Elizabeth C W Gregory’s scientific contributions


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Publications (16)


Fetal Mortality in the United States: Final 2021-2022 and 2022-Provisional 2023
  • Article

October 2024

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2 Reads

NCHS data brief

Elizabeth C W Gregory

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Claudia P Valenzuela

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Trends and Characteristics in Maternal Syphilis Rates During Pregnancy: United States, 2016-2022

February 2024

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6 Reads

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14 Citations

NCHS data brief

After reaching historic lows in 2000 and 2001, rates of primary and secondary syphilis in the overall U.S. population have increased nearly every year through 2022 (1). For 2017-2022, rates of syphilis for women of reproductive age and congenital syphilis (a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy) increased by more than 250% (1,2). Congenital syphilis can cause adverse pregnancy outcomes such as fetal and neonatal death, low birthweight, preterm birth, and brain and nerve disorders (2). This report presents trends in maternal syphilis rates in women giving birth in the United States for 2016-2022 by selected maternal demographic and health factors.


Perinatal Mortality in the United States, 2020-2021

December 2023

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3 Reads

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4 Citations

NCHS data brief

Perinatal mortality(late fetal deaths at 28 completed weeks of gestation or more and early neonatal deaths younger than age 7 days) can be an indicator of the quality of health care before, during, and after delivery, and of the health status of the nation (1,2). The U.S. perinatal mortality rate declined 30% from 1990 through 2011, was stable from 2011 through 2016, and declined 4% from 2017 through 2019 (1,3-5). This report describes changes in perinatal mortality, as well as its components, late fetal and early neonatal mortality, from 2020 to 2021, during the COVID-19 pandemic. Also shown are perinatal mortality rates by mother's age, the three largest race and Hispanic-origin groups, and state for 2021 compared with 2020.


Fetal Mortality: United States, 2021

July 2023

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18 Reads

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45 Citations

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

Objectives-This report presents 2021 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined. Methods-Descriptive tabulations of data are presented and interpreted for all fetal deaths reported for the United States for 2021 with a stated or presumed period of gestation of 20 weeks or more. Cause-of-fetal-death data are restricted to residents of the 41 states and the District of Columbia, where cause of death was based on the 2003 fetal death report revision and less than 50% of deaths were attributed to Fetal death of unspecified cause (P95). Results-A total of 21,105 fetal deaths at 20 weeks of gestation or more were reported in the United States in 2021. The 2021 U.S. fetal mortality rate was 5.73 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, which was essentially unchanged from the rate of 5.74 in 2020. The fetal mortality rate in 2021 for deaths occurring at 20-27 weeks of gestation was 2.95, essentially unchanged from 2020 (2.97). For deaths occurring at 28 weeks of gestation or more, the rate in 2021 (2.80) was not significantly different from 2020 (2.78). In 2021, the fetal mortality rate ranged from 3.94 for non-Hispanic, single-race Asian women to 9.89 for non-Hispanic, single-race Black women. Fetal mortality rates were highest for females under age 15 and aged 40 and over, for women who smoked during pregnancy, and for women with multiple gestation pregnancies. Five selected causes accounted for 89.9% of fetal deaths in the 41-state and District of Columbia reporting area.


Trends and Characteristics in Prepregnancy Diabetes: United States, 2016-2021

May 2023

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2 Reads

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13 Citations

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

Objectives-This report presents data on trends for prepregnancy diabetes mellitus (PDM), diabetes diagnosed before pregnancy, in mothers giving birth in the United States for 2016-2021, and rates by selected maternal characteristics for 2016 and 2021.


Changes in Home Births by Race and Hispanic Origin and State of Residence of Mother: United States, 2018-2019 and 2019-2020

December 2021

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8 Reads

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20 Citations

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

Objectives-This report describes changes between 2019 and 2020 in the percentage of U.S. home births by month, race and Hispanic origin, and state of residence of the mother and makes comparisons with changes occurring between 2018 and 2019.


