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APPENDIX B Data on Selected Low Birthweight Trends (Supplement to Chapter 3) The following tables supplement those contained in Chapter 3. They include data for the On ited States as a whole and for f ive states: California, Massachuetts, Michigan, North Carolina, and Oregon. For assistance in compiling the tables included in this appendix and in Chapter 3, the committee gratefully acknowledges contributions of the following individuals : Selma Taffel, Joel Kleinman, Jacob Feldman, and Paul Placek at the U. S. National Center for Health Statistics; Gary B. Pohl and Jeffrey Taylor at the Office of Vital and Health Statistics, Michigan Department of Public Health; David Hopkins and Nancy Clarke at the Center for Health Statistics, Oregon Department of Human Resources, Health Division; Peter M. Chen, Elizabeth J. Clingman, and Ronald L. Williams at the Community and Organization Research Institute, University of California, Santa Barbara; Charles G. Rothwell and Michael Patetta at the State Center for Health Statistics, North Carolina Division of Health Services; and Charlene Zion, Irene Klangos, and Sharon Rosen at the Division of Health Statistics, Massachusetts Department of Public Health. 252

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253 1 ~ o ~ ~ ~ ~ ~ ~ o ~ US ~ ~ o o o ~ ~ CO ~ U~ ~ ~ ~ o o lD Ln e e e e e e O O O O O O O O O CQ OO O O U~ ~ S~ ~ O a' 1 U) ~Q ~: ~: Y ~: S . - ~. 3 s ._~ Ll - m U] .,. m :> .,, o ~: c) P4 . m E~ 0 0 O O U~ C~ 0 O O O n ~ eq O O U~ ~ 0 {Q ~Q O O ~ C~ 0 U) c) 1 O 0 0 ~ tQ O O ~ 0 ~ cn O O U~ ~ 0 O O O ~ ~ ~ U. ~ O ~ ~ 0 O 0 ~ ~ ~ ~ ~ - ~ co r~ ~ ~o ~ 0 ~ ~ u~ ~ ~ ~ ~ oN ~ c~ ~ ~ ~ c~ ~ ql e ~ e e e e e e ~ ~ ~ C~ C~ ~ ~ C~ ~ C~ ~ O O O U~ C~ ~ _ _ _ _ O O ~ O m) ~ 0 0 ~ t a~ ~ d. 1D ~ ~ e ~ c~ 0 ~ a' ~ a, kD (D ~ ~ ~ ~ c~ O a' a, ~ ~ e e ~ In IO ~n Lr u~ ~ ID ~ ~ ~ ~ C~ ~ ~ ~ C~ ~ ~ ~ O O O a~ ~ c~ cs~ ~ ~ c~o a~ a~ o~ ~ ~ O O O O O O O O O O O as cx~ ~ _~ ~ 0 ~ a~ ~o u~ d e e ~ e ~ ~ ~ ~ tD kD ~ U~ ~ ~ U~ ~ ~ co a, ~ 0 e - O O O t-) ~ [_ CO e - O O O ~ ~ U, - ~ - cn 0 ~ 0 0 . . . . O 0 U~ ~r ~ ~ ~ ~ u~ e e e e O O O ~ ~ ~ 0 c~ r~ ~ c~ ~ ~r ~ ~ ~ d. ~ ~n ~D ~ ~ ~ ~ ~ 0 ~ ~ ~ ~ ~ ~ e, a: e e ~ ~ e e e . e e e ~ ~ ~ kD ~ ~ ~n ~ u~ ~ un 0 0 0 kD ~ ~ _ _ _ ~ _ ~ ~r ~ ~ ~ u~ ~ ~ ~ un u~ O O O aD ~ ~ ~ ~ e e e e ~ O ~ ~ ~ ~ ~ ~ ~ ~ ~ O O O O O ~ _ _ _ _ _ _ u~ ~ 0 ~ ~ ~ 0 0 ~ 0 0 ~ ~ ~ a: u~ ~ ~ ~ 0 ~ C~ ~ ~ ~ ~ a, e e e e e e r~ ~ r~ ~ ~ ~ 0 0 0 u~ ~ O U] kD ~ ~ \9 ~ ~ ~ ~ co ao ~ a:~ CD C) ~ ~ ~ a' a, 1 1 1 ~ 1 1 1 ~1 ~D1 _I tD I r~ C: O ~ a' cn ~ ~ ~ a' U] O ~ C) ~ ~ t_ I_ !_ [_ r_ r~ a~ ~ ~ ~ a: cs, ~ a~ a, ~ ~ ~ cn cr' ~{ tQ V V _ `: U] Q) 00 S c: P.

