Baton Rouge Advocate Online

Report Mixed on Babies' Health

Mothers More Likely To Get Prenatal Care, but Birth Weights Drop

By LAURA MECKLER, .c The Associated Press

WASHINGTON (Feb. 20) - Pregnant women were more likely to see a doctor but less likely to be married. They were less likely to smoke, but their babies were more likely to arrive too early.

It was a mixed bag for babies in the 1990s, when there were improvements in several measures that help predict children's well-being, but setbacks too.

''Conditions at birth often reflect the forces that will shape a young person's life,'' said a report released Tuesday, ''The Right Start,'' produced by Child Trends, a research firm, and Kids Count, a project that produces an annual survey of child well-being.

The report, which examined trends from 1990 to 1998 in the 50 states and 50 largest cities, said progress varied widely. Differences may be related to socio-economic, demographic and economic factors, with children born to poor women and racial minorities facing greater risks than other new mothers.

The nation overall made more progress during the 1990s than did large cities, which lagged behind in almost every measure. And researchers noted wide variability.

In Dallas, for instance, the portion of pregnant women who failed to get important prenatal care by their second trimester dropped from 17 percent to 5 percent between 1990 and 1998. Meanwhile, in Columbus, Ohio, it increased from 4 percent to 12 percent.

''If you were Columbus, you'd say, 'What are they doing in Dallas?''' said Richard Wertheimer, a senior researcher at Child Trends. ''If the cities can figure out what works, they may have an opportunity to improve.''

Nationally, the report found progress on several measures:

-- Prenatal care: Mothers who get timely prenatal care are less likely to have babies with health problems, the report said. In 1998, just 4 percent of pregnant women failed to get prenatal care, an improvement from 6 percent in 1990. Among the 50 largest cities, there was a significant drop: from 9 percent in 1990 to 5 percent in 1998. El Paso, Texas, ranked worst, with 13 percent of moms failing to get care.

-- Smoking: Nationally, the percentage of babies born to mothers who smoked during pregnancy fell from 18 percent in 1990 to 13 percent in 1998 as smoking rates among all women of childbearing age fell. The portion of children born to smoking moms ranged from 5 percent in Washington, D.C., to 26 percent in West Virginia. On this measure alone, cities did better than the nation as a whole. In the 41 cities with 1998 data, an average of 11 percent of babies were born to smoking mothers, ''a stunning drop'' from 18 percent in 1990, the report said. It ranged from 2 percent in Miami to 24 percent in Des Moines, Iowa.

-- Education: 22 percent of babies in 1998 were born to mothers with less than 12 years of education, a modest drop from 1990's 24 percent, consistent with an overall increase in high school graduation rates. Babies with poorly educated mothers are more likely to die in the first year and face a host of other problems growing up, the report noted. State figures of babies born to high school dropouts ranged from 10 percent in North Dakota to 33 percent in Texas. Among cities, the average was 27 percent, down from its peak of 30 percent in 1991. Ranking worst was Los Angeles, where 45 percent of mothers had little education.

The nation lost ground on other measures:

-- Unmarried parents: The portion of babies born to unmarried mothers continued its steady climb, reaching 33 percent in 1994 and staying there. It ranged from 17 percent in Utah to 45 percent in Mississippi. Out-of-wedlock births were significantly higher in cities: An average of 43 percent in 1998. The range was 24 percent in San Francisco to 78 percent in Hartford, Conn.

-- Underweight babies: Babies born at less than 5.5 pounds are more likely to be sickly and die than larger babies, and often result from inadequate prenatal care. Nationally, the percentage born too small crept up from 7 percent in 1990 to 8 percent in 1998. Among cities, the average was 9 percent, with Baltimore ranking worst at 14 percent.

-- Preterm births: Babies born more than three weeks early often suffer health and development problems, plus they have an increased chance of death in the first year. Nationally, the share of preterm babies edged up from 11 percent in 1990 to 12 percent in 1998. Among cities, the average was 13 percent, with St. Louis ranking worst at 21 percent.

Researchers limited their report to statistics gathered on birth certificates, which allowed for analysis of cities. But that meant sometimes passing over more telling data only available for states and the nation. For instance, the report found only modest progress in the portion of all births to teen-agers. That's because while teen births have been dropping, so have births to older women. A better measure, experts agree, is the portion of all teens who give birth in any one year, and by that score, there's been considerable improvement. Births to girls age 15-17 fell 18 percent between 1991 and 1998, hitting a 40-year low.

Differences among states often are related to racial makeup, the report said. On all measures except smoking, whites did best and blacks worst, with Hispanics in between. Researchers note that these racial gaps have deeper roots explained by differences in education, income and availability of high-quality services.