IN PNSS 09 Slide Showreported as percent poverty levelreported as percent poverty level 0 10 20 30 40 50 Percentage State Nation 60 70 80 90 100 0-50 51-100 101-130 131-150 151-185

INDIANAINDIANA

20092009Pregnancy Nutrition

Surveillance System

GrapGrapComparing ContribuComparing Contribu

20082008 (prior year) national (prior year) national

Contributors included 30 sContributors included 30 sC l bi 6 I di T ib lC l bi 6 I di T ib lColumbia, 6 Indian TribalColumbia, 6 Indian Tribalterritory.territory.

phicsphicsutor and National Datautor and National Data

PNSS data are presented.PNSS data are presented.

states, the District of states, the District of l O i ti d 1 U Sl O i ti d 1 U Sl Organizations, and 1 U.S. l Organizations, and 1 U.S.

Source of dataSource of data

0 10 20 30 40 50

Percentage

State

Nation

* Special Supplemental Nutrition Program for Women, Infan

60 70 80 90 100

WIC*

MaternalHealth

Other

2009 IN PNSS Table 1C nts and Children.

Racial and ethnic distriRacial and ethnic distri

0 10 20 30 40 50

Percentage

0 10 20 30 40 50

State

Nation

ibutionibution

60 70 80 90 100

e

60 70 80 90 100WhiteBlackHispanicAmerican IndianA iAsianMultipleOther

2009 IN PNSS Table 1C

Trends in racial and ethTrends in racial and eth

60

80

ntag

e

20

40

Perc

en

02000 2001 2002 2003 20

White Black Hispanic

hnic distributionhnic distribution

004 2005 2006 2007 2008 2009

Year

American Indian Asian Multiple


Age distributionAge distribution

0 10 20 30 40 50

Percentage

0 10 20 30 40 50

State

Nation

60 70 80 90 100

e

60 70 80 90 100

<15 Years15-17 Years18 19 Y18-19 Years20-29 years30-39 Years≥40 Years


Trends in age distributiTrends in age distributi

60

80

ntag

e

20

40

Per

cen

02000 2001 2002 2003 20

<15 Years20-29 Years

ionion

004 2005 2006 2007 2008 2009

Year

15-17 Years 18-19 Years30-39 Years 40+ Years


Education levelEducation level

0 10 20 30 40 50

Percentage

0 10 20 30 40 50

State

Nation

60 70 80 90 10060 70 80 90 100

<High School High School>High School


Migrant statusMigrant status

0 10 20 30 40 50

Percentage

0 10 20 30 40 50

State

Nation

60 70 80 90 100

e

60 70 80 90 100

YesNo


Household income Household income reported as percent poverty levelreported as percent poverty levelHousehold income Household income reported as percent poverty levelreported as percent poverty levelreported as percent poverty levelreported as percent poverty levelreported as percent poverty levelreported as percent poverty level

0 10 20 30 40 50

Percentage

0 10 20 30 40 50

State

Nation

60 70 80 90 100 0-5060 70 80 90 100 0-5051-100101-130131-150151-185186-200Over 200Adj. Eligibility


Program participationProgram participationat initial prenatal visitat initial prenatal visitat initial prenatal visitat initial prenatal visit

100

75

100

e

50

Per

cent

age

0

25

P

0WIC* SNAP**

Stat* Special Supplemental Nutrition Program for Women, Infa** Supplemental Nutrition Assistance Program. *** Temporary Assistance for Needy Families.

Medicaid TANF***

te Nation


ants, and Children.

Timing of WIC enrollmeTiming of WIC enrollme

WIC Enrollmen

8090

100

40506070

rcen

tage

010203040

Pe

01st

Trimester2nd

Trimester3rd

Trimester

* Year 2010 target: 90% of pregnant women will enter into p

ent and medical careent and medical care

nt Medical Care

Year 2010target*

Postpartum 1st Trimester No Care

State NationState Nation

2009 IN PNSS Table 2C prenatal care during the first trimester.

Trends in WIC enrollmeTrends in WIC enrollme

60708090

100

age

2030405060

Per

cent

a

01020

2000 2001 2002 2003 20

P

Medical Care 1st Trimester No MeMedical Care 1st Trimester No Me

ent and medical careent and medical care

004 2005 2006 2007 2008 2009

Year

dical Care 1st Trimester WIC Enrollmentdical Care 1st Trimester WIC Enrollment


Trends in first trimesterby race and ethnicityTrends in first trimesterby race and ethnicityby race and ethnicityby race and ethnicity