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254 TABLE B.2 Low-Weight Births (Less Than 2,500 Grams) per 1,000 Live Births in Five States, 1968-1982 Calif.a Mass.b MiCh.C N.c.d Oreg.e 1968 73 97 1969 71 76 91 1970 69 74 78 92 1971 66 71 77 87 57 1972 65 70 78 88 58 1973 65 71 77 87 59 1974 63 67 74 87 56 1975 63 68 74 87 57 1976 62 66 75 83 54 1977 61 64 72 80 52 1978 62 64 72 81 51 1979 60 61 71 79 52 1980 59 61 69 80 50 1981 58 59 69 79 50 1982 69 80 Average Annual Percent 1.6 2.0 1.2 1.3 1.7 Declinef (0.1) (0.1) (0.1) (0.1) (0.2 NOTE: All data include both singleton and multiple births. Births with unknown birthweights are excluded. aBased on tabulations provided by the Community and Organization Research Institute, University of California, Santa Barbara . bComputed from vital records data provided by the Division of Health Statistics, Massachusetts Department of Public Health. CBased on tabulations provided by Michigan Department of Public Health, Office of Vita' and Health Statistics. am ~~ a ~ ~ _ a ~ ~ ~ a_ ompucea Prom vital records data provided by the Division of Health Services, Norm Carolina State Center for Health Statistics. Abased on tabulations provided by the Center for Health Statistics, Oregon Department of Homan Resources psalm ni`1ici^" ~ ~ ~ ~ _~- ~~- __~e -estimated from ordinary least squares regression of the natural logarithm of the low-weight rate against time. Standard errors in parentheses.

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255 TABLE B.3 Low-Weight Births and Late Fetal Deaths per 1,000 Live Births and Late Fetal Deaths in Four States, 1968-1982 Calif .a M, ch.b N.c.b oreg.b 1968 78 102 1969 76 96 1970 74 97 1971 71 93 60 1972 70 81 93 61 1973 69 81 93 63 1974 68 77 91 59 1975 66 77 91 60 1976 66 77 87 S7 1977 64 74 83 54 1978 66 74 84 53 1979 63 73 85 54 1980 62 72 83 52 1981 61 72 82 Sl 1982 72 83 Average Annual Percent 1.8 1 .3 DeclineC (O. . 1) (O. . 1) 1.5 (O .1) 2.0 (0 .3) . aLate fetal deaths include all fetal deaths weighing 500 granny or more. bLate fetal deaths include all fetal deaths of at least 28 weeks gestation. CSee Table B . 2, note f . SOUPBONES: See footnote a, c, d, and e on Table B . 2 .

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256 TABLE B.4 Effect of Adding Fetal Deaths to Live Births on Changes in LOw B1rthweight Rates, by Race in the United States, 1973 and 1977 (Rates per 100 Live Births and Fetal Deaths) White Black Birthweight Percent Percent (grams) 1973 1977 Changea 1973 1977 Changea Live Births <1,500 0.94 0.89 5.3 2.28 2.37 {4 .3) b <2,500 6.4 5.9 7.2 13.3 12.8 3 .5 Live births plus fetal deaths, >28 weeks gestation <1,500 1.14 2.06 7.0 2.66 2.72 (2.3) <2,500 6.8 6.3 7.7 13.9 13.3 4.0 Live births plus fetal deaths, >20 weeks gestation <1,500 1.40 1.29 7.8 3.27 3.24 0.1 <2,500 7.0 6.5 8.1 14.5 13.8 4.4 aPercent change based on birthweight rates to 2 decimal places. arentheses indicate increase.

