Guyer B, Strobino D M, Ventura S J, MacDorman M, Martin J A
Department of Maternal and Child Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
Pediatrics. 1996 Dec;98(6 Pt 1):1007-19.
Recent trends in the vital statistics of the United States continued in 1995, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate; life expectancy at birth increased to a level equal to the record high of 75.8 years in 1992. Marriages and divorces both decreased. An estimated 3,900,089 infants were born during 1995, a decline of 1% from 1994. The preliminary birth rate for 1995 was 14.8 live births per 1000 total population, a 3% decline, and the lowest recorded in nearly two decades. The fertility rate, which relates births to women in the childbearing ages, declined to 65.6 live births per 1000 women 15 to 44 years old, the lowest rate since 1986. According to preliminary data for 1995, fertility rates declined for all racial groups with the gap narrowing between black and white rates. The fertility rate for black women declined 7% to a historic low level (71.7); the preliminary rate for white women (64.5) dropped just 1%. Fertility rates continue to be highest for Hispanic, especially Mexican-American, women. Preliminary data for 1995 suggest a 2% decline in the rate for Hispanic women to 103.7. The birth rate for teenagers has now decreased for four consecutive years, from a high of 62.1 per 1000 women 15 to 19 years old in 1991 to 56.9 in 1995, an overall decline of 8%. The rate of childbearing by unmarried mothers dropped 4% from 1994 to 1995, from 46.9 births per 1000 unmarried women 15 to 44 years old to 44.9, the first decline in the rate in nearly two decades. The proportion of all births occurring to unmarried women dropped as well in 1995, to 32.0% from 32.6% in 1994. Smoking during pregnancy dropped steadily from 1989 (19.5%) to 1994 (14.6%), a decline of about 25%. Prenatal care utilization continued to improve in 1995 with 81.2% of all mothers receiving care in the first trimester compared with 78.9% in 1993. Preliminary data for 1995 suggests continued improvement to 81.2%. The percent of infants delivered by cesarean delivery declined slightly to 20.8% in 1995. The percent of low birth weight (LBW) infants continued to climb in 1994 rising to 7.3%, from 7.2% in 1993. The proportion of LBW improved slightly among black infants, declining from 13.3% to 13.2% between 1993 and 1994. Preliminary figures for 1995 suggest continued decline in LBW for black infants (13.0%). The multiple birth ratio rose to 25.7 per 1000 births for 1994, an increase of 2% over 1993 and 33% since 1980. Age-adjusted death rates in 1995 were lower for heart disease, malignant neoplasms, accidents, and homicide. Although the total number of human immunodeficiency virus (HIV) infection deaths increased slightly from 42,114 in 1994 to an estimated 42,506 in 1995, the age-adjusted death rate for HIV infection did not increase, which may indicate a leveling off of the steep upward trend in mortality from HIV infection since 1987. Nearly 15,000 children between the ages of 1-14 years died in the United States (US) in 1995. The death rate for children 1 to 4 years old in 1995 was 40.4 per 100,000 population aged 1 to 4 years, 6% lower than the rate of 42.9 in 1994. The 1995 death rate for 5- to 14-year-olds was 22.1, 2% lower than the rate of 22.5 in 1994. Since 1979, death rates have declined by 37% for children 1 to 4 years old, and by 30% for children 5 to 14 years old. For children 1 to 4 years old, the leading cause of death was injuries, which accounted for for an estimated 2277 deaths in 1995, 36% of all deaths in this age group. Injuries were the leading cause of death for 5- to 14-year-olds as well, accounting for an ever higher percentage (41%) of all deaths. In 1995, the preliminary infant mortality rate was 7.5 per 1000live births, 6% lower than 1994, and the lowest ever recorded in the US. The decline occurred for neonatal as well as postneonatal mortality rates, and among white and black infants alike.
1995年美国人口统计的近期趋势仍在持续,包括出生人数、出生率、年龄调整死亡率和婴儿死亡率下降;出生时预期寿命提高到与1992年创纪录的75.8岁相当的水平。结婚和离婚数量均下降。1995年估计有3900089名婴儿出生,比1994年下降了1%。1995年的初步出生率为每1000总人口中有14.8例活产,下降了3%,是近二十年来的最低记录。生育率(即生育年龄妇女的生育数)降至每1000名15至44岁妇女中有65.6例活产,是1986年以来的最低水平。根据1995年的初步数据,所有种族群体的生育率均下降,黑人和白人的生育率差距缩小。黑人妇女的生育率下降7%,降至历史最低水平(71.7);白人妇女的初步生育率(64.5)仅下降1%。西班牙裔妇女,尤其是墨西哥裔美国妇女的生育率仍然最高。1995年的初步数据显示,西班牙裔妇女的生育率下降2%,降至103.7。青少年生育率已连续四年下降,从1991年每1000名15至19岁妇女中的62.1例降至1995年的56.9例,总体下降了8%。未婚母亲的生育率从1994年到1995年下降了4%,从每1000名15至44岁未婚妇女中的46.9例降至44.9例,是近二十年来该比率的首次下降。1995年未婚妇女生育的所有婴儿的比例也下降了,从1994年的32.6%降至32.0%。孕期吸烟率从1989年的19.5%稳步下降至1994年的14.6%,下降了约25%。1995年产前护理利用率继续提高,所有母亲中有81.2%在孕早期接受护理,而1993年为78.9%。1995年的初步数据显示继续提高至81.2%。1995年剖宫产分娩的婴儿比例略有下降,降至20.8%。低体重(LBW)婴儿的比例在1994年继续攀升,从1993年的7.2%升至7.3%。黑人婴儿中低体重的比例略有改善,在1993年至1994年间从13.3%降至13.2%。1995年的初步数据显示黑人婴儿的低体重比例继续下降(13.0%)。1994年多胞胎比率升至每千例出生中有25.7例,比1993年增加2%,自1980年以来增加了33%。1995年年龄调整后的心脏病、恶性肿瘤、事故和杀人案死亡率较低。尽管人类免疫缺陷病毒(HIV)感染死亡总数从1994年的42114例略有增加至1995年估计的42506例,但HIV感染的年龄调整死亡率并未增加,这可能表明自1987年以来HIV感染死亡率急剧上升的趋势趋于平稳。1995年美国有近15000名1至14岁的儿童死亡。1995年1至4岁儿童的死亡率为每100000名1至4岁人口中有40.4例,比1994年的42.9例低6%。1995年5至14岁儿童的死亡率为22.1,比1994年的22.5低2%。自1979年以来,1至4岁儿童的死亡率下降了37%,5至14岁儿童的死亡率下降了30%。对于1至4岁的儿童,主要死因是伤害,1995年估计有2277例死亡,占该年龄组所有死亡的36%。伤害也是5至14岁儿童的主要死因,占所有死亡的比例更高(41%)。1995年,初步婴儿死亡率为每1000例活产中有7.5例,比1994年低6%,是美国有记录以来的最低水平。新生儿和新生儿后期死亡率均下降,白人和黑人婴儿均如此。