Maternal, Infant, and Child Health

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 The health of mothers, infants, and children is a reflection of the overall health of a community and a predictor of the health of the next generation. 

Objective: 
Reduce low birth weight (<2500 grams) and very low birth weight (<1500 grams) births.

		LBW	VLBW
	NH Baseline 1998	5.7%15	1.1%15
	US Baseline 1998	7.6%6	1.4%6
	NH Target 2010	5.0%	0.8%

Low birth weight (LBW) is a major cause of infant mortality. It is associated with long-term disabilities, such as cerebral palsy, autism, mental retardation, vision and hearing impairments, and other developmental disabilities. Despite the low proportion of pregnancies resulting in LBW, expenditures for the care of LBW infants total more than half of the costs incurred for all newborns. Risk factors associated with LBW include maternal smoking, maternal LBW, prior LBW birth history, low pre-pregnancy weight, multiple births, and low pregnancy weight gain. 
     Nationally, the disparity in incidence of LBW is wide. African Americans experience a higher proportion of LBW and VLBW births than other population groups. Current data do not permit an adequate assessment of low birth weight rates by race in New Hampshire.

Objective: 
Increase the percentage of women who receive early and adequate prenatal care.

	NH Baseline 1998	86.5%15
	US Baseline 1997	74%6
	NH Target 2010	90%

Studies have established that prenatal care reduces the risk of low birth weight. Timely, high-quality care, begun early in pregnancy and continued throughout pregnancy, helps prevent poor birth outcomes and improve health by reducing risks and behaviors that contribute to poor outcomes. Risk assessment, risk reduction, and education are key components of prenatal care.
     In New Hampshire, African American and Hispanic women are less likely to begin prenatal care in the first trimester. To begin to remedy causes that prevent women from obtaining the care they need, we need to identify and address barriers to health care such as economics, access to health insurance, and a lack of understanding of minority health issues. 

Objective: 
Reduce the percentage of pregnant women who report smoking cigarettes.

	NH Baseline 1998	17%15
	US Baseline 1997	13%6
	NH Target 2010	10%

Cigarette smoking is the greatest known risk factor for low birth weight births. In New Hampshire, more than one-third of pregnant teens smoke. 

Objective: 
Reduce the percentage of pregnant women who report drinking alcohol in the past month.

	NH Baseline	NA
	US Baseline 1997	14%6
	NH Target 2010	Developmental

Alcohol use during pregnancy is linked to fetal death, LBW, growth abnormalities, mental retardation, and fetal alcohol syndrome (FAS). New Hampshire specific data that measures prevalence of use requires development.

Objective: 
Increase the proportion of newborns that are screened for hearing loss by age one month.

	NH and US Baseline	NA
	NH Target 2010	Developmental

Hearing loss is the most commonly occurring congenital disability in the United States. The consequences of hearing loss are significant and can result in lifelong communication, social, psychological, behavioral, and educational problems. However, infants identified with hearing loss can be fitted with amplification devices as young as 4 weeks of age. These children are then able to learn, speak, and develop socially at the same rate as children with normal hearing. Implementation of a universal newborn hearing-screening program in New Hampshire in 2000 will provide baseline data for this developmental objective.

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