60

40

50

60

ge

20

30

40

Per

cent

ag

0

10

2000 2001 2002 2003 200

Whit Bl k Hi i AWhite Black Hispanic Ame

r WIC enrollmentr WIC enrollment

04 2005 2006 2007 2008 2009

Year

i I di A i M lti l T t lrican Indian Asian Multiple Total


Parity and interpregnanParity and interpregnan

Parity

50

60

e

y

20

30

40

erce

ntag

e

0

10

20Pe

0 1 2

Sta

ncy intervalncy interval

Interpregnancy Intervalp g y

3 or More < 6Months

6-18Months

ate Nation


Prevalence of prepregnd i ht*

Prevalence of prepregnd i ht*and overweight*and overweight*

60

40

50

60

tage

10

20

30

Per

cent

0

10

Underweight N

State

* Underweight (BMI < 18.5); overweight (BMI = 25.0-29.9); a

nancy underweight nancy underweight

ormal Overweight (top) andObese

Nation

2009 IN PNSS Table 2C and obese (BMI > 30.0).

Prevalence of prepregnby race and ethnicityPrevalence of prepregnby race and ethnicityby race and ethnicityby race and ethnicity

15

10

age

5Per

cent

0White Black Hispanic American

Indian

State

* BMI < 18.5.

nancy underweight*nancy underweight*

Asian Multiple Total

Nation


Prevalence of prepregnby race and ethnicityPrevalence of prepregnby race and ethnicityby race and ethnicityby race and ethnicity

70

40

50

60

age

20

30

40

Per

cent

0

10

White Black Hispanic AmericanIndian

State

* BMI > 25.0 (includes overweight and obese women).

nancy overweight*nancy overweight*


Nation


Prevalence of less thanweight gain*Prevalence of less thanweight gain*g gby race and ethnicity

g gby race and ethnicity

40

30

age

10

20

Per

cent


Indian

State

* Ideal weight gain: prepregnancy underweight = 28-40 pouprepregnancy overweight = 15-25 pounds; and prepregnan

n ideal maternal n ideal maternal


Nation

2009 IN PNSS Table 9C nds; prepregnancy normal weight = 25-35 pounds; ncy obese = 11-20 pounds.

Prevalence of greater tweight gain*Prevalence of greater tweight gain*g gby race and ethnicity


70

40

50

60

age

20

30

40

Per

cent

0

10


State

* Ideal weight gain: prepregnancy underweight = 28-40 pounprepregnancy overweight = 15-25 pounds; and prepregnan

than ideal maternal than ideal maternal


Nation


Prevalence of less thant th id l t

Prevalence of less thant th id l tgreater than ideal mategreater than ideal mate

50

60

30

40

rcen

tage

10

20Pe

0< Ideal

St* Ideal weight gain: prepregnancy underweight = 28-40 poun

prepregnancy overweight = 15-25 pounds; and prepregnan

n ideal, ideal and l i ht i *

n ideal, ideal and l i ht i *ernal weight gain*ernal weight gain*

Ideal > Ideal

ate Nation


Maternal weight gain*by prepregnancy BMI**Maternal weight gain*by prepregnancy BMI**by prepregnancy BMIby prepregnancy BMI

70

40

50

60

tage

20

30

40

Perc

en

0

10

Underweight Normal

Prepregn

< Ideal Weight Gain

* Ideal weight gain: prepregnancy underweight = 28-40 poupounds; prepregnancy overweight = 15-25 pounds; and p

** Underweight (BMI < 18.5); overweight (BMI = 25.0-29.9);

Overweight Obese

nancy BMI

> Ideal Weight Gain


unds; prepregnancy normal weight = 25-35 prepregnancy obese = 11-20 pounds. and obese (BMI > 30.0).

