Objectives: This is the first report to present maternal and infant health information exclusive to the 2003 revision of the U.S. Standard Certificate of Live Birth. Information is shown for the items: Risk factors in this pregnancy, Obstetric procedures, Characteristics of labor and delivery, Method of delivery, Abnormal conditions of the newborn, and Congenital anomalies of the newborn. These items are included on both the 1989 and the 2003 U.S. Standard Certificate of Live Birth; however, many of the specific checkboxes were modified, or are new to the 2003 certificate. The new checkboxes are the focus of this report.

Methods: Descriptive tabulations are presented on births occurring in 2004 to residents of the seven states (Idaho, Kentucky, New York (excluding New York City), Pennsylvania, South Carolina, Tennessee, and Washington), which implemented the 2003 U.S. Standard Certificate of Live Birth as of January 1, 2004.

Results: There were 571,858 births to residents of the seven-state area in 2004 (14 percent of all U.S. births). Gestational and prepregnancy diabetes were reported at rates of 44.0 and 7.2 per 1,000; levels for both types of diabetes increased steadily with maternal age. One percent (1.4) of births were reported to have resulted from infertility therapies; nearly all (90 percent) of the infertility therapy-related births were to non-Hispanic white mothers. More than one-half of all attempts at external cephalic version successfully converted the infant to vertex position. Steroids for fetal lung maturation were administered prior to delivery to 13 of every 1,000 newborns and were inversely associated with gestational age. More than two-thirds of all women received epidurals to help control the pain of labor. A trial of labor was reportedly attempted for 36 percent of all women who then had a cesarean delivery. Six percent of singletons, one-third of all twins, and more than three-fourths of triplets were admitted to a neonatal intensive care unit (NICU) at delivery (Figure 1). The most frequently reported congenital anomalies were cyanotic heart disease (81 per 100,000 infants) and hypospadias (174 per 100,000 male births).