Annual Summary of Vital Statistics: 2009

Kenneth D. Kochanek; Sharon E. Kirmeyer; Joyce A. Martin; Donna M. Strobino; Bernard Guyer

doi:10.1542/peds.2011-3435

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Pediatrics

February 2012, VOLUME 129 / ISSUE 2

From the American Academy of Pediatrics

Special Article

Annual Summary of Vital Statistics: 2009

Kenneth D. Kochanek, Sharon E. Kirmeyer, Joyce A. Martin, Donna M. Strobino, Bernard Guyer

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FIGURE 1
Percent change in birth rates by selected age of mother: United States, 2007–2009. Note: The area of each column represents the group's contribution to the overall change. Column widths are proportional to the number of births in 2007 in each group. See Sutton et al.¹⁹ Source: CDC/NCHS, National Vital Statistics System.
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FIGURE 2
Preterm birth rates by race and Hispanic origin of mother: United States, 1990–2009. Note: Preterm birth is <37 completed weeks of gestation. Source: CDC/NCHS, National Vital Statistics System.
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FIGURE 3
Infant, neonatal, and postneonatal mortality rates by race and Hispanic origin of mother, United States, 2007. Includes persons of Hispanic and non-Hispanic origin. Note: Neonatal is <28 days and postneonatal is 28 days to <1 year. See Mathews et al.¹⁴. Source: CDC/NCHS, National Vital Statistics System.
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FIGURE 4
Revised Birth Certificate* Reporting Area, 2009. *2003 US Standard Certificate of Live Birth. Note: See Martin et al.¹ Source: CDC/NCHS, National Vital Statistics System.

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TABLE 1

Vital Statistics of the United States, Selected Years: 1915–2008 (Final) and 2009 Birth (Final) and Death (Preliminary)

	Number			Rate^a
	2009	2008	2000	2009	2008	2000	1990	1980	1950	1915^b
Live births	4 130 665	4 247 694	4 058 814	13.5	14.0	14.4	16.7	15.9	24.1	29.5
Fertility rate	NA	NA	NA	66.7	68.6	65.9	70.9	68.4	106.2	125.0
Deaths	2 436 682	2 471 984	2 403 351	7.9	8.1	8.5	8.6	8.8	9.6	13.2
Age-adjusted rate	NA	NA	NA	7.4	7.6	8.7	9.4	10.4	14.5	21.7
Natural increase	1 693 983	1 775 710	1 655 463	5.5	5.8	5.9	8.1	7.1	14.5	16.3
Infant mortality	26 531	28 059	28 035	6.42	6.61	6.89	9.2	12.6	29.2	99.9
Population base (in thousands)	NA	NA	NA	307 007	304 060	281 422	248 710	226 546	150 697	100 546

2009 data for births are final. Data for 2008 and all earlier years are final. Populations are as of July 1 for 2008 and 2009, and as of April 1 in 1950, 1980, 1990, and 2000. Population for 1915 is the midyear estimate based on the April 15, 1910, census. NA, not applicable. Data sources: Centers for Disease Control and Prevention/NCHS, National Vital Statistics System, and the US Census Bureau.
↵a Rates per 1000 population, except for fertility, which is per 1000 women aged 15 to 44 years of age, and infant mortality, which is per 1000 live births.
↵b Birth rate was adjusted to include states not in registration area (10 states and the District of Columbia when started in 1915). Death rate is for death registration area. The IMR is for birth registration area.

