MHLU - Health Status Resource

Health-related Behaviours

In Middlesex-London, 62.1% of women who had given birth reported in 2010 having visited a health care provider to help plan for a healthy pregnancy. Compared to 2001, this represents a 1.7 fold increase in this health-enhancing practice for Middlesex-London women. Also in 2010, almost two-thirds of Middlesex-London women who had given birth said they had taken a vitamin supplement containing folic acid within 12 months of becoming pregnant. Furthermore, about nine out of every ten pregnant women reported from 2001 to 2010 having received prenatal care from a health care provider during the first three months of their pregnancy. These are examples of practices recommended for healthy pregnancies which have been monitored through an ongoing telephone survey of adults in Middlesex-London.

Pregnancy & Fertility Rates

Pregnancy rates in Middlesex-London have increased slightly from 2001 to 2009 whereas those in Ontario and the Peer Group have remained relatively stable. Despite the slight increase, Middlesex-London’s pregnancy rates were still consistently lower than those in Ontario and similar to those of the Peer Group. Fertility rates are the number of live births per 1000 females of childbearing age. In Middlesex-London, fertility rates were for the most part slightly lower than those for Ontario and similar to the Peer Group. They have increased slightly since 2000 and reached Ontario rates by 2009. In 2009, the pregnancy rate in Middlesex-London was 25% higher than its fertility rate, whereas in Ontario, the pregnancy rate was 33% higher than its fertility rate. The difference likely reflects a lower rate of therapeutic abortions for Middlesex-London females compared to their Ontario counterparts, given that Middlesex-London and Ontario's fertility rates were very similar in 2009.

Mothers of newborns who are particularly young (ie. teenagers) or old (ie ages 35 and older) tend to experience more problems delivering the baby and with various birth outcomes, eg. prematurity, low birth weight, and neonatal death, to name a few. These mothers may therefore require more supports before and after birth than mothers in their twenties and early thirties.

Trends and rates of pregnancy and fertility varied significantly depending on mother’s age. Pregnancy and fertility rates across age groups in Middlesex-London followed the trend seen for Ontario but with lower rates in every age group except for ages 15-19 where fertility rates were higher than Ontario and pregnancy rates similar to Ontario, and ages 45 to 49 where pregnancy rates were similar to Ontario. This again would likely reflect a lower rate of therapeutic abortions for Middlesex-London teens ages 15 to 19 compared to Ontario. Teen pregnancies (ages 15 to 19) in Middlesex-London also appear to have mirrored the slight downward trend seen for Ontario which fell by 20% from 2001 to 2009. About 32 for every 1000 females ages 15 to 19 in Middlesex-London were pregnant in 2009.

Age groups 25 through to 34 had the highest fertility rates in Middlesex-London, Ontario and the Peer Group. Compared to the Peer Group, Middlesex-London females tended to be pregnant or give birth at older ages peaking at ages 30 to 34 rather than 25 to 29. Although the 40 to 44 age group had the second lowest pregnancy rate at 10.7 in 2009, rates for this age group showed the most growth by 47% from 2001 to 2009. During this time period, pregnancy rates in Middlesex-London rose by 24% for the 35 to 39 age group and by 20% for the 30 to 34 age group.

The average number of children per female ages 15 to 49 in Middlesex-London was 1.5 in 2007 compared to 1.6 for Ontario and the Peer Group. This is up from 1.4 for Middlesex-London and 1.5 for Ontario and the Peer Group in 2003. The rate of multiple births has increased steadily from 2003 to 2009 in Ontario. The rates for Middlesex-London appear for the most part to follow the trend for Ontario and the Peer Group.

Birth Outcomes

The birth rate in Middlesex-London has decreased slightly over time between 2006 and 2017. During this period, the birth rate in Middlesex-London was similar to Ontario but slightly higher than the average of health units in Ontario with similar characteristics to Middlesex-London (i.e., the Peer Group).1

On average between 2006 and 2017, rural births made up 11.4% of live births in Middlesex-London. In 2011 and 2016, the birth rate was higher in the rural population than in the urban population. While the birth rates for both populations decreased during this time, the decrease was smaller in the rural population than in the urban population.

Childbirth among females who are particularly young (i.e., teenagers) or old (i.e., age 35 and older) tend to be associated with greater odds of complications during pregnancy and delivery.2 In Middlesex-London, mothers age 15 to 19 had the highest rates of small for gestational age (SGA) babies; that is, babies with a birth weight below the tenth percentile of birth weights for their gestational age and sex. Similarly, mothers age 40 to 49 had the highest rates of preterm births (born before 37 weeks of pregnancy) and large for gestational age (LGA) babies (i.e., babies with a birth weight above the ninetieth percentile of birth weights for their gestational age and sex).

In Middlesex-London, the rural population had higher rates of LGA babies, while the urban population had higher rates of SGA babies. The differences in birth weight may be due to differences in the characteristics of the two populations, such as demographics (e.g., ethnicity) or socio-economic status.

A stillbirth (or fetal death) is the death of a fetus in the womb after 20 weeks of pregnancy. Between 2006 and 2017, stillbirth rates in Middlesex-London were higher compared to Ontario and the Peer Group.

References:

  1. Statistics Canada. Health Region (2014) Peer Groups – Working Paper [Internet]. Ottawa, ON: 2014 [cited 2018 Nov 9]. Available from: https://www150.statcan.gc.ca/n1/pub/82-402-x/2015002/wp-dt/wp-dt-eng.htm
  2. Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Bommarito K, Madden T, Olsen MA, et al. Maternal Age and Risk of Labor and Delivery Complications. Matern Child Health J [Internet]. 2015 [cited 2018 Nov 8];19(6):1202-11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418963/ DOI: 10.1007/s10995-014-1624-7

Last modified on: November 12, 2018