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1<?xml version="1.0" encoding="ISO-8859-1"?>
2
3<HTML_CONTENT xmlns:ibis="http://www.ibisph.org">
4<div class="Error">COMMENT: Can we rename this to Reproductive and Birth Outcomes? So we can delete the Vital Statistics file and combine them into one!</div>
5        <ibis:doc>
6                <name>topic/ReproductiveHealthOutcomes</name>
7                <summary>Topic Page</summary>
8                <description>
9                </description>
10
11                <author>Garth Braithwaite</author>
12                <company>Utah Department of Health/Software Technology Group</company>
13        </ibis:doc>
14
15        <TITLE>Reproductive and Birth Outcomes</TITLE>
16
17        <CONTENT>
18                <ibis:ExpandableContent titleLevel="1">
19                        <TITLE>Description</TITLE>
20                        <CONTENT>
21        Reproductive and birth outcomes track mother and infant health. This includes measures such as sex ratio; infertility; premature births; low birth weight; and fetal, infant, and maternal mortality.
22
23
24                        </CONTENT>
25                        <SHOW/>
26                </ibis:ExpandableContent>
27               
28<ibis:ExpandableContent titleLevel="1">
29<TITLE>Learn About Reproductive and Birth Outcomes</TITLE>
30<CONTENT>
31
32                <ibis:ExpandableContent titleLevel="2">
33                        <TITLE>Why Important</TITLE>
34                        <CONTENT>
35        Reproductive and birth outcomes are important because they directly affect the mother and child's health. In 2016, 1 in 10 babies was born prematurely in the United States. In 2015, preterm births and low birth weight
36        accounted for 17% of all infant deaths. Despite the United States' medical technology and level of development, it ranked among the top ten countries with the highest number of preterm births alongside Bangladesh and
37        Indonesia. Adverse reproductive health outcomes can greatly impact a child's survival and health throughout the rest of his or her life. Because the fetus is vulnerable during pregnancy, environmental toxins and exposures
38        can affect the fetus before birth. However, environmental exposures may not always be the direct cause of poor reproductive and birth outcomes; many other factors, like access to healthcare, can play a role as well.
39
40
41
42
43                        </CONTENT>
44                </ibis:ExpandableContent>
45
46                <ibis:ExpandableContent titleLevel="2">
47                        <TITLE>What is Known</TITLE>
48                        <CONTENT>
49
50
51<span Class="Bold">Infant mortality</span> refers to all infant death before one year of age.
52<br></br><br></br> 
53<span Class="Bold">Postneonatal mortality </span> refers to infant death between the ages of 28 days and 1 year.
54<br></br><br></br>
55<span Class="Bold">Neonatal mortality </span> refers to death before 28 days of life.
56<br></br><br></br>
57<span Class="Bold">Perinatal mortality</span> refers to infant death under age seven days and fetal deaths at 24 weeks of pregnancy or more.
58<br></br><br></br>
59<span Class="Bold">Fetal deaths </span> are those at, at least 24 weeks of pregnancy.
60<br></br><br></br> 
61Outdoor <a href="http://epht.health.utah.gov/epht-view/topic/AirQuality.html" target="_blank"> air pollution </a> (particulate matter that is 10 micrometers long [PM10]) has been associated with a higher risk of infant death,
62specifically from respiratory causes and <a href="http://www.cdc.gov/SIDS/" target="_blank">Sudden Infant Death Syndrome (SIDS)</a>.
63<br></br><br></br>
64<span Class="Bold">Maternal mortality</span> refers to the death of a woman while she is pregnant or within 42 hours of giving birth and where the cause of death is related to the pregnancy itself.
65<br></br><br></br>
66<span Class="Bold">Preterm birth</span> is the leading cause of death of newborn babies. A baby is considered preterm if he or she is born before the 37th week of pregnancy. Preterm birth increases the risk of many health problems such as intellectual disabilities, cerebral palsy, breathing problems, vision and hearing loss, and feeding and digestive problems. Many of these problems can be a lifelong issue for the child. It is important to remember that every birth is different and many preterm babies do not have any serious health complications.