TABLE 2

Age-Specific Birth Rates and Total Fertility Rates by Race and Hispanic Origin of Mother: United States, 2009

	Age-Specific Birth Rate by Age of Mother^a								Total Fertility Rate^b
	15–44 y^c	15–17 y	18–19 y	20–24 y	25–29 y	30–34 y	35–39 y	40–44 y	Total Fertility Rate^b
Total	66.7	20.1	66.2	96.3	110.5	97.7	46.5	10.1	2007.0
Non-Hispanic White	58.5	11.0	46.1	76.7	102.6	97.4	43.9	9.0	1780.0
Non-Hispanic Black	68.9	32.1	97.5	123.8	101.9	73.2	36.5	9.0	2026.0
Native American^d	62.8	30.6	90.5	109.1	90.8	63.9	29.0	6.5	1779.5
Asian or Pacific Islander	68.7	7.1	25.8	57.5	110.5	123.3	68.1	15.8	1956.5
Hispanic^e	93.3	41.0	114.0	151.2	145.0	108.2	56.1	14.0	2732.5

Race and Hispanic origin are reported separately on birth certificates. Persons of Hispanic origin may be of any race. Race categories are consistent with the 1977 OMB standards. Thirty-three states and the District of Columbia reported multiple-race data in 2009. Multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards for comparability with other states. Data source: Centers for Disease Control and Prevention/NCHS, National Vital Statistics System, natality.
↵a Rates per 1000 women in age-specific group.
↵b Sum of age-specific birth rates times 5 (includes rates for ages 10–14, 15–19, and 45–49 years, not shown separately).
↵c Relates the number of births to women of all ages (women aged 15–44 years).
↵d Includes births to Aleuts and Eskimos.
↵e Includes all persons of Hispanic origin of any race.

TABLE 3

Birth Rates for Teens According to Age, Race, and Hispanic Origin, United States, Selected Years: 1991–2009

Age, Race, and Hispanic Origin of Mother	Birth Rate^a					Percent Change
Age, Race, and Hispanic Origin of Mother	2009	2008	2007	2005	1991	2007–2009	2005–2007	1991–2009
15–19 y
All races	39.1	41.5	42.5	40.5	61.8	−8	5	−37
Non-Hispanic white^b	25.6	26.7	27.2	25.9	43.4	−6	5	−41
Non-Hispanic black^b	59.0	62.8	64.2	60.9	118.2	−8	5	−50
Asian or Pacific Islander	14.7	16.2	16.9	17.0	27.3	−13	—^c	−46
Native American^d	55.5	58.4	59.3	52.7	84.1	−6	13	−34
Hispanic^b^,^e	70.1	77.5	81.8	81.7	104.6	−14	—^c	−33
15–17 y
All races	20.1	21.7	22.1	21.4	38.6	−9	3	−48
Non-Hispanic white^b	11.0	11.5	11.8	11.5	23.6	−7	3	−53
Non-Hispanic black^b	32.1	34.8	35.8	34.9	86.1	−10	3	−63
Asian or Pacific Islander	7.1	7.9	8.2	8.2	16.3	−13	—^c	−56
Native American^d	30.6	32.5	31.8	30.5	51.9	−4	—^c	−41
Hispanic^b^,^e	41.0	46.1	47.9	48.5	69.2	−14	−1	−41
18–19 y
All races	66.2	70.6	73.9	69.9	94.0	−10	6	−30
Non-Hispanic white^b	46.1	48.5	50.4	48.0	70.6	−9	5	−35
Non-Hispanic black^b	97.5	104.6	109.3	103.0	162.2	−11	6	−40
Asian or Pacific Islander	25.8	28.4	29.9	30.1	42.2	−14	—^c	−39
Native American^d	90.5	96.6	101.6	87.6	134.2	−11	16	−33
Hispanic^b^,^e	114.0	127.2	137.2	134.6	155.5	−17	2	−27

Race and Hispanic origin are reported separately on birth certificates. Persons of Hispanic origin may be of any race. Race categories are consistent with the 1977 OMB standards. Thirty-three states plus the District of Columbia in 2009, 30 states in 2008, 27 states in 2007, and 19 states in 2005 reported multiple-race data. Multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards for comparability with other states. Data source: Centers for Disease Control and Prevention/NCHS, National Vital Statistics System, natality.
↵a Rates per 1000 women in specified group.
↵b In 1991 excludes data for New Hampshire, which did not report Hispanic origin on the birth certificate.
↵c Not statistically significant
↵d Includes births to Aleuts and Eskimos.
↵e Includes all persons of Hispanic origin of any race.

