ANNUAL SUMMARY OF VITAL-STATISTICS - 1994

Recent trends in the vital statistics of the United States continued i n 1994, including decreases in the number of births, the birth rate, t he age-adjusted death rate, and the infant mortality rate. Life expect ancy increased slightly to 75.7 years. Only marriages reversed the rec ent trend with a slight increase in 1994. An estimated 3 979 000 infan ts were born during 1994, a decline of <1% from 1993. The birth rate w as 15.3 live births per 1000 population, a 1% decline. These decreasin g rates reflect a decline in the fertility rate to 67.1 live births pe r 1000 women aged 15 to 44 years. Final figures for 1993 indicate that fertility rates declined for all racial groups, by 1% for white women (to 65.4) and 3% for black women (to 80.5). The fertility rate for Hi spanic women (106.9) was 84% higher than that for non-Hispanic white w omen and 31% higher than for non-Hispanic black women. Between 1991 an d 1993, birth rates for teenage mothers remained virtually unchanged, and abortion rates have steadily declined, suggesting that teenage pre gnancy rates are levelling off. The number and proportion of births to women over age 30, however, continued to rise. The rate of births to all unmarried women (45.3 per 1000 in 1993) has been stable for 3 year s. Prenatal care utilization improved in 1993; 79% of women initiated care in the first trimester and <5% had delayed care or no care. Impro vements occurred among nearly all racial and ethnic groups. Reported s moking during pregnancy declined to 15.8% in 1993 from 16.9% in 1992. The proportion of babies delivered by cesarean section was 21.8% in 19 93, a 2% decrease from 1992. Between 1992 and 1993, the rate of low bi rth weight (LBW) rose slightly to 7.2%, while very low birth weight (V LBW) remained stable at 1.3%. Most of the increase in LBW occurred amo ng white infants and reflected, primarily, an increase in the proporti on of multiple births. The black/white ratio in LBW continued to incre ase to more than two-fold with the largest difference recorded among t erm and postterm infants. Age-adjusted death rates in 1994 were lower for heart disease, malignant neoplasm, pulmonary diseases, other accid ents, and homicides. The age-adjusted death rate for human immunodefic iency virus disease continued to rise to 15.1 in 1994. The infant mort ality rate declined 4% in 1994, to 7.9 per 1000, the lowest rate ever recorded in the United States. The decline was primarily in neonatal m ortality. Among the states, Massachusetts (5.4) and Washington (5.7) h ad the lowest rates. The overall national trend appears to be related to declines in respiratory distress and sudden infant death syndrome d eaths. Over the next 25 years, the number of children in the United St ates is expected to rise by only 10 million, and the composition of th e child population will become more ethnically and racially diverse.