67<br></br><br></br>
68<span Class="Bold">Low birth weight</span> refers to newborn babies that weigh less than 5.5 pounds (2500 grams) at birth. Low-birth weight can make it easier for the baby to get sick or infected and can delay motor skills, social development, and learning ability. 
69<br></br><br></br>
70<span Class="Bold">Infertility</span> refers to the inability to have children and it can affect both men and women. Risk factors for infertility include certain medical conditions and waiting to have children until later in life. However, a growing body of literature suggests that environmental contaminants such as <a href="https://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html" target="_blank"> phthalates</a>, <a href="https://www.epa.gov/pcbs/learn-about-polychlorinated-biphenyls-pcbs" target="_blank"> PCB </a> (polychlorinated biphenyls), <a href= "https://www.epa.gov/dioxin/learn-about-dioxin" target="_blank"> dioxins</a>, and <a href="https://www.epa.gov/pesticides/pesticides-and-public-health" target="_blank"> pesticides </a> can lead to infertility too.
71<br></br><br></br>
72<span Class="Bold">Sex ratio</span> is the numbers of male babies to the number of female babies; the expected sex birth ratio is 105 males to 100 females. Because population growth is in part related to the number of males, it is important to track sex ratio and understand trends.
73                        </CONTENT>
74                </ibis:ExpandableContent>
75
76                <ibis:ExpandableContent titleLevel="2">
77                        <TITLE>Who is at Risk</TITLE>
78
79
80                        <CONTENT>
81        Factors such as parents' age, genetics, medical health, socioeconomic status, behavior, diet, access to health care, and environmental exposures can all play a role in reproductive and birth outcomes. The following factors increase a woman's risk of poor reproductive and birth outcomes:
82<ul>
83<li>Environmental exposures such as secondhand smoke, <a href="http://www.health.utah.gov/utahair/birthoutcomes/" target="_blank">air pollution</a>, biocides (i.e., a chemical that destroys life by poisoning, especially a pesticide, herbicide, or fungicide), <a href= "http://epht.health.utah.gov/epht-view/topic/Mercury.html" target="_blank"> mercury </a> and <a href="http://epht.health.utah.gov/epht-view/topic/ChildhoodBloodLead.html" target="_blank"> lead </a></li>
84<li>Behaviors such as smoking, drinking alcohol, and using illicit drugs</li>
85<li>Medical conditions such as diabetes, high blood pressure, blood clotting disorders, and cervical or uterine problems </li>
86<li>Social and economic factors like domestic violence, stress, lack of social support, and marital status</li>
87
88</ul>
89
90</CONTENT>
91                </ibis:ExpandableContent>
92
93                <ibis:ExpandableContent titleLevel="2">
94                        <TITLE>How to Reduce Risk</TITLE>
95                        <CONTENT>
96Women can reduce their risk of negative reproductive and birth outcomes by getting prenatal care before becoming pregnant and <span Class="Bold">avoiding</span> the following:
97<ul>
98<li>Tobacco smoke</li>
99<li>High concentrations of particulate matter in the air</li>
100<li>Alcohol</li>
101<li>Illicit drugs</li>
102<li>Biocides (pesticide, rodentcide, fungicide, herbicide, etc.)</li>
103<li><a href="http://epht.health.utah.gov/epht-view/topic/ChildhoodBloodLead.html" target="_blank"> Lead </a></li>
104<li><a href= "http://epht.health.utah.gov/epht-view/topic/Mercury.html" target="_blank"> Mercury </a></li>
105</ul>
106
107                        </CONTENT>