Trends in prevalence oi ht d d

Trends in prevalence oi ht d doverweight and underwoverweight and underw

40

60

ntag

e

20

Per

cen

02000 2001 2002 2003 20

Overweig

* Underweight (BMI < 18.5); overweight (BMI > 25.0; includ

of prepregnancy i ht*

of prepregnancy i ht*weight* weight*

004 2005 2006 2007 2008 2009

Year

ght Underweight

2009 IN PNSS Table 16Cdes overweight and obese).

Trends in prevalence ot th id l i

Trends in prevalence ot th id l igreater than ideal weiggreater than ideal weig

40

60

ntag

e

20

Per

cen

02000 2001 2002 2003 20

< Ideal Weight G

* Ideal weight gain: prepregnancy underweight = 28-40 pounprepregnancy overweight 15-25 pounds and prepregnancy

of less than ideal and ht i *

of less than ideal and ht i *ght gain*ght gain*

004 2005 2006 2007 2008 2009

Year

Gain > Ideal Weight Gain

2009 IN PNSS Table 16Cnds; prepregnancy normal weight = 25-35 pounds;

y obese = 11-20 pounds.

Trends in the prevalencmaternal weight gain*Trends in the prevalencmaternal weight gain*g gby race and ethnicity


30

40

ntag

e

10

20

Per

cen

02000 2001 2002 2003 20

White Black Hispanic A


ce of less than ideal ce of less than ideal

004 2005 2006 2007 2008 2009

YearAmer Indian Asian Multiple Total


Trends in the prevalencmaternal weight gain*Trends in the prevalencmaternal weight gain*g gby race and ethnicity


40506070

ntag

e

10203040

Per

cen

02000 2001 2002 2003 20

White Black Hispanic Am


ce of greater than ideal ce of greater than ideal

04 2005 2006 2007 2008 2009

Year

mer Indian Asian Multiple Total


nds; prepregnancy normal weight = 25-35 pounds; ncy obese = 11-20 pounds.

Prevalence of anemia*ll t

Prevalence of anemia*ll tenrollmentenrollment

40

20

30

cent

age

0

10Perc

01st Trimester 2nd Trimester 3

S

* Hb or Hct < 5th percentile, CDC MMWR vol. 47 (No. RR-3)

* by timing of program * by timing of program

3rd Trimester Postpartum

State Nation

2009 IN PNSS Table 2C 3), 1998.

Prevalence of third-trimby race and ethnicityPrevalence of third-trimby race and ethnicityby race and ethnicityby race and ethnicity

60

40

50

age

20

30

Per

cent

0

10


State

* Hb or Hct < 5th percentile, CDC MMWR vol. 47 (No. RR-3

mester anemia*mester anemia*


Nation

2009 IN PNSS Table 9C 3), 1998.

Prevalence of postpartby race and ethnicityPrevalence of postpartby race and ethnicityby race and ethnicityby race and ethnicity

50

30

40

age

10

20

30

Per

cent

0

10


State


tum anemia* tum anemia*


Nation

2009 IN PNSS Table 9C 3), 1998.

Trends in prevalence oanemia*Trends in prevalence oanemia*by race and ethnicityby race and ethnicity

405060

ntag

e

102030

Per

cen

02000 2001 2002 2003 20



of third trimester of third trimester

004 2005 2006 2007 2008 2009

Year

Amer Indian Asian Multiple Total

2009 IN PNSS Table 20C 3), 1998.

Trends in the prevalencanemia*Trends in the prevalencanemia*by race and ethnicityby race and ethnicity

30

40

50

ntag

e

10

20

Per

cen

02000 2001 2002 2003 20



ce of postpartum ce of postpartum

004 2005 2006 2007 2008 2009

Year

Amer Indian Asian Multiple Total

2009 IN PNSS Table 20C 3), 1998.

Prevalence of smokingh h ld bPrevalence of smokingh h ld bhousehold by pregnanchousehold by pregnanc

Smoking

30

35

40

20

25

30

rcen

tage

10

15Per

0

5

3 Mos Prior toPregnancy

DuringPregnancy

Last 3 Mos ofPregnancy

Pog y g y g y

SYear 2010 target: 99% of pregnant women report no smoking

g and smoking in the t t

g and smoking in the t tcy statuscy status

Smoking in the HouseholdHousehold

ostpartum DuringPregnancy

Postpartumg y

State Nation2009 IN PNSS Table 2C g in the past month.