TABLE 4

Percentage of Births with Selected Characteristics by Race and Hispanic Origin of Mother, United States, Selected Years: 1990, 2008, and 2009

	All Races			Non-Hispanic White			Non-Hispanic Black			Hispanic^a
	2009	2008	1990	2009	2008	1990^b	2009	2008	1990^b	2009	2008	1990^b
Mother
<20 y of age	10.0	10.4	12.8	7.3	7.5	9.6	16.4	17.1	23.2	13.8	14.1	16.8
≥40 y of age	2.8	2.7	1.2	3.0	2.9	1.2	2.2	2.1	0.8	2.3	2.2	1.2
Unmarried	41.0	40.6	28.0	29.0	28.7	16.9	72.8	72.3	66.7	53.2	52.6	36.7
Diabetes during pregnancy	4.8	4.6	2.1	4.4	4.3	2.2	4.2	4.0	1.8	5.0	4.8	2.0
Pregnancy-associated hypertension	4.1	3.9	2.7	4.6	4.4	3.0	5.0	4.8	2.8	2.9	2.8	1.8
Health care utilization
Midwife-attended births^c	7.6	7.5	3.9	7.5	7.3	3.2	6.9	6.9	4.4	8.1	8.2	6.2
Cesarean delivery rate	32.9	32.3	22.7	32.8	32.4	23.4	35.4	34.5	22.1	31.6	31.0	21.2
Wt gain of >40 lbs^d	20.8	20.8	15.9	23.5	23.4	16.5	20.5	20.2	14.8	16.1	16.3	14.1
Infant
Birth weight
LBW^e	8.16	8.18	7.0	7.19	7.22	5.6	13.61	13.71	13.3	6.94	6.96	6.1
VLBW^e	1.45	1.46	1.27	1.16	1.18	0.93	3.06	3.01	2.93	1.19	1.20	1.03
Gestational age
Preterm birth^f	12.18	12.33	10.6	10.92	11.14	8.5	17.47	17.54	18.9	11.97	12.10	11.0
Early^f	3.51	3.56	3.3	2.91	2.98	2.4	6.22	6.28	7.4	3.33	3.33	3.2
Late^f	8.66	8.77	7.3	8.00	8.16	6.1	11.24	11.27	11.5	8.64	8.77	7.8
Multiple births
Live births in twin deliveries  (per 1000 live births)	33.2	32.6	22.6	37.0	36.6	22.9	38.0	36.8	26.7	22.5	22.3	18.0
Live births in higher-order multiple deliveries (per 100 000 live births)	153.5	147.6	72.8	201.4	198.1	89.8	105.6	91.3	46.2	83.5	80.1	39.4

Race and Hispanic origin are reported separately on birth certificates. Persons of Hispanic origin may be of any race. Race categories are consistent with the 1977 OMB standards. Three-three states and the District of Columbia in 2009 and 30 states in 2008 reported multiple-race data. Multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards for comparability with other states. Data source: Centers for Disease Control and Prevention/NCHS, National Vital Statistics System, natality.
↵a Includes all persons of Hispanic origin of any race.
↵b Excludes data for New Hampshire and Oklahoma, which did not report Hispanic origin.
↵c Delivered by certified nurse midwives.
↵d Mother gained more than 40 pounds during pregnancy.
↵e VLBW is birth weight of <1500g (3 lb, 4 oz), and LBW is birth weight of <2500g (5 lb, 8 oz).
↵f Preterm indicates birth before 37 completed weeks of gestation, early preterm indicates birth before 34 completed weeks of gestation, and late preterm indicates birth between 34 and 36 completed weeks of gestation.

