Expanded data from the new birth certificate, 2008.

OBJECTIVES: This report presents data for selected items exclusive to the 2003 U.S. Standard Certificate of Live Birth as well as key items considered not comparable between the 1989 (unrevised) and 2003 (revised) versions for states and territories that implemented the 2003 revision as of January 1, 2008. Information is shown for educational attainment, tobacco use during pregnancy, month prenatal care began, and checkboxes in the following categories: "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."
METHODS: Descriptive statistics are presented on births occurring in 2008 to residents of the 27 states that implemented the revised birth certificate.
RESULTS: There were 2,748,302 births to residents of the 27-state reporting area, representing 65 percent of 2008 U.S. births. About 78 percent of women had at least a high school diploma; 24.5 percent had an advanced education. One out of 10 women smoked during pregnancy (24-state reporting area) and one out of five smokers quit while pregnant. Almost three-quarters of women began prenatal care in the first trimester of pregnancy. The rate of prepregnancy diabetes was 6.5 per 1,000 and gestational diabetes was 40.6; risk of both types rose with maternal age. Nearly one out of four women had a primary cesarean delivery; less than 1 out of 10 women had a vaginal birth after cesarean delivery. About 27 percent of women attempted a trial of labor before a cesarean delivery. Seven percent of all infants were admitted to a neonatal intensive care unit.