Smoking changes durinamong women who reported smokinSmoking changes durinamong women who reported smokinamong women who reported smokinamong women who reported smokin

40

50

ge

20

30

Per

cent

ag

0

10

Quit by 1st Prenatal Visit

State

ng pregnancyng three months prior to pregnancyng pregnancyng three months prior to pregnancyng three months prior to pregnancyng three months prior to pregnancy

Quit by 1st Prenatal Visit andStayed Off Cigarettes

Nation


Trends in prevalence o3 months of pregnancyTrends in prevalence o3 months of pregnancyp g yby race and ethnicity

p g yby race and ethnicity

50

30

40

50

tage

10

20

Perc

ent

02000 2001 2002 2003 20


of smoking during the last yof smoking during the last yyy

004 2005 2006 2007 2008 2009

YearYear

American Indian Asian Multiple Total


Trends in the prevalenchousehold*Trends in the prevalenchousehold*by race and ethnicityby race and ethnicity

60

40

50

60

tage

10

20

30

Perc

ent

02000 2001 2002 2003 20


* During the prenatal period.

ce of smoking in the ce of smoking in the

004 2005 2006 2007 2008 2009

YearYear



Prevalence of maternaPrevalence of materna

10

5

erce

ntag

e

0

Pe

03 Months Prior to Pregnancy

State

Year 2010 Target: 6% or less of pregnant women report use

al drinkingal drinking

y Last 3 Months of Pregnancy

e Nation

2009 IN PNSS Table 2Cof alcohol in the previous month.

Prevalence of medical Prevalence of medical **pregnancy*pregnancy*

1010

e

5

Perc

enta

ge

0Di b tDiabetes

State

* Woman reports being told by doctor she had diabetes prioWoman reports being told by doctor she had hypertension

conditions during conditions during

H t iHypertension

e Nation

2009 IN PNSS Tables 2Cor to and/or during pregnancy.

prior to and/or during pregnancy.

Prevalence of diabetesby race and ethnicityPrevalence of diabetesby race and ethnicityby race and ethnicityby race and ethnicity

10

age

5

Per

cent


Indian

State

* Includes diabetes mellitus and gestational diabetes.

s during pregnancy*s during pregnancy*


Nation


Prevalence of hypertenby race and ethnicityPrevalence of hypertenby race and ethnicityby race and ethnicityby race and ethnicity

10

age

5

Per

cent


Indian

State

* Includes chronic hypertension and pregnancy-induced hyp

nsion during pregnancy*nsion during pregnancy*


Nation

2009 IN PNSS Table 9C pertension.

Prevalence of multivitaPrevalence of multivitad i *d i *during pregnancy*during pregnancy*

60708090

30405060

Per

cent

age

0102030P

Prepregnancy Use

State

* Multivitamin use prior to pregnancy is a proxy for folic acid Multivitamin use prior to pregnancy is a proxy for folic acidproxy for iron consumption. Year 2010 Target: Increase to 400 mcg. of folic acid each day.

amin use prior to andamin use prior to and

During Pregnancy

e Nation

d consumption Multivitamin use during pregnancy is a

2009 IN PNSS Tables 2C

d consumption. Multivitamin use during pregnancy is a 80% the number of women of childbearing age who take in

Prevalence of multivitapregnancy*Prevalence of multivitapregnancy*p eg a cyby race and ethnicityp eg a cyby race and ethnicity

30

20

age

10Per

cent


Indian

State

* Multivitamin use prior to pregnancy is a proxy for folic acid 80% the number of women of childbearing age who take in

amin use prior to amin use prior to


Nation


d consumption. Year 2010 Target: Increase to n 400 mcg. of folic acid each day.

