GateHouse Media analysis of infant mortality and Apgar scores for out-of-hospital births
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PLBID Fields 2006-2015.xlsx
README.md
parseCDC.py

README.md

PLBID

We used the CDC's Period Linked Birth-Infant Death Data Files to determine whether there was a difference in neonatal mortality rates and five-minute Apgar scores of 0 among babies born in the hospital and those born outside the hospital from 2006-2015.

Specifically, we looked at four groups:

  • babies born in a hospital with a midwife
  • babies born in a hospital with a physician
  • babies born at home with a midwife
  • babies born in a freestanding birth center (not attached to a hospital) with a midwife

For the neonatal mortality analysis, we restricted our analysis to full-term infants (37+ weeks gestation, weighing at least 2,500 grams) with no congenital anomolies or chromosomal disorders. In other words, we exluded babies who might have died regardless of birth setting or birth attendant. We also excluded twins and other multiple births. And we exluded babies born to mothers who were not U.S. residents and whose prenatal care might have happened outside of the United States.

For the Apgar=0 analysis, we we restricted our analysis to full-term infants (37+ weeks gestation, weighing at least 2,500 grams) who were not twins or triplets, etc. But we did not exlude babies who had congenital anomolies or chromosomal disorders, nor did we exclude babies of non-U.S. resident mothers.

We based our research on older studies done by Amos Grunebaum et al published in the American Journal of Obstetrics & Gynecology.

You can run a simpler analysis in the user-friendly CDC WONDER online database, but it does not allow you to break down the out-of-hospital births by specific location (home birth versus birth center birth). It's still a nice feature, though, and I would recommend it if you want to bypass converting flatfiles.

Getting Started

Download the PLBID flatfiles

You need to getthe CDC's Period Linked Birth-Infant Death Data flatfiles for every year beginning in 2006. We ran our analysis in April and May 2018 when the 2016 data was not yet available. It's there now, if you want to grab it, too, but your numbers will be slightly different than ours.

Each year will download two files: a denominator file (all the births) and a numerator file (all the deaths linked to those births). You'll need to query both to do this analysis.

If you have statistical software like SAS/SPSS/STATA, you can download the code files here.

Convert the flatfiles into a query-able format

Since we didn't have statistical software, we relied on the record layout in the User's Guide provided for each year to map out the fields based on character width. The record layout changes from time to time, so you have to pay attention across each year. For example: From 2006-2013, the field containing the year of infant death was called DTHYR and located in character positions 1188-1191. But from 2014-2015, the field changed its name to DOD_YY and its character positions to 1672-1675.

We noted all the field names and character positions for each year in an Excel spreadsheet called PLBID Fields 2006-2016.xlsx, which is in our repository.

We then used a Python script to format the flatfiles into CSV files with the appropriate column headers so we can import it into Google BigQuery.

Quick note on this: If you want a smaller data set (in other words, if you know you're going to call only a handful of fields for your analysis), you can edit the PLBID Fields 2006-2016.xlsx spreadsheet to just those fields before you run the Python script on it.

Prerequisites for the Python script

Python ( 2.7 or greater ).
Pandas module - pip install pandas
If you are using Python 2.7 the xlrd module may also be needed - pip install xlrd

Running the Python script

From the command line or terminal execute the parseCDC.py Python script and provide the required parameters.
-i <input file name> ( the CDC file to parse )
-s <sheet name> ( name of the Excel sheet to grab column positions from )

Example command for VS13LINK.PSNUMPUB ( found in the example folder ). Since the column positions for 2013 are on the 2011-13 sheet we will pass that to -s parameter
python parseCDC.py -i 'example/VS13LINK.PSNUMPUB' -s '2011-13'

This will create a new CSV file in the same folder as the input file.

Load the data into Google BigQuery

Or whatever database you prefer. But we used Google BigQuery because of the size of the files -- in particular, the denominator files, which contains tens of millions of records.

Query the data

Here are the queries we used to run the analysis.

Quick note on CDC reporting flags: The CDC recommends that you invoke reporting flags to generate accurate numbers by residence for items which are not reported by all states. However, we were told by the CDC that for our specific analysis "you do not have to (