108                </ibis:ExpandableContent>
109               
110                        <ibis:ExpandableContent titleLevel="2">
111                        <TITLE>FAQs and Resources</TITLE>
112                        <CONTENT>
113                <h4>Resources</h4>
114                <ul>
115                <li><a href="http://www.health.utah.gov/utahair/birthoutcomes/" target="_blank">Air Pollution and Adverse Birth Outcomes - Utah Environmental Epidemiology Program</a></li>
116                <li><a href="http://www.cdc.gov/reproductivehealth/" target="_blank">Reproductive Health information - Centers for Disease Control and Prevention</a></li>
117                </ul>
118                <br/>
119                <h4>Program Websites</h4>
120                <ul>
121                <li> Utah Department of Health - <a href="http://health.utah.gov/mihp" target="_blank">Maternal and Infant Health Program</a></li>
122                </ul>
123
124                        </CONTENT>
125                </ibis:ExpandableContent>
126</CONTENT>
127</ibis:ExpandableContent>
128               
129<ibis:ExpandableContent titleLevel="1">
130<TITLE>Explore Reproductive and Birth Outcomes Data</TITLE>
131<CONTENT>
132
133                <ibis:ExpandableContent titleLevel="2">
134                        <TITLE>Data tables, charts, and more detailed information</TITLE>
135                        <CONTENT> <!---->
136
137<ibis:ExpandableContent titleLevel="3">
138<TITLE>Birth Rates</TITLE>
139<CONTENT>
140<h3>Indicator Reports (includes contextual information)</h3>
141
142<ibis:SelectionsList>
143<SELECTION>
144<TITLE>Birth Rates, Utah and U.S.</TITLE>
145<LOCAL_URL>indicator/view/BrthRat.UT_US.html</LOCAL_URL>
146</SELECTION>
147
148<SELECTION>
149<TITLE>Birth Rate by Age</TITLE>
150<LOCAL_URL>indicator/view/BrthRat.Age.html</LOCAL_URL>
151</SELECTION>
152
153<SELECTION>
154<TITLE>Birth Rates by Local Health Department</TITLE>
155<LOCAL_URL>indicator/view/BrthRat.LHD.html</LOCAL_URL>
156</SELECTION>
157
158<SELECTION>
159<TITLE>Birth Rates by Utah Small Area</TITLE>
160<LOCAL_URL>indicator/view/BrthRat.SA.html</LOCAL_URL>
161</SELECTION>
162
163</ibis:SelectionsList>
164</CONTENT>
165</ibis:ExpandableContent>
166
167<ibis:ExpandableContent titleLevel="3">
168<TITLE>Fertility</TITLE>
169<CONTENT>
170
171
172<h3>Total Fertility Rate per 1,000 Women of Reproductive Age, by Year</h3>
173<ul>
174<li><a ibis:href="query/definition/result/utahepht/fertility_annual_county.html">By County</a></li>
175<li><a ibis:href="query/definition/result/utahepht/fertility_annual_state.html">Statewide</a></li>
176</ul>
177<ibis:SelectionsList>
178<SELECTION>                                     
179<TITLE>Utah compared to the U.S.</TITLE>                       
180<LOCAL_URL>indicator/view/FertRat.UT_US_Age.html</LOCAL_URL>
181</SELECTION>
182</ibis:SelectionsList>
183<br/>
184
185<h3>General Fertility Rates</h3>
186<ibis:SelectionsList>
187
188<SELECTION>
189<TITLE>By Age Group</TITLE>
190<LOCAL_URL>indicator/view/FertRat.Age.html</LOCAL_URL>
191</SELECTION>
192
193<SELECTION>
194<TITLE>By Utah Small Areas</TITLE>
195<LOCAL_URL>indicator/view/FertRat.SA.html</LOCAL_URL>
196</SELECTION>
197
198<SELECTION>
199<TITLE>By Local Health Department</TITLE>
200<LOCAL_URL>indicator/view/FertRat.LHD.html</LOCAL_URL>
201</SELECTION>
202
203</ibis:SelectionsList>
204<br/>
205
206</CONTENT>
207</ibis:ExpandableContent>
208
209<ibis:ExpandableContent titleLevel="3">
210<TITLE>Low Birth Weight and Very Low Birth Weight</TITLE>
211<CONTENT>
212<br/>
213Low Birth Weight: less than 2,500 grams at birth (approximately 5 lbs. 8 ozs.)