Prevalence of multivitapregnancy*Prevalence of multivitapregnancy*p eg a cyby race and ethnicityp eg a cyby race and ethnicity

90

50607080

tage

20304050

Per

cent

01020

White Black Hispanic AmericIndian

State

* Multivitamin use during pregnancy is a proxy for iron consu

amin use during amin use during

an Asian Multiple Totaln

e Nation

2009 IN PNSS Table 10C umption.

Prevalence of low birthwPrevalence of low birthw**birthweight *birthweight *

10

ge

5

Per

cent

ag

LBW (top) andVLBW

0

State

* VLBW < 1500 g; LBW = 1500 - < 2500 g; HBW > 4000 g** Year 2010 Target: Reduce very low birthweight to < 0.9 p

weight and high weight and high

HBW

Nation


g. percent and low birthweight to < 5.0 percent.

Prevalence of selectedPrevalence of selectedPrevalence of selectedPrevalence of selected

20

10

15

erce

ntag

e

0

5Pe

Preterm F

St

* Preterm: < 37 weeks gestation. Full term low birthweight:

d birth outcomes*d birth outcomes*d birth outcomes*d birth outcomes*

Full Term LowBirthweight

Multiple Births

tate Nation

2009 IN PNSS Table 2C 37 or more weeks and < 2500 g.

Prevalence of low birthby race and ethnicityPrevalence of low birthby race and ethnicityby race and ethnicityby race and ethnicity

20

15

ntag

e

5

10

Per

cen


IndianIndian

State

* Low birthweight includes VLBW < 1500 g and LBW = 150** Year 2010 target: Reduce low birthweight to < 5.0 percen

hweight*hweight*

Year 2010target**


target

Nation

2009 IN PNSS Table 12C 00-<2500 g. t.

Prevalence of low birthby selected health indicatorsPrevalence of low birthby selected health indicatorsby selected health indicatorsby selected health indicators

Under- Normal Over- < Ideal Ide

15

20weight weight

10

15

cent

age

5

Per

c

0Prepregnancy BMI Weigh

* Low birthweight includes VLBW < 1500 g and LBW = 150** Year 2010 target: Reduce low birthweight to < 5.0 percen

hweight*hweight*

eal > Ideal Smoker Nonsmoker

Year 2010target**

ht Gain Smoking DuringPregnancyPregnancy

2009 IN PNSS Table 13C00-<2500 g. t.

Prevalence of high birtby race and ethnicityPrevalence of high birtby race and ethnicityby race and ethnicityby race and ethnicity

10

age

5

Per

cent


Indian

State

* High birthweight > 4000 g.

hweight*hweight*


Nation


Prevalence of preterm by race and ethnicityPrevalence of preterm by race and ethnicityby race and ethnicityby race and ethnicity

20

15

age

5

10

Per

cent


Indian

State

* Preterm: < 37 weeks gestation.

delivery* delivery*


Nation


Trends in the prevalenby race and ethnicityTrends in the prevalenby race and ethnicityby race and ethnicityby race and ethnicity

15

10

15

tage

5Perc

ent

02000 2001 2002 2003 20


* < 2500 g.

ce of low birthweight* ce of low birthweight*

004 2005 2006 2007 2008 2009

YearYear




15

10

15

tage

5Perc

ent

02000 2001 2002 2003 20


* > 4000 g.

ce of high birthweight* ce of high birthweight*

004 2005 2006 2007 2008 2009

YearYear




20

15

20

tage

5

10

Perc

ent

02000 2001 2002 2003 20


* < 37 weeks gestation.

ce of preterm delivery* ce of preterm delivery*

004 2005 2006 2007 2008 2009

YearYear



Percentage of infants eby race and ethnicityPercentage of infants eby race and ethnicityby race and ethnicityby race and ethnicity

90100

60708090

tage

2030405060

Per

cent

01020

White Black Hispanic AmericIndian

State* Includes infants currently breastfeeding or ever breastfed Includes infants currently breastfeeding or ever breastfed** Year 2010 Target: Increase the proportion of mothers who

period to 75%.

ever breastfed*ever breastfed*

Year 2010 target**

can Asian Multiple Totaln

e Nationd as reported by mother at postpartum visit


d as reported by mother at postpartum visit . o breastfeed their babies in the early postpartum

Trends in the percentabreastfed*Trends in the percentabreastfed*by race and ethnicityby race and ethnicity