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257 0 U) ~5 ,1 TIC - 0 C) ~5 as A: 0 3 S m 0 m s 0 - o o Q Q 0 ~8 V ~4 ED Cat U. ~ C: m ~ at; P as c) ~ ~ al m ~ as a' _ :~ ~ a, so V en_ U] 0 ~ 3 n5 , . m O ~ ~ ~ Cat ED CD r ED ~ Cut 0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ e O ~ ~ Cat ~ d. ~ an fir 0 0 0 O ~ to _1 O ~ ~ t ~ ~ ~ ~ ~ _I 0 _~ ~ Lt-) ~ a~ ~ co a~ ~ ~ _I e e ~ 0 ~ ~ ~ ~ ~ a' ~ ~ 0 0 0 O C~ t~ _I _I O ~ ~ 0 1~ 0 0 ~ ~ U~ ~ U~ 0 0 c~ ~ ~ a:, 0 a' t ~ _1 e 0 ~ ~ ~ ao u~ 0 ~ ~ 0 0 0 O 0 ~ ~ ac 0 kD ~ C~ ~ O O ~ ~ O ~ ~ CO e e e - O O O ~ ~ d' ~ ~ ~ ~ O O O _I ~ ~ O ~ O CO ~ O ~ C~ ~ O ~ O o ~ ~ _1 0 un _t ~ O t C~J ~ e ~ e O O O ~ ~ ~ ~ C~ ~ ~ O O O _I ~ t~ O ~ ~ ~ ~ O O ' O ~ U~ C~ ~ ~ ~ ~ ~ d. e e ~ e e ~ 0 0 0 ~ ~ ~ a) a, ~ ~ 0 0 O ~ ~ C~ O u~ ~ O ~ d. ~ ~ U. ~ ~ O O u~ tD ~ ~ ~ ~ O CX) u~ ~ ~ e e e ~ e e e e O O O ~ ~ ~ ~ ~ ~ ~ O O O _I t~ O1 O ~ ~ ~ 0 ~D ~ 0 ac o ~ ~ ~ ~ ~ er ~ ~ ~ ~ c~ e e e e e ~ e 0 0 0 ~ ~ r~ ~ ~ a) ~ 0 0 O O ~ ~ ~ ~ CX} C~ O ~ ~ d. O (D t~ d' C~ C~ _' C~ e e e e e e 0 0 0 ~ u~ a, 0 ~ ~ ~ 0 0 O ~ ~ C~ O O O O O O O O O O O O O O O O O ~ O ~ O ~ O ' ' ~ c~ c~ ~ ~ ~ ~r 0 1 1 1 1 1 1 1 ~ ~ ~ O ~ ~ ~ ~ ~ ~ ~ ~ O U] ~S O O O O O O O O O O O IS, O U~ O ~ O It~ ~ ~ O ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ O E~ V I ~ ~ {~ ~ ~. ~ ~ ~ ~ 1 Z

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258 TABLE B.6 Low-Weight Births per 1,000 Live Births in Relation to Race for Five States, 1968-1982 Calif .a Mass .b Mich .b N .c. ~ Or eg ~ ~ . . , W ~ S W B W B W B W B 1968 58 116 57 78 147 1969 55 115 55 73 135 72 142 1970 53 113 53 71 136 66 143 72 145 1971 51 111 53 65 113 64 144 70 135 56 118 1972 49 113 52 66 137 63 145 69 138 57 152 1973 49 112 51 68 135 63 143 70 133 57 122 1974 48 110 48 64 111 62 135 67 135 54 129 1975 47 109 49 65 115 61 138 68 135 55 109 1976 46 108 47 63 125 61 140 64 130 52 127 1977 45 108 46 61 116 59 135 61 126 50 110 1978 46 107 48 60 123 59 137 64 124 49 109 1979 44 103 46 57 114 58 137 63 126 50 111 1980 45 103 44 56 114 57 133 62 123 48 104 1981 44 101 45 55 111 57 137 61 124 47 103 1982 56 141 61 126 Average Annual Percent 1.9 1.0 1.8 2.2 1.4 1.3 O.4 1.6 1.2 2.0 2.6 DeclineC (0.2) (0.1 ~ (0.~) (0.2) (0.5) (0.1) (0.2) (0.2} (0.1) (0.3) (1.0) an = white births of non-Spanish surname. B = black births. S = white births inferred to be Spanish by surname. ~Race. refers to race of newborn. Only singleton live births included. Births of unknown weight excluded. be = white births. B = black births. "Race. refers to race of mother. Both singleton and multiple live births included. Births of unknown weight excluded. CSee Table B.2, note f. SOURCES: See footnotes a through e on Table B.2.

