Indicator Definitions

Maternal and Child Health Status Indicator Definitions

(in order of appearance in reports)

Indicator 1: Deliveries: The number of Florida resident women who delivered a live newborn during a calendar year. The total number of births during the delivery is not reflected in the number of deliveries as multiple births are counted as one delivery.

Indicator 2: Cesarean Delivery: A delivery that requires a surgical incision in the wall of the abdomen and uterus of a pregnant woman so that the infant does not have to pass through the birth canal.

Indicator 3: Inadequate Prenatal Care: Prenatal care begins at fifth month of pregnancy or later, or the pregnant woman receives less than 50% of the recommended number of prenatal care visits, adjusted for delivered infant’s gestational age.

Indicator 4: Mothers who Participated in the Family Planning Waiver Program: Women between the ages of 14 through 55 who lost full Medicaid eligibility coverage within the past two years and whose family income is at or below 185% of the federal poverty level and are not otherwise eligible for Medicaid, Children’s Health Insurance Program or health insurance coverage that provides family planning services.  “Participated” means that these women had at least one family planning service claim paid during the time they were eligible under the waiver.

Indicator 5: Preterm Delivery: Delivery occurs between 20 to 36 completed weeks of gestation when all fetal organs are present but not fully mature and functional outside the mother’s womb.

Indicator 6: First Trimester Entry into Prenatal Care: Prenatal care begins within the first three months of pregnancy.

Indicator 7: Smoking During Pregnancy: Women who report using tobacco or smoking one or more cigarettes per day during pregnancy.

Indicator 8: Obese Prepregnancy Body Mass Index (BMI): Women whose weight and height prior to pregnancy as recorded on the infant’s birth certificate indicated a Body Mass Index of 30 or greater, a condition associated with elevated risk of obstetrical complications and obese offspring.

Indicator 9: Underweight Prepregnancy Body Mass Index (BMI): Women whose weight and height prior to pregnancy as recorded on the infant’s birth certificate indicated a Body Mass Index less than 18.5, a condition associated with increased risk of obstetrical complications and delivering a small for gestational age and/or a low birth weight infant.

Indicator 10: Overweight Prepregnancy Body Mass Index (BMI): Women whose weight and height prior to pregnancy as recorded on the infant’s birth certificate indicated a Body Mass Index between 25 and 29, a condition associated with increased risk of Caesarean delivery and overweight offspring.

Indicator 11: Adolescent Delivery: Deliveries born to Florida residents who were less than or equal to eighteen years of age.

Indicator 12: Vaginal Delivery without Physical Complications: Passage of the fetus and placenta from the birth canal into the external world without any physical complications.

Indicator 13: Vaginal Delivery with Physical Complications: Expulsion or extraction of the fetus through the birth canal accompanied by morbid processes such as premature rupture of the membranes, prolonged or precipitous labor, meconium staining, etc.

Indicator 14: WIC Participation: Low-income pregnant women who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC provides foods to supplement diets, nutrition education, and referrals to health care and social services.

Indicator 15: Mothers Diagnosed with a Mental Health Condition: Women with a record in Medicaid Claims and Hospital Discharge files with diagnostic codes related to mental health problems (see Appendix 5) observed up through the child’s first year of life.

Indicator 16: Mother Plans to Breastfeed: A Yes response recorded on item number 52 of the Florida Certificate of Live Birth: Is Infant Being Breastfed?

 Indicator 17: Healthy Start Prenatal Screen: A questionnaire that identifies medical, obstetric or socio-demographic risk factors present in a pregnant woman to determine if she should be referred for services beyond normal prenatal care that will enhance the likelihood of the birth of a healthy infant.

Indicator 18: Pregnant Women Screened at Increased Risk by Healthy Start: Women who received a score of six or above on the Healthy Start Prenatal Risk Screen.  A score of six is classified as a positive screening, indicating elevated risk of delivering preterm and/or giving birth to a low birth weight infant.