90

5060708090

ntag

e

1020304050

Perc

en

02000 2001 2002 2003 200

Y

White Black Hispanic Am

* Reported by mother at postpartum visit. Year 2010 target:breastfeed their babies in the early postpartum period to 75

ge of infants ever ge of infants ever

4 2005 2006 2007 2008 2009

Year

merican Indian Asian Multiple Total

2009 IN PNSS Table 23C : increase the proportion of mothers who 5%.

MaMaState Maps ofState Maps of

apsapsf County Dataf County Data

2007-20092007-2009Pregnancy Nutrition

Surveillance System

Percentage of pregnanaged ≤ 17 years, by coun

Percentage of pregnanaged ≤ 17 years, by coun

ncies among females nty

ncies among females nty

0 - < 4

4 - < 6

6 - < 8

8 +

No Data

2007-2009 IN PNSS Table 4B

Percentage of women their first trimester, by co

Percentage of women their first trimester, by co

enrolling in WIC during unty

enrolling in WIC during unty

0 - < 30

30 - < 38

38 - < 46

46 +

No Data


Prevalence of prepregnby countyPrevalence of prepregnby county

* BMI < 18.5.

nancy underweight*, nancy underweight*,

0 - < 4

4 - < 6

6 - < 8

8 +

No Data


Prevalence of prepregnby countyPrevalence of prepregnby county

* BMI > 25.0.

nancy overweight*, nancy overweight*,

0 - < 48

48 - < 52

52 - < 56

56 +

No Data


Prevalence of < ideal wby countyPrevalence of < ideal wby county


weight gain*, weight gain*,

0 - < 16

16 - < 18

18 - < 20

20 +

No Data

nds; prepregnancy normal weight = 25-35 pounds; ncy obese = 11-20 pounds. 2007-2009 IN PNSS Table 5B

Prevalence of > ideal wby countyPrevalence of > ideal wby county


weight gain*, weight gain*,

0 - < 51

51 - < 55

55 - < 59

59 +

No Data

nds; prepregnancy normal weight = 25-35 pounds; ncy obese = 11-20 pounds. 2007-2009 IN PNSS Table 5B

Prevalence of smokingof pregnancy, by county

Prevalence of smokingof pregnancy, by county

g during the last 3 months g during the last 3 months

0 - < 20

20 - < 28

28 - < 36

36 +

No Data


Incidence of gestationaby countyIncidence of gestationaby county

* Postpartum woman reports being told by doctor she had g

al diabetes*, al diabetes*,

0 - < 2

2 - < 4

4 - < 6

6 +

No Data


gestational diabetes during her most recent pregnancy.

Prevalence of hypertenby countyPrevalence of hypertenby county

* Postpartum woman reports being told by doctor she had hy

nsion during pregnancy*, nsion during pregnancy*,

0 - < 2

2 - < 5

5 - < 8

8 +

No Data


ypertension during her most recent pregnancy.

Prevalence of multivitapregnancy*, by county


* Multivitamin use prior to pregnancy is a proxy for folic acid

amin use prior to amin use prior to

0 - < 11

11 - < 16

16 - < 21

21 +

No Data

2007-2009 IN PNSS Table 7B d consumption.



* Multivitamin use during pregnancy is a proxy for iron consu

amin use during amin use during

0 - < 79

79 - < 86

86 - < 93

93 +

No Data

2007-2009 IN PNSS Table 7B umption.

Prevalence of low birthby countyPrevalence of low birthby county

* < 2500 grams.

hweight*, hweight*,

0 - < 6

6 - < 8

8 - < 10

10 +

No Data


Prevalence of high birtby countyPrevalence of high birtby county

* > 4000 grams.

hweight*, hweight*,

0 - < 4

4 - < 6

6 - < 8

8 +

No Data


Prevalence of preterm by countyPrevalence of preterm by county

* < 37 weeks gestation.

delivery*,delivery*,

0 - < 12

12 - < 15

15 - < 18

18 +

No Data


Percentage of infants eby countyPercentage of infants eby county

* Reported by mother at postpartum visit..

ever breastfed*, ever breastfed*,

0 - < 52

52 - < 62

62 - < 72

72 +

No Data


Documents

IN PNSS 09 Slide Showreported as percent poverty levelreported as percent poverty level 0 10 20 30 40 50 Percentage State Nation 60 70 80 90 100 0-50 51-100 101-130 131-150 151-185