214<br/>
215Very Low Birth Weight: less than 1,500 grams at birth (approximately 3 lbs. 4 ozs.)
216<br/><br/>
217
218<h4>Low Birth Weight</h4>
219<ul>
220<li>Annual Rates of Low Birth Weight Births: <a ibis:href="query/definition/result/utahepht/lowbw_annual_state.html">Statewide</a> and <a ibis:href="query/definition/result/utahepht/lowbw_annual_county.html">by County</a></li>
221
222<li>Low Birth Weight Percentages</li>
223
224<ibis:SelectionsList>
225
226<SELECTION>
227<TITLE>By Ethnicity</TITLE>
228<LOCAL_URL>indicator/view/LBW.Eth.html</LOCAL_URL>
229</SELECTION>
230
231<SELECTION>
232<TITLE>By Race</TITLE>
233<LOCAL_URL>indicator/view/LBW.Race.html</LOCAL_URL>
234</SELECTION>
235
236<SELECTION>
237<TITLE>By Utah Small Areas</TITLE>
238<LOCAL_URL>indicator/view/LBW.SA.html</LOCAL_URL>
239</SELECTION>
240
241<SELECTION>
242<TITLE>By County</TITLE>
243<LOCAL_URL>indicator/view/LBW.Cnty.html</LOCAL_URL>
244</SELECTION>
245
246<SELECTION>
247<TITLE>By Local Health Department</TITLE>
248<LOCAL_URL>indicator/view/LBW.LHD.html</LOCAL_URL>
249</SELECTION>
250
251<SELECTION>
252<TITLE>Utah compared to the U.S.</TITLE>
253<LOCAL_URL>indicator/view/LBW.Ut_USYear.html</LOCAL_URL>
254</SELECTION>
255</ibis:SelectionsList>
256</ul>
257<br/>
258
259<h4>Very Low Birth Weight</h4>
260<ul>
261<li>Percent of Very Low Birth Weight Births: <a ibis:href="query/definition/result/utahepht/verylowbw_5yr_state.html">Statewide</a> and <a ibis:href="query/definition/result/utahepht/verylowbw_5yr_county.html">by County</a>  </li>
262</ul>
263<br/>
264
265</CONTENT>
266</ibis:ExpandableContent>
267
268<ibis:ExpandableContent titleLevel="3">
269<TITLE>Mortality (Fetal, Infant, Neonatal, and Post Neonatal)</TITLE>
270<CONTENT>
271<br/>
272
273<!--
274Fetal Mortality: Deaths that occur from 20 weeks of gestation or more<br/>
275Infant Mortality: Deaths that occur under 1 year of age<br/>
276Neonatal Mortality: Less than 28 days of age<br/>
277Post-Neonatal Mortality: Equal to or greater than 28 days of age to 1 year of age<br/><br/>
278-->
279
280<!--
281<h4>Perinatal Mortality</h4>
282<ibis:SelectionsList>
283<SELECTION>
284<TITLE>Utah Perinatal Mortality Rate by Year</TITLE>
285<LOCAL_URL>indicator/view/FetMort.Peri_State.html</LOCAL_URL>
286</SELECTION>
287</ibis:SelectionsList>
288<br/>
289
290<h4>Fetal Mortality</h4>
291<ibis:SelectionsList>
292
293<SELECTION>
294<TITLE>Rates by Local Health Department</TITLE>
295<LOCAL_URL>indicator/view/FetMort.LHD.html</LOCAL_URL>
296</SELECTION>
297
298<SELECTION>                                    
299<TITLE>Rates in Utah and U.S.</TITLE>                                  
300<LOCAL_URL>indicator/view/FetMort.UT_US.html</LOCAL_URL>
301</SELECTION>
302</ibis:SelectionsList>
303<br/>
304
305-->
306
307<h4>Fetal Mortality</h4> 
308<ul>
309<li>Rates by 5-Year Groups: <a ibis:href="query/definition/result/utahepht/DeathPeri5yr_State.html">Statewide</a> and <a ibis:href="query/definition/result/utahepht/DeathPeri5yr_County.html">by County</a></li>
310</ul>
311
312<br/>
313
314<h4>Infant Mortality</h4>
315
316<ul>