Indicator 19: Interpregnancy Interval Less than 18 months: An interconceptional period considered insufficient for a healthy gestation and birth. Calculated as the number of months between the date of the previous live birth to the date of the last menstrual period before the next pregnancy began. The date of the last menstrual period is obtained from the Healthy Start Pre-natal Screen or from the child’s Birth Certificate for women who are not screened.

Indicator 20: Women Who Died Within a Year of Giving Birth: Women who died for any reason within a year of giving birth.

Indicator 21: Maternal Deaths[1]: The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Indicator 22: Births: The number of infants born in Florida during a calendar year. The total number of births during delivery, including multiple births, is counted.

Indicator 23: Infants Who Required Neonatal Intensive Care: Infants who had a birth weight of less than 2,500 grams or were discharged from their birth hospitalization with DRG codes 790 or 791 which characterize the care received for what is defined as NICU level III services.

Indicator 24: Infant Mortality Rate: The number of infants per 1,000 live births who die within the first year after birth. This infant mortality rate (IMR) is different from that reported by the Florida Department of Health (DOH). IMR in this report refers to a death occurring within one calendar year to any child born within a calendar year. This method provides an estimate of mortality risk for a given birth cohort. The Department of Health’s IMR refers to all deaths occurring in a given calendar year to children under one year of age regardless of the year the child was born.

Indicator 25: Infant Screened for Health and Developmental Risk: A questionnaire administered by hospitals that identifies physical, socioeconomic, or maternal psychosocial factors, which potentially may cause future health problems, impair development, and are associated with infant mortality.

Indicator 26: Infants Diagnosed with Developmental Delay or Disability: Infants found to be eligible for services during their first year of life under the Federal Part C initiative in the DOH’s Children Medical Services Early Steps program.

Indicator 27: Infants with Verified Maltreatment: Infants up to one year of age who were verified as having been maltreated by the Department of Children and Families

Indicator 28: Infants Diagnosed With At Birth Anomalies: Infants up to one year of age who were diagnosed with a physiological or structural abnormality that develops at or before birth and is present at the time of birth. The indicator includes both major and minor anomalies [See Appendix 6 for a complete listing of all included diagnostic codes.]

Indicator 29: Infants Placed in Foster Care: Infants up to one year of age reported by the Florida Department of Children and Families as having been placed in out of home care because they can no longer remain safely in their family home.

Indicator 30: Infants Diagnosed with a Mental Health Condition or Mental Retardation Diagnosis: An infant with a record in Medicaid Claims and Hospital Discharge files with diagnostic codes related to mental health or mental retardation observed from birth up to one year of age. See Appendix 5 for a listing of diagnosis codes used to identify these conditions.

Indicator 31: Infant Screened at Increased Risk for Health and Developmental Problems: A risk score of 4 or more on the Infant Risk Screen Instrument is considered positive. Such infants are classified as having an elevated risk of post-neonatal death. Families of infants screened at risk are referred to services offered by early intervention programs.

Indicator 32: Medicaid Infant Readmitted to Hospital after Birth: Infants observed with a post birth hospitalization record in Medicaid Claims and Hospital Discharge files through the first year of life.

Indicator 33: Preterm Low Birth Weight: An infant who is delivered before the termination of a normal pregnancy (37 to 40 weeks) and who weighs less than 2,500 grams.

Indicator 34: Term Low Birth Weight: An infant who is delivered at the termination of a normal pregnancy (37 to 40 weeks) and who weighs less than 2,500 grams.

Indicator 35: Post-Neonatal Mortality Rate: The number of infants per thousand live births who die between 28 days and 364 days after birth.

Indicator 36: Neonatal Mortality Rate: The number of infants per thousand live births who die within the first 28 days after birth.

Indicator 37: Low Birth Weight: An infant who weighs less than 2,500 grams (5 lbs. 8 oz.) at birth.

Indicator 38: Very Low Birth Weight: An infant who weighs less than 1,500 grams (3 lbs. 5 oz.) at birth.

[1] Tables for Indicator 21, Maternal Deaths have not been included.  Low number of maternal deaths resulted in blank tables due to data suppression.

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