Prepregnancy Body Mass Index and Infant Outcomes by Race and Hispanic Origin: United States, 2020

December 2021

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6 Reads

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12 Citations

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

Objectives-This report presents data on distributions in prepregnancy body mass index (BMI), including the three classes of obesity, by maternal race and Hispanic origin for women who gave birth in 2020. It also examines newborn outcomes by BMI by maternal race and Hispanic origin.


Increases in Prepregnancy Obesity: United States, 2016-2019

November 2020

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41 Reads

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198 Citations

NCHS data brief

Obesity (body mass index [BMI] of 30.0 and over) has risen in the United States in recent decades (1). Obesity varies by demographic factors, such as age, race and Hispanic origin, and socioeconomic status (2,3). Maternal obesity has been linked to a variety of adverse health outcomes for mothers and newborns, including gestational diabetes, hypertension, preeclampsia, cesarean delivery, preterm delivery, large size for gestational age, and infant death (4-10). The 2016 natality data file is the first for which prepregnancy BMI is available for all states and the District of Columbia (D.C.). This report presents trends in prepregnancy obesity for 2016 through 2019 by maternal race and Hispanic origin, age, and educational attainment. Trends by state for 2016-2019 and 2019 rates also are shown.


Infant Mortality by Maternal Prepregnancy Body Mass Index: United States, 2017-2018

August 2020

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2 Reads

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16 Citations

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

Objective-This report presents 2017-2018 infant mortality rates in the United States by maternal prepregnancy body mass index, and by infant age at death, maternal age, and maternal race and Hispanic origin. Methods-Descriptive tabulations of infant deaths by maternal and infant characteristics are presented using the 2017-2018 linked period birth/infant death files; the linked period birth/infant death file is based on birth and death certificates registered in all states and the District of Columbia. The 2017 linked birth/infant death file is the first year that national data on maternal prepregnancy body mass index were available. Results-Total infant, neonatal, and postneonatal mortality rates were lowest for infants of women who were normal weight prepregnancy, and then rose with increasing prepregnancy body mass index. Total, neonatal, and postneonatal rates were higher for infants of women who were underweight prepregnancy compared with infants of women who were normal or overweight before pregnancy. Mortality rates for infants of underweight women were generally, but not exclusively, lower than those of infants born to women with obesity. Infants born to women of normal weight generally had lower mortality rates than infants born to women who had obesity prepregnancy for all maternal age and race and Hispanic-origin groups.


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Citations (14)


... Our findings of increasing rates of known PTB risks, such as preexisting diabetes and gestational hypertension, and of mental health conditions across SES groups also align with other studies, [65][66][67] as do our results with respect to increasing rates of maternal obesity and STIs during pregnancy. 68,69 Importantly, our findings showing an increased number of individuals reporting housing insecurity while pregnant, particularly those with public health insurance, align with those of other investigators who have reported this increase, 70,71 as do our findings of increasing IPV rates in some groups. 70 Our observation of decreasing WIC participation rates in low-income populations has also been reported by others in differing locations. ...

Reference:

Risk and Protective Factors for Preterm Birth Among Racial, Ethnic, and Socioeconomic Groups in California
Trends and Characteristics in Maternal Syphilis Rates During Pregnancy: United States, 2016-2022
  • Citing Article
  • February 2024

NCHS data brief

... Recognizing and addressing the holistic needs of the individual facilitates the restoration of hope, vitality, P erinatal loss is a global concern, with 2.3 million deaths worldwide annually according to the World Health Organization (2024). Perinatal loss due to miscarriage, stillbirth, termination for fetal anomalies, or newborn death is defined as the death of a fetus or newborn between conception and 28 days after birth (Valenzuela et al., 2023). Perinatal loss is often an emotional experience for parents and health care professionals alike, regardless of etiology (Westby et al., 2021). ...