TABLE 5

Percent Preterm and Percent LBW (Final), IMR, and NMR (Preliminary), United States and Each State: 2009

State of Residence	Preterm^a	LBW^b	IMR^c	NMR^d	State of Residence	Preterm^a	LBW^b	IMR^c	NMR^d
United States	12.2	8.2	6.42	4.19
Alabama	15.6	10.3	8.42	5.15	Montana	10.9	7.1	5.87	3.34
Alaska	10.0	5.9	6.80	2.74	Nebraska	11.5	7.1	5.42	3.30
Arizona	12.7	7.1	5.98	3.98	Nevada	13.8	8.1	5.87	3.99
Arkansas	13.1	8.9	7.70	4.27	New Hampshire	9.9	6.9	4.86	3.36
California	10.3	6.8	4.94	3.33	New Jersey	12.0	8.3	5.12	3.63
Colorado	11.3	8.8	6.25	4.20	New Mexico	12.3	8.3	5.31	3.24
Connecticut	10.2	8.0	5.50	4.19	New York	12.2	8.2	5.32	3.65
Delaware	12.5	8.6	7.87	5.71	North Carolina	13.0	9.0	7.92	5.31
District of Columbia	14.2	10.3	9.40	6.08	North Dakota	10.6	6.4	6.11	3.33
Florida	13.5	8.7	6.88	4.48	Ohio	12.3	8.6	7.68	5.21
Georgia	13.8	9.4	8.15	5.62	Oklahoma	13.8	8.4	7.90	4.43
Hawaii	12.6	8.4	6.14	4.55	Oregon	9.8	6.3	4.81	3.33
Idaho	10.1	6.5	5.44	3.41	Pennsylvania	11.5	8.3	7.14	4.88
Illinois	12.4	8.4	6.90	4.39	Rhode Island	11.4	8.0	6.20	4.98
Indiana	11.9	8.3	7.82	4.96	South Carolina	14.5	10.0	7.41	4.49
Iowa	11.3	6.7	4.58	2.72	South Dakota	10.9	5.8	6.70	3.77
Kansas	11.2	7.3	6.98	4.25	Tennessee	13.0	9.2	8.00	4.77
Kentucky	13.6	8.9	6.79	3.49	Texas	13.1	8.5	5.99	3.78
Louisiana	14.7	10.6	8.69	5.09	Utah	11.3	7.0	5.29	3.90
Maine	9.9	6.3	5.42	3.93	Vermont	9.3	6.7	6.22	4.42
Maryland	12.7	9.1	7.27	5.18	Virginia	11.4	8.4	7.14	4.67
Massachusetts	10.9	7.8	5.03	3.85	Washington	10.3	6.3	4.91	2.84
Michigan	12.4	8.4	7.52	5.13	West Virginia	12.9	9.2	7.76	5.22
Minnesota	10.1	6.5	4.61	2.69	Wisconsin	10.9	7.1	6.08	3.98
Mississippi	18.0	12.2	10.02	6.13	Wyoming	11.2	8.4	5.96	3.55
Missouri	12.2	8.1	7.16	4.51

Data source: Centers for Disease Control and Prevention/NCHS, National Vital Statistics System.
↵a Preterm birth is <37 weeks of completed gestation.
↵b LBW is <2500 g.
↵c Infant deaths (< 1 year) per 1000 live births.
↵d Neonatal deaths (<28 days) per 1000 live births.

TABLE 6

Deaths, Percentages of Total Deaths, and Mortality Rates for the 10 Leading Causes of Infant Death: United States, 2008 (Final) and 2009 (Preliminary)

Causes of Death and International Classification of Diseases, 10th Revision Codes¹²	Rank^a	2009			2008
	Rank^a	n	%	Rate^c	n	%	Rate^c
All causes	—^b	26 531	100.0	642.1	28 059	100.0	660.6
Congenital malformations, deformations and chromosomal abnormalities (Q00–Q99)	1	5358	20.2	129.7	5638	20.1	132.7
Disorders related to short gestation and low birth weight, not elsewhere classified (P07)	2	4463	16.8	108.0	4754	16.9	111.9
Sudden infant death syndrome (R95)	3	2168	8.2	52.5	2353	8.4	55.4
Newborn affected by maternal complications of pregnancy (P01)	4	1586	6.0	38.4	1765	6.3	41.6
Accidents (unintentional injuries) (V01-X59)	5	1158	4.4	28.0	1315	4.7	31.0
Newborn affected by complications of placenta, cord, and membranes (P02)	6	1022	3.9	24.7	1080	3.8	25.4
Bacterial sepsis of newborn (P36)	7	682	2.6	16.5	700	2.5	16.5
Respiratory distress of newborn (P22)	8	587	2.2	14.2	630	2.2	14.8
Diseases of the circulatory system (I00–I99)	9	565	2.1	13.7	594	2.1	14.0
Neonatal hemorrhage (P50–P52,P54)	10	537	2.0	13.0	556	2.0	13.1

