacific Islander).

Rates using Census Population Estimates in the denominator are not calculated when a selected race is not available in the denominator, or zero.

Nevertheless, selections available in OASIS' Race query box reflect the 1997 Race classifications described above. Most of the numerators used in indicators in Oasis *do* have the year 2000 race selections. Therefore, selections of multiple years that span <2000 and 2000+ will return a *number (count)* for all race selections, but the *rates* may be limited by the change in racial classifications the federal government used as noted above. In these cases you will see NA₁ in the output cell (NA₁ therefore by definition will only show up in rates for the years before 2000).

In some cases, the numerator's race classification may be more precise, or up to date, than the Census population estimate counterpart used in the denominator. You may find that there are a number of births of a given race for a county/age-group selection, but no count of population estimated for the denominator. In such cases where the race selection was available for both the numerator and the denominator, but the denominator's estimate was zero, you will see a NA₂. If the numerator was greater than the denominator, but the denominator was > 0, you will see a NA₃ returned.

Non-Rural

Any county with 50,000 or more total population according to the United States decennial census of 2010 or any future such census (GA Code § 31-6-2 and 31-7-94.1).

Rural

Any county having a population of less than 50,000 according to the United States decennial census of 2010 or any future such census (GA Code § 31-6-2 and 31-7-94.1).

Socioeconomic (SES) Vulnerability

Socioeconomic (SES) Vulnerability refers to the socioeconomic status domain/subset of the CDC’s Social Vulnerability Index (SVI) 2020. Socioeconomic vulnerability ranks census tracts within Georgia on 5 factors: below 150% poverty, unemployed, housing cost burden, no high school diploma, and no health insurance. Percentile ranking values range from 0 to 1, with higher values indicating greater vulnerability/lower socioeconomic status. Quintiles of the percentile rankings were used to create class breaks (Very Low, Low, Average, High and Very High SES Vulnerability). Keep in mind that “Very Low” SES Vulnerability equates to a High SES status. For more information see https://www.atsdr.cdc.gov/placeandhealth/svi/index.html. For data dictionary click here.

V3.6 (3/18/2024)