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259 in U. v .,' s i: c) at: s o A: o Ql A: s - ~. .,' 3 S - m 3 o m 00 s m o c) CO q:5 m ~ ' ~D m ~ ~S E~ ao ~ r~ oo ~ L~ ~ co a:) ~ a, e e ~ ~ e e - ~n 0 ~ co ~ ~n ~ ~r ~ ~ O 0 00 0 0 0 0 0 ~ O O O O O O O 0 C0 ~ d~ ~ O ~ ~ ~ ~1 ~ o ~ ~ ~ O _I _l e ~ e ~ e ~ e e ~ ~r ~ ~ ~ tD ~ ~ ~ ~ ~ O ~ ~ ~ ~ O a' ~ ~ 0 ~ ~ a~ 0 LO ~ ~ ~ O O ~ ~ ~ U~ a) 0 ~ ~ ~ ~ ~ 0 O _I I 1 1 0 0 ~ t CD C~ ~ t 1 1 _~ u~ a~ a~ c~ w) a~ a~ ~ 1 e I | e e e e | | e e e e | | e ~ ~D ~ Lr) ~ ~ U~ ~ ~ ~ ~r ~ ~ ~ 0 ~ ~ 0 ~ ~ 0 0 0 ~ ~ ~ ~ ~ ~ 0 ~ ~ a' r~ 0 ~ ~ c~ 1 1 0 t _I ts-) ~ ~ ~ 0 1 1 ~ ~ ~ CX) _~ e e e | | e ~ ~ e e e e e I | e e e e e kD C~ (X) ~ ) ~ t t Ln ~ ~ Lt~ J 10 ~ t d' C~ ~ O ~ ~ ~ ~ \9 0 0 0 0 0 0 0 0 0 0 0 c~ C~ ~ L9 ~ (D C~ a~ a~ co ~ 0 e ~ e e e e e e e O ~ ~ ~ O ~ ~ ~ ~ O O O ~n ~ ~ ~ ~ 0 a) ~ ~ a~ ~ o~ _~ u~ ~ 1 1 ~1 ~ O _I ~ ~ t ~ 1 1 C~ a~ ~ _I ~ ~ ~ I | ~ ~ e ~ ~ ~ e e ~ I e _~ ~) ~ ~1 0 _t _I _~ O C~ ~ O O O O ~t a~ ~ ~ 0 a' O O er 1 1 ~ t ~ C~ _' ~ e e | | e e _I Ir~ C~J O _~ _I ~ _I _ O O O O O O O O a) 0 ~ ~ ~ e e ~ e e ~ e C~ ~ ~ C~ C~ 0 ~ a' u~ ~ ~ `9 CN ~ ~ e ~ ~ C~ ~ ~ ~ C~ ~ C~ C~ ~ ~ LO ~ ~ ~ ~ ~ ~ ~ CO ~ ~ ~ ~ ~ C~ ~ U~ ~ O 1 1 0 ~ O ~J c~ ~ ~) 1 1 1 C~ ~ O _~ c~ ~ kD 1 1 _i o _~ ~ t_ ~ ~ ~ I | ~ ~ e ~ ~ ~ ~ | | ~ ~ ~ ~ ~ ~ ~ ~ I | ~ ~ ~ ~ _1 ~ _~ _I O ~ ~ O ~) _i O O O _I _t C~ ~) C~ C~ C~ c~ C~ _~% O ~D ~) C~ ~~ ~ O ~ ~ ~ O O O O O O O O O co ~ ~ ~ t~ a) ~) 0 ~ ~c> ~ t~ t c~ a) e e e ~ ~ a' 0 oo ~ ~ ~ ~ ao ~ 0 ~ ao ~ u~ ~ u~ O O O O O O O O O u~ ~ O ~D ~ L~ e e e C~ CO _l kD ~D I O _I ~ ~ ~ ~ ~ ~ co ~ co ~ u~ c~ 1 1 - 1 ~ ~ ~ C~ ~1 ~ 0 1 1 0 c~ ~ a, ~ ~ cr, ~ 1 1 u~ ~ ~ o 0 ~ ~ ~ | | ~ e ~ ~ e ~ ~ ~ I | e e e ~ e ~ | | ~ ~ ~ t ~ a~ ~ ~ _d CD ~ ~ 1~1 ~ CO C~ k0 ~) ~ _1 _t t~ u~ ~ ao k9 ~ 1 1 1 0 e ~ I | ~ e t~ O t ~ 1 U, 00 ~ ~ ~ d. r ~ 1 1 0 ~ d. ~ C~] I | e ~ c~ co ~C) ln ~ t a, CO Ln ~ ~ ~ 0\ ~) o 0 1 1 ~ ~ ~ CO 1 1 ~ ~ . a, u~ u~ un U~ s~ ~ ~ ~ ~5 ~ ~ S ~ ~ O S ~ ~ O S ~ ~ O _I _I ~ _I _1 ~ _I ~t t I e, O' ~ a' ~ ~ I I ~ 01 ~ a' ~ a' I I d. ~ ~ ~ ~4 1D U) ~ (X) C~ C~ ~) ~) O U] ~ ~ ~ C~ ~ ~ O U] ~ ~ ~ C~ ~ ~ O C) U] I _' _I I I I I U) I _I ~ I I I I ~Q t ~1 I I I I 1 O U~O U~O ~ ~ 0 m0 U~ O ~ ~ O U~ O ~ O -t ~ ~ ~ ~ ~ (V ~ ~ ~ ~ ~ ~ ~ V ~~ ~ C~ ._' ~ s3 m

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260 TABLE B.8 Low-Weight Births Per 1,000 Live Births in Relation to Maternal Are in Four States, 1968-1982 . Mass. Mich. N.C. Oreg. c20 20-34 >35 35 35 35 1968 166 94 109 1969 103 72 85 149 88 108 1970 110 69 92 105 72 83 150 89 100 1971 ll5 66 89 104 70 85 147 83 109 80 56 62 1972 127 66 78 106 70 83 140 85 98 76 56 79 1973 126 67 83 102 71 84 134 85 101 81 56 86 1974 125 62 81 101 67 88 139 84 95 75 55 69 1975 126 63 83 101 67 87 131 85 98 92 54 71 1976 120 63 73 104 68 84 138 81 88 91 51 73 1977 114 60 74 97 71 90 138 77 97 79 50 63 1978 113 60 67 100 66 84 129 79 90 86 49 55 1979 109 57 70 96 65 91 135 80 85 72 51 53 1980 106 57 66 97 64 76 131 77 91 87 48 56 1981 100 56 67 98 65 76 141 77 89 92 48 52 1982 99 65 73 133 79 81 Average Annual Percent 1.2 1.9 2.7 0.7 0.9 0.8 1.1 1.2 1.6 -0.9 1.8 3.9 Declinea (0.2) (0.1) (0.3) (0.2) (0.2) (0.5) (0.3) (0.2) (0.2) (0.8) (0.2) (1.1) - aSee Table B . 2, note f . SEES: See footnotes b through e on Table B. .2 .