Data source: Centers for Disease Control and Prevention/NCHS, National Vital Statistics System: mortality, 2009 and 2008 (www.cdc.gov/nchs/nvss/mortality_tables.htm).
a Rank is based on 2009 data.
↵b Indicates that data are not applicable.
↵c IMRs are per 100 000 live births.

TABLE 7

Number of Live Births for 2009 and IMRs for 2007, 2008, and 2009 for 30 Countries

Country	No. of Births in 2009/2010^a	IMR
Country	No. of Births in 2009/2010^a	2009	2008	2007
Hong Kong	82 095	1.7	1.8	1.8
Japan	1 070 035	2.4	2.6	2.6
Sweden	115 641^a	2.5	2.5	2.5
Finland	60 980^a	2.6	2.6	2.7
Czech Republic	117 153^a	2.9	2.8	3.1
Norway	61 442^a	3.1	2.7	3.1
Greece	117 933	3.1	2.7	3.5
Denmark	63 411	3.1	4.0	4.0
Republic of Korea	444 849	3.2	3.5	3.6
Ireland	73 940^a	3.2	3.8	3.1
Spain	479 999^a	3.3	3.3	3.5
Belgium	127 000^a	3.4	3.7	4.0
Germany	681 000^a	3.5	3.5	3.9
Portugal	101 320	3.6	3.3	3.4
Italy	561 980^a	3.7	3.3	3.5
Austria	78 742^a	3.8	3.7	3.7
Israel	165 950^a	3.8	3.8	3.9
Netherlands	183 866^a	3.8	3.8	4.1
France	829 000^a	3.9	3.8	3.8
Switzerland	80 000^a	4.3	4.0	3.9
Australia	295 738	4.3	4.1	4.2
United Kingdom	778 823^a	4.7	4.6	4.8
Cuba	130 036	4.8	4.7	5.3
New Zealand	62 543	4.9	5.0	4.9
Canada	377 886	—^b	5.1^c	5.1
Hungary	90 350^a	5.1	5.6	5.9
Croatia	44 577	5.3	4.5	5.6
Poland	413 300^a	5.6	5.6	6
Slovenia	60 410^a	5.7	5.9	6.1
United States	4 130 665	6.4^d	6.6	6.8

Data sources: Tables 9 and 15 in United Nations Demographic Yearbook, 2008.¹⁸
↵a Data are for 2010.
↵b Data are not available.
↵c Statistics Canada, CANSIM, table 102-0504 and Catalogue no. 84F0211X.
↵d Preliminary data.

TABLE 8

Deaths and Death Rates for the 5 Leading Causes of Childhood Death in Specified Age Groups, United States, 2008 (Final) and 2009 (Preliminary)