317<li>Rates by 5-Year Groups: <a ibis:href="query/definition/result/utahepht/infmort_5yr_state.html">Statewide</a> and
318<a ibis:href="query/definition/result/utahepht/infmort_5yr_county.html">by County</a></li>
319<li>Infant Mortality Rates</li>
320</ul>
321<ul>
322<ibis:SelectionsList>
323<SELECTION>
324<TITLE>By Utah Small Areas</TITLE>
325<LOCAL_URL>indicator/view/InfMort.SA.html</LOCAL_URL>
326</SELECTION>
327
328<SELECTION>
329<TITLE>By County</TITLE>
330<LOCAL_URL>indicator/view/InfMort.Cnty.html</LOCAL_URL>
331</SELECTION>
332
333<SELECTION>
334<TITLE>by Local Health Department</TITLE>
335<LOCAL_URL>indicator/view/InfMort.LHD.html</LOCAL_URL>
336</SELECTION>
337
338<SELECTION>
339<TITLE>Utah compared to the U.S.</TITLE>
340<LOCAL_URL>indicator/view/InfMort.Ut_USYear.html</LOCAL_URL>
341</SELECTION>
342</ibis:SelectionsList>
343</ul>
344<br/>
345
346<h4>Neonatal and Post-Neonatal Mortality</h4>
347
348<ul>
349<li>Neonatal Rates: <a ibis:href="query/definition/result/utahepht/neomort_5yr_state.html">Statewide</a> and
350<a ibis:href="query/definition/result/utahepht/neomort_5yr_county.html">by County</a> </li>
351<li>Post-Neonatal Rates: <a ibis:href="query/definition/result/utahepht/postneonatal_5yr_state.html">Statewide</a> and
352<a ibis:href="query/definition/result/utahepht/postneonatal_5yr_county.html">by County</a></li>
353</ul>
354<br/>
355
356</CONTENT>
357</ibis:ExpandableContent>
358
359<ibis:ExpandableContent titleLevel="3">
360<TITLE>Prematurity (Preterm and Very Preterm Birth)</TITLE>
361<CONTENT>
362<br/>
363
364
365<h4>Preterm Birth (Less Than 37 Weeks Gestation)</h4>
366
367<ul>
368<li>Percent of Preterm Births, by Year: <a ibis:href="query/definition/result/utahepht/preterm_annual_state.html">Statewide</a> and
369<a ibis:href="query/definition/result/utahepht/preterm_annual_county.html">by County</a></li>
370<li>Percentage of Live Births that are Preterm:</li>
371</ul>
372<ul>
373<ibis:SelectionsList>
374
375<SELECTION>
376<TITLE>By Ethnicity</TITLE>
377<LOCAL_URL>indicator/view/PreBir.Eth.html</LOCAL_URL>
378</SELECTION>
379
380<SELECTION>
381<TITLE>By Race</TITLE>
382<LOCAL_URL>indicator/view/PreBir.Race.html</LOCAL_URL>
383</SELECTION>
384
385<SELECTION>
386<TITLE>By Utah Small Areas</TITLE>
387<LOCAL_URL>indicator/view/PreBir.SA.html</LOCAL_URL>
388</SELECTION>
389
390<SELECTION>
391<TITLE>By County</TITLE>
392<LOCAL_URL>indicator/view/PreBir.Cnty.html</LOCAL_URL>
393</SELECTION>
394
395<SELECTION>
396<TITLE>By Local Health Department</TITLE>
397<LOCAL_URL>indicator/view/PreBir.LHD.html</LOCAL_URL>
398</SELECTION>
399
400<SELECTION>
401<TITLE>Utah compared to the U.S.</TITLE>
402<LOCAL_URL>indicator/view/PreBir.UT_US.html</LOCAL_URL>
403</SELECTION>
404
405</ibis:SelectionsList>
406</ul>
407<br/>
408
409<h4>Very Preterm Birth (Less than 32 Weeks Gestation)</h4>
410<ul>
411<li>Percent of Very Preterm Births, by 5-Year Group: <a ibis:href="query/definition/result/utahepht/verypreterm_5yr_state.html">Statewide</a> and <a ibis:href="query/definition/result/utahepht/verypreterm_5yr_county.html">by County</a> </li>
412</ul>
413<br/>
414
415</CONTENT>
416</ibis:ExpandableContent>
417