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A: o .,1 ca As n In to o to to UP - s . - s m o cr' a' In s ~ A: _ ~ ' 0 ~ or ' ~ 0 0 V 0 m s D3 0 .:1 En O .^ a; do: 261 a, CD a' a, a' . - As O .,. 0 a: kD ~ ~ O U~ O ~ r~ 0 ~ r~ r~ ~ ~ r~ ~ 0 ~ ~ ~ 0 ~ e e e e e e e e e e e e ~ ~ e e ~r ~ ~ 0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 0 ~ c~ ~ ~ ~ 0 O ~ d' ~ ~ ~ ~ ~ ~ ~ ~ ~ a) ~ a~ ~ ~ 0 e e e e e e e e e e e e e e e e e e e e c~ _I a~ t ~ ~ 11~) ~) ~ ~) ~ _t 0 ~ ~ ~ t) c~ U~ ~ ~ d. ~ O e ~ e e e e ~ ~ ~ ~ 0 0 ~ a, ~ a' ~ c~ ~ ao ~ ~ ~ e e ~ U~ ~ ~ ~ ~ ~ C _ O ~ ~ U~ ~ ~ ~ e 1 0 0 ~ C~ . ~ ~ ~ ~ ~ kD c~ kD O ~ ~ ~ ~ L~ ~ ~r ~ ~ ~ ~ ~ ~ ~ e e e e e e e e u~ 0 ~ un ~r q 0 ~ ~ co ~ ~ ~ a) LO ~ ~r ~ ~ oo c~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a) ~ ~D ~ r~ ~ ~ r~ e e e e e e e ~ e e e e e ~ e e ~ co co u~ ~ ~ ~ c~ 0 ao ~ ~ ~ ~ u~ ~ ~ 0 ~ ao ~D ~ d~ C~ O ~ ~ ~ O ~ a~ ~ ~ 0 ~ ~ e ~ e e e e e e e e e 0 c~ ~ ~ a~ ao (D ~ d~ aD O CO ~ a' ~ ~ ~D ~ ~ O C~ u~ e e e e ~ e e e CO ~ ~ ~ d~ ~ d~ ~ ~ oo ~ a, ~ ~ oo ~ U~ 0 ~ ~ u~ ~ 0 ~ ~ 0 d. O e e e e e e ~ ~ e e ~ e e e e ~ e e e e O ~ ~ ~ L~ ~ ~ O CO ~ CO C~ ~ U~ U~ ~ C~ _~ _1 _4 _~ _ O C~ ~D CD ~ U~ ~ ~ ~ cr, e e e e e e e e e e e e e e e e e e e e 0 0 ~ ~n In ~ t~ 1 CO t O' 0 ~4 o ~n ~ ~ O {Q ~ ~ U] ~q ~ U] U~ S" ~ ~ ~ ~ ~" ~ ~ 0 0 ^ 0 U~ ` - ~ ~ ~ 1 1 ~ oo _1 1 1 C~ ~t ~ 1 1 o o` - ~ ~ ~ o (1, O ~ oo U] ~ ~ ~ ~ ~ 0 0 ` a' ~ ~ U~ ^ - 1 a) _1 1 1 Lf, 1 1 C~ ~ o m~ ~ ~ 0 0 d5: ~: 0 O O CQ ~ ~ U] ~ 0 0 a, ~ O oq ~ ~ ~ a, ~ u2 O ~ 0 ~ ^ ~ ^a ~ ~ ~ ~ 0 ~ 0 ~ ~ ~ U~ 0 ` - ~ 0 ~ ^ - _1 1 ~ _1 1 1 1 ~ ~ ~ ~ 1 1 ~ mm 0 ~ ~ ~ ~ ~ 0 a~ ~ ~ ~ - ~s C U) U] ao 0\ - .~ . C~ e Q ~: O `: S ce 3 ~5 `: 0 ca d. er - o' `: C) e a s: s ~n 3 C (Q 0 ~ ' - C) O .. ~ ~ s E~ tQ Z