Age, Causes of Death, and International Classification of Diseases, Tenth Revision Codes¹²	Rank^a	2009			2008
	Rank^a	n	%	Rate^b	n	%	Rate^b
Total: 1–19 y
All causes	—^c	21 542	100.0	27.2	22 788	100.0	29.1
Accidents (unintentional injuries) (V01–X59,Y85–Y86)	1	7871	36.5	9.9	8869	38.9	11.3
Assault (homicide) (U01–U02,X85–Y09,Y87.1)	2	2597	12.1	3.3	2836	12.4	3.6
Intentional self-harm (suicide) (*U03,X60–-X84,Y87.0)	3	1922	8.9	2.4	1826	8.0	2.3
Malignant neoplasms (C00–C97)	4	1896	8.8	2.4	1969	8.6	2.5
Congenital malformations, deformations, and chromosomal abnormalities (Q00–Q99)	5	1062	4.9	1.3	1082	4.7	1.4
Diseases of heart (I00–I09,I11,I13,I20–I51)	6	679	3.2	0.9	778	3.4	1.0
Influenza and pneumonia (J09–J18)	7	521	2.4	0.7	295	1.3	0.4
Chronic lower respiratory diseases (J40-J47)	8	260	1.2	0.3	244	1.1	0.3
Septicemia (A40–A41)	9	185	0.9	0.2	208	0.9	0.3
Cerebrovascular diseases (I60–I69)	10	174	0.8	0.2	232	1.0	0.3
1–4 y
All causes	—^c	4448	100.0	26.1	4730	100.0	28.3
Accidents (unintentional injuries) (V01–X59,Y85–Y86)	1	1446	32.5	8.5	1469	31.1	8.8
Congenital malformations, deformations, and chromosomal abnormalities (Q00–Q99)	2	485	10.9	2.8	521	11.0	3.1
Assault (homicide) (U01–U02,X85–Y09,Y87.1)	3	385	8.7	2.3	421	8.9	2.5
Malignant neoplasms (C00–C97)	4	349	7.8	2.0	394	8.3	2.4
Diseases of heart (I00-I09,I11,I13,I20–I51)	5	154	3.5	0.9	186	3.9	1.1
5–9 y
All causes	—^c	2508	100.0	12.2	2502	100.0	12.5
Accidents (unintentional injuries) (V01–X59,Y85–Y86)	1	776	30.9	3.8	835	33.4	4.2
Malignant neoplasms (C00–C97)	2	467	18.6	2.3	457	18.3	2.3
Congenital malformations, deformations, and chromosomal abnormalities (Q00–Q99)	3	189	7.5	0.9	170	6.8	0.8
Assault (homicide) (U01–U02,X85–Y09,Y87.1)	4	118	4.7	0.6	113	4.5	0.6
Influenza and pneumonia (J09–-J18)	5	111	4.4	0.5	40	1.6	0.2
10–14 y
All causes	—^c	3121	100.0	15.6	3149	100.0	15.7
Accidents (unintentional injuries) (V01–X59,Y85–Y86)	1	891	28.5	4.5	1024	32.5	5.1
Malignant neoplasms (C00–C97)	2	426	13.6	2.1	433	13.8	2.2
Intentional self-harm (suicide) (*U03,X60–X84,Y87.0)	3	259	8.3	1.3	215	6.8	1.1
Assault (homicide) (U01–U02,X85–Y09,Y87.1)	4	201	6.4	1.0	207	6.6	1.0
Congenital malformations, deformations, and chromosomal abnormalities (Q00–Q99)	5	161	5.2	0.8	161	5.1	0.8
15–19 y
All causes	—^c	11 465	100.0	53.2	12 407	100.0	57.7
Accidents (unintentional injuries) (V01–X59,Y85–Y86)	1	4758	41.5	22.1	5541	44.7	25.8
Assault (homicide) (U01–U02,X85–Y09,Y87.1)	2	1893	16.5	8.8	2095	16.9	9.7
Intentional self-harm (suicide) (*U03,X60–X84,Y87.0)	3	1656	14.4	7.7	1604	12.9	7.5
Malignant neoplasms (C00–C97)	4	654	5.7	3.0	685	5.5	3.2
Diseases of heart (I00–I09,I11,I13,I20–I51)	5	325	2.8	1.5	363	2.9	1.7

Data source: Centers for Disease Control and Prevention / NCHS, National Vital Statistics System: mortality, 2009 and 2008 (www.cdc.gov/nchs/nvss/mortality_tables.htm).
↵a Rank is based on 2009 data.
↵b Rate per 100 000 population in specified group.
↵c Indicates that data are not available.