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Michigan Council for Maternal and Child Health Friday Notes

Posted almost 4 years ago by Rachel VanDenBrink

November 21, 2014

Subscribers please note: Friday Notes publication will resume on December 5.

In this issue
  • Report: Fetal, Perinatal Mortality Rates Stay Largely Unchanged in U.S.
  • Grand Traverse County Schools See Pertussis Cases
  • C.S. Mott National Poll Shows Parents Support Vaccine Requirements in Daycare

Report: Fetal, Perinatal Mortality Rates Stay Largely Unchanged in U.S.
The U.S. fetal mortality rate declined 8 percent from 2000 to 2006 and remained stable from 2006 to 2012, and the perinatal mortality rate declined 4 percent from 2006 to 2011, according to a new report from the National Center for Health Statistics (NCHS) of the U.S. Centers for Disease Control and Prevention (CDC).

Elizabeth C. W. Gregory, MPH, Marian F. MacDorman, PhD, and Joyce A. Martin, MPH, all with the NCHS, analyzed data from the 2000-2012 Fetal Death Data Files, the 2006-2011 Linked Birth/Infant Death Data Sets, and the 2000-2012 Birth Data Files of the National Vital Statistics System for their NCHS Data Brief.

They found that the overall fetal mortality rate declined from 6.61 to 6.05 per 1000 births from 2000 to 2006; the 2012 rate was also 6.05.

Early fetal mortality remained about the same, at 3.10 in 2006 and 3.11 in 2012, and the late fetal mortality rate went from 2.97 to 2.96 during the period. Early fetal deaths occur at 20 to 27 weeks of gestation, and late fetal deaths occur at 28 weeks' or longer gestation.

The overall perinatal mortality rate declined at less than 1% per year, from 6.51 per 1000 births in 2006 to 6.26 in 2011, the latest year for which data were available.

Overall fetal mortality rates were essentially flat among the three largest race and Hispanic origin groups (non-Hispanic white, non-Hispanic black, and Hispanic women).

The perinatal mortality rate declined 8 percent among non-Hispanic black women during the period but did not change significantly for the other two groups.

Geographically, perinatal mortality rates fell by 10 percent or more in 2005-2006 and 2010-2011 in 11 states (Arizona, Connecticut, Georgia, Idaho, Illinois, Kansas, Louisiana, Missouri, New Hampshire, North Carolina, and Tennessee). California, Texas, and Maryland experienced declines of less than 10 percent.

The rates in all of the other states were relatively unchanged except for South Dakota, which recorded an increase in prenatal mortality.

For 2010-2011, perinatal mortality rates ranged from 3.65 per 1000 in Vermont to 8.91 in Mississippi. In addition to Vermont, the rate was less than 5 per 1000 in Alaska, Iowa, New Hampshire, and New Mexico. Alabama, Delaware, Mississippi, and the District of Columbia had rates higher than 8 per 1000.

The NCHS authors conclude, "Total, early, and late fetal mortality rates were generally flat in the United States from 2006 through 2012. Over this same period, fetal mortality rates were also essentially unchanged among each of the three largest race and Hispanic origin groups."

The full report, "Trends in Fetal and Perinatal Mortality in the United States, 2006-2012," including data from Michigan, is available here.

Grand Traverse County Schools See Pertussis Cases
Last week's outbreak of pertussis, also known as whooping cough, in the Traverse City area caused Michigan physicians to urge parents statewide to vaccinate their children against the potentially fatal disease.

Figures from the Department of Community Health show that total cases of the once rare disease will likely be higher in 2014 than they were in 2013.

On Nov. 14, the Traverse City Public Schools said it had three confirmed cases of pertussis. This came after the Grand Traverse Academy, a charter school, reported 12 cases and closed its campus for the week.

Officials with the Michigan State Medical Society said the Grand Traverse County Public Health Department had indicated as many as 161 other children at the Academy were at risk of contracting the disease.

The outbreak comes as the state's weekly disease reports show that 984 cases of pertussis have been reported in the state through November 8.

At that rate the state will likely surpass the 1,016 cases reported in 2013, and may be the highest number reported since 1,577 cases were reported in 2010. There were 868 cases in 2012 and 670 cases in 2011.

Cases in the state were once quite rare after a vaccine was developed in the early 1960s. In the late 1990s, the state averaged often fewer than 80 cases a year. The increase in the disease was first noted in 2003 when the number of cases doubled to 140.

The outbreak in Traverse City also comes as the federal Centers for Disease Control reported, last month, that Michigan had the fourth-highest percentage of unvaccinated children in the nation. The federal agency said that during the 2013-14 school year, 5.4 percent of kindergarten-aged children were unvaccinated, up by 0.1 percent from the year before.

C.S. Mott National Poll Shows Parents Support Vaccine Requirements in Daycare
Most parents agree that all children in daycare centers should be vaccinated, and that daycare providers should be checking vaccine records every year, according to the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health.

All states require vaccines for children who attend daycare, but those requirements may not include every vaccine from birth to age 5 years. As a result, some children still don't receive all recommended vaccines-leaving daycare providers and parents to decide how to handle the situation of a child who is not up-to-date on vaccines.

In this national sample of parents of child 0-5 years, most indicate that daycare providers should review children's immunization status every year to ensure they are up-to-date (52 percent strongly agree, 22 percent agree).

"Results of this poll indicate that most parents want strong policies around making sure children in daycare are up-to-date on vaccines," says Sarah J. Clark, M.P.H. , associate director of the National Poll on Children's Health and associate research scientist in the University of Michigan Department of Pediatrics. "Checking vaccination records every year is beyond the scope of many state requirements, and may represent a significant change in practice at many daycares."

The poll gave parents a scenario where 1 in 4 children in their daycare center were not up-to-date on vaccines. In response to this scenario, 74 percent of parents would consider removing their own child from the daycare.

"This scenario mirrors the national statistics that show approximately 25 percent of preschool children in the United States are not fully vaccinated," says Clark. "Parents may not realize that so many children are not up-to-date; in some daycares, this scenario is a reality."

The full report, including survey questions and summary is available here.

Contributors to this Issue
C.S. Mott Children's Hospital
Gongwer News Service
HealthDay

Quick Links . . .

Mobile Dentistry Forms Open for Comment
Public comment is now open for several draft documents related to mobile dentistry operations. The comment period will end the close of business December 12, 2014.
Signed by Governor Snyder in April, PA 100 requires owners of mobile dental facilities to apply for a permit through the Department of Community Health, and it defines appropriate equipment and supplies for such facilities. The law also requires mobile dental facilities to establish relationships with local area dentists to ensure patients are referred for proper follow-up dental procedures and improved treatment. PA 100 takes effect April 1, 2015.
The nine draft forms and supporting documents are available here.
Comments can be emailed to: MDCH-MobileDentistry@michigan.gov

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Altarum Seeks Senior Oral Health Program Manager
Altarum Institute is seeking a Senior Program Manager to join their Information & Technology Strategies (ITS) group inĀ Ann Arbor, MI to manage a 3-year Centers for Medicare and Medicaid Services innovation program that is designed to reduce the burden of childhood dental disease. A full job description is available here. Apply online here.