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262 TABLE B.10 Low-Weight Births Per 1,000 Live Births in Relation to Years of Maternal Education in Four States, 1968-1982 Mass . Mich . N. C . Or eg . 13 13 13 13 1968 119 85 68 1969 98 71 67 114 80 64 1970 99 69 65 104 72 57 114 82 64 1971 93 69 57 106 70 55 110 78 60 80 54 44 1972 94 69 55 107 69 56 111 80 59 78 56 48 1973 97 70 55 108 69 57 110 80 61 84 56 45 1974 91 65 54 106 68 54 109 80 61 79 55 43 1975 93 67 52 105 67 57 113 79 61 76 54 48 1976 88 67 52 106 68 57 109 76 59 77 50 45 1977 89 64 50 102 66 55 106 73 56 71 53 40 1978 88 64 50 106 66 54 107 77 58 72 52 48 1979 86 61 47 100 67 53 110 78 57 72 52 40 1980 88 61 46 102 63 54 107 75 58 68 48 42 1981 87 59 46 104 66 53 110 76 55 71 48 40 1982 108 65 52 106 80 60 Average Annual Percent Decliner 1.1 1.4 2.9 (0.2) (0.2) (0.3) aSee Table B.2 ~ note f. 0.2 0.8 0.6 0~5 0.5 l.0 (0.2) (0.1) (0.1) (0.1) (0.2) (0.2) 1.9 1.3 1.0 (0.4) (0.4) (0.7) - SOURCES : See footnotes b through e on Table B .2

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In a] o a, m ~ ~ d. ~ - LO C' ~ O ,, O ~ US :) ~ ~ 1 s . , ~ a, ~ IO S" to 0 ~ 0 s ~ on ~ Ll .,. m ~ C' 0 U. ~ a, s 3 At ~ an _ m In 3 es O Q O en A s 34 C' m 0 0 IO to o In C' to U. A A o A ~4 C' to o 263 ~ ~ C~ o ao ~ Ln U~ ~ \9 ~ e, o o o ~ ~ o ~ o ~ ~ ~ o ~ ~ ~ u~ O ~ ~ ~D ~ `9 ~ ~ ~ ~ ~ un a, a) 0 ~ c~ o o c~ ~ e - C~ ~ ~ ~ O O O ~ d. . O ~ ~ C~ _1 U~ ~ In ~ d' L~ 0 0 ~ ~ In d' ~ U~ U~ ~ ~ LO Lr) ~ c~ ao ~ Ir, kD C~ U~ ~ U~ ~ ~ ~ U~ ~ ~ ~ CD o o o Ln . o aD ~ U~ ~ CO ~ a' 0 ao ~ CO O O O O _1 _~ ~ U~ ~D ~ ~ O ~ O O O O _~ _I ~t ~ O ~9 . ~ ~ C~ ~ C~ ~ C~ O ~ d. ~ cn ~ C~ ~ C~ C~ ~ C~ un u~ tD eD ~ u~ ~ ~D 0O 0 0 0 ~ ~ a' ~ a) a) ~ 0 c~ c~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ o o o o o ~ ~ c~ c~ 0 ~ u~ 0 cr, ~ ~ ~ 0 0 0 co o ~ ~ k ~ ~ ~ ko ~ ~ co ~ ~ ~ ~ ~ ~ ~Q a; #5 - O d. ~ ~ C~ ~ LO ~ cx) ~ o o ~ ~ ~ ~ ~ ~ Co co ~ o u~ ~ ~ un ~ ~ ~ u~ ~ ao (D kD ~ ~ ~ o ~ ~ ~ o ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a~ O ~ ~ (D ~ U~ ~ , ~ ~ ~ r~ ~ ~ ~ ~ ~ s s s s s ~ s ~ s s ~ s ~ s s4 ~ ~ ~ $4 S~ - ~ ~ _ Q ~ Q ~ ~ ~ Q ~ Q ~ ~ Q Q Q O Q Q Q O S ~S S c~ ~S~ ~ =~ ~s~ {Q O ~ ~ ~ ~ ~ O S~ V ~rl ~ S O '- ~ ~ ~ S O "rl ~ u, E~ ~ ~ ~ ~ CQ E~ ~ 1~ C) 'S ~ 3 m . s s s ~s ~s ~ ~ ~ _ S" Q~ Q ~ ~ Q Q Q O ~S S c~ ~s O ~ ~4 V~ :3 Q, ~ O u~ E~