Perinatal Mortality in the United States, 2020-2021
  • Citing Article
  • December 2023

NCHS data brief

... Fetal death refers to the intrauterine death of a fetus at any time during the pregnancy, including medical termination of pregnancy (TOP). Fetal death is generally divided into three periods based on gestational age: < 20 weeks of gestation, 20-27 weeks of gestation (early fetal deaths), and ≥ 28 weeks of gestation (late fetal deaths) 3 . Late fetal death is also termed stillbirth 4 . ...

Fetal Mortality: United States, 2021
  • Citing Article
  • July 2023

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

... The influence of T2DM on developing teeth is evident in fetuses of diabetic pregnant women, as these mothers are primarily obligated to avoid medications for diabetes during pregnancy to prevent side effects to fetuses [12], resulting in an untreated diabetic condition. Diabetes patients during pregnancy consist of two groups: gestational diabetes mellitus (GDM) and pregnancy diabetes mellitus (PDM), with prevalences of approximately 7.8% in 2020 [13] and 1.1% in 2021 [14], respectively, in the US. In a prospective cohort study assessing 50 children of women with GDM and 250 children of normoglycemic women in Brazil, children of GDM mothers showed a 2.6-fold higher prevalence of developmental defects of enamel compared to the control group [3]. ...

Trends and Characteristics in Prepregnancy Diabetes: United States, 2016-2021
  • Citing Article
  • May 2023

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

... Seeking support for any mental health issues can help ensure a more positive pregnancy experience. 5 ...

Prepregnancy Body Mass Index and Infant Outcomes by Race and Hispanic Origin: United States, 2020
  • Citing Article
  • December 2021

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

... Childbirth is a leading reason for hospital admission in the United States (Agency for Healthcare Research and Quality, 2021). In 2020, there were 3,613,482 U.S. births, 98.7% of which occurred in hospitals (Gregory et al., 2021). Although multiple aspects of nursing care quality have been studied in medical-surgical and intensive care settings, established nurse-sensitive indicators (e.g., hospitalacquired pressure injuries and central line-associated bloodstream infections) have little relevance to maternity settings. ...

Changes in Home Births by Race and Hispanic Origin and State of Residence of Mother: United States, 2018-2019 and 2019-2020
  • Citing Article
  • December 2021

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

... In developed countries, over 50% of pregnant women are overweight or obese. 1,2 This trend is likely associated with the consumption of high-calorie diets, the intake of processed high-sugar foods, and sedentary lifestyles. 3 Numerous studies have shown that obesity not only reduces fertility of women during pregnancy, 4 but also increases the risk of gestational diabetes and other health complications. ...

Increases in Prepregnancy Obesity: United States, 2016-2019
  • Citing Article
  • November 2020

NCHS data brief

... Maternal nutritional status is a major intrauterine environmental factor in fetal development. The greater the mother's weight gain, the better the anthropometric measurements of the babies born (weight, body length, head circumference) (17). Gizi ibu pada masa pra-kehamilan berperan penting sehingga status gizi ibu hamil perlu mendapat perhatian yang besar. ...

Infant Mortality by Maternal Prepregnancy Body Mass Index: United States, 2017-2018
  • Citing Article
  • August 2020

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

... Despite screening recommendations [6,7], uptake during pregnancy is suboptimal, and there are reports of significant delays in treatment and antibiotic resistance [8][9][10]. Thus, alternative preventative strategies are needed, but this requires that we better understand how gonorrhea directly impacts specific adverse pregnancy outcomes [9,11,12]. ...

Trends and Characteristics of Sexually Transmitted Infections During Pregnancy: United States, 2016-2018
  • Citing Article
  • March 2020

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System

... obesity, hypertension, diabetes mellitus, autoimmune disorders, intrahepatic cholestasis of pregnancy) causes [5]. Still, in up to 30% of cases, the causes remain unexplained even with complete clinical and autopsy records [6,7]. The causes of neonatal death include factors such as prematurity, multifetal pregnancies, birth defects, and intrapartum-related complications such as birth asphyxia and infections [5,8]. ...

Cause-of-death Data From the Fetal Death File, 2015-2017
  • Citing Article
  • April 2020

National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System