418<ibis:ExpandableContent titleLevel="3">
419<TITLE>Sex Ratio at Birth</TITLE>
420<CONTENT>
421<br/>
422<h4>Male to Female Sex Ratio at Birth, by Year</h4>
423<ul>
424<li><a ibis:href="query/definition/result/utahepht/sexratio_annual_state.html">Statewide</a></li>
425<li><a ibis:href="query/definition/result/utahepht/sexratio_annual_county.html">by County</a></li>
426</ul>
427<br/>
428
429</CONTENT>
430</ibis:ExpandableContent>
431</CONTENT>
432</ibis:ExpandableContent>
433
434<ibis:ExpandableContent>
435<TITLE>Custom Data Queries</TITLE>
436<CONTENT>
437<h3>Birth Query Module</h3>
438<ul>
439<li><a href="http://epht.health.utah.gov/epht-view/query/selection/birth/BirthSelection.html">Birth - includes Count, Adolescent Births, Prenatal Care, Infant Birth Weight, and Pre-term Births</a></li>
440</ul>
441<br/>
442<h3>Fetal Mortality Query Module</h3>
443<ul>
444<li><a href="http://epht.health.utah.gov/epht-view/query/selection/fetmort/FetMortSelection.html">Fetal Mortality</a></li>
445</ul>
446<br/>
447<h3>Infant Mortality Query Module</h3>
448<ul>
449<li><a href="http://epht.health.utah.gov/epht-view/query/selection/infmort/InfMortSelection.html">Infant Mortality - includes Infant, Neonatal, and Post-neonatal Rates and Infant Mortality Rates by Major Causes</a></li>
450</ul>
451<br/>
452Click here to view all available <a href="http://epht.health.utah.gov/epht-view/dataportal/PublicDatasetIndex.html">public queries</a> and metadata for all <a href="http://epht.health.utah.gov/epht-view/dataportal/SecureDatasetIndex.html">secure portal queries</a>.
453</CONTENT>
454</ibis:ExpandableContent>
455
456                <ibis:ExpandableContent titleLevel="2">
457                        <TITLE>About the Data</TITLE>
458                        <CONTENT>
459The Utah EPHT Network receives reproductive and birth outcome data from the Office of Vital Records and Statistics in the Utah Department of Health.
460<br/><br/>
461        <a ibis:href="metadata/VRBirths.html">View complete metadata.</a>
462                        </CONTENT>
463                </ibis:ExpandableContent>
464</CONTENT>
465</ibis:ExpandableContent>
466
467<ibis:ExpandableContent titleLevel="1">
468<TITLE>Utah Health Assessments involving Reproductive and Birth Outcomes </TITLE>
469<CONTENT>
470
471The links listed below redirect you to health assessments that have been conducted in Utah that are relevant to reproductive and birth outcomes. The Utah APPLETREE program at the Utah Department of Health is responsible for evaluating and responding to environmental public health issues in Utah. For more information, please visit the <a href="http://health.utah.gov/enviroepi/appletree/" target="_blank">Utah APPLETREE website</a>.
472<br/><br/>
473<ul>
474<li><a href="http://health.utah.gov/enviroepi/appletree/TriCountyABO/" target="_blank">TriCounty Adverse Birth Outcomes Statistical Review (Industrial and mining activities), Uintah, Duchesne, and Dagget Counties, 2015 </a></li>
475</ul>
476
477</CONTENT> 
478</ibis:ExpandableContent>
479
480
481
482        </CONTENT>
483</HTML_CONTENT>
484
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