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264 A: P. I: - ~. SO s s Q lo lo lo sol U] SO o SO C' A To US = - ~ CO a; S 0 3 ~ s u nil P; Cal ~5 m ~ ' El3 lo; EN ID ~ Go co ~ ~ ~ ~ ~ ~ ~ ~ Or To . ~ V m - ED as ~9 a) - .. [Q V 0 m (11 SJ C) s 0 Q p. _ ao ~ ~ ~ ~ a e e ~r ~ ~ ~ ao C~ C~ . ~ e ~ e m. ~ ~ CO C~ ~ CX) C~ (D r~ c~ e e d. ~ ~ ~ ~ ~ (D ~ ~ ao kD c~ ac ao 0 ~ 0 c~ ~ e IO ~ co a:~ c~ u~ IO tD C0 ~ L~ O ~ ~ . ~ e e e . e e . _~ _~ t C~ ~ I_ I~ t~ ~ I~ O ~ ~ ~ ~ ~ e e e ~ e ~ el. ~ ao 0 0 ~ - U-) ~ r r 0 ~ CD C~ kD CO U~ ~ ~ ~ ~ e e e e * C~ CO ~ O ~ 0 C~ _I e e ~ ~ U, ~ ~ ~ C~ M0 (D ~ CO 0 S~ SJ O V S~ V ttS S C) S O O S J~ ~ S S `: ~ ~ ~ C: O X ~ ~ O ~ ~ ~ V ~ ~ ~ ~ O O O (D {Q 1 AS 1 S c: S ~ ~ 1 S ~ ~ ~ ~ S 0 U2 S~ ~ ~J ~ 0 ~ S~ 3 ~ ~ ~ O U) Z ~Q O `: CQ U] - tD . O S ~0 ~S U] - a' ~Q 0 u) 0 ::} o {Q v H C~ e o - a3 S C) Z

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265 TABLE B.13 Low-We~ght Births per 1,000 Live Births in Relation to Timing of First Prenatal Visit in Four States, 1968-1982 . Masa. Mich. N.C. Oreg. First Other & First Other & Tr im. Unknown Tr im. Unknown First Other & First Other & Tr im. Unknown Tr An. Unknown 1968 85 119 1969 70 93 78 117 1970 62 88 69 100 82 113 1971 64 87 69 97 79 107 53 69 1972 66 93 69 99 79 108 53 73 1973 62 101 69 99 80 107 53 74 1974 62 90 68 92 78 111 51 72 1975 63 95 67 96 79 110 50 7S 1976 62 89 67 96 76 106 46 78 1977 60 85 64 93 72 104 46 68 1978 60 88 65 94 75 102 45 67 1979 57 86 64 93 75 105 47 67 1980 56 92 63 90 74 100 44 68 1981 55 90 62 95 75 97 46 62 1982 63 97 76 97 Average Annual Percent 1.5 0.3 1.0 0.5 0.8 1.3 2.3 0.8 Declinea (0~2) (0.4) (0~1) (0.2) (0.2) (0.1) (0.3) (0.6) . _ . . . . NOTES: First Trim.. = Prenatal care initiated in the first trimester of pregnancy. "Other & Unknown. = other prenatal care, no care, or unknown care. aSee Table B. .2, note f. SOURCES: See footnotes b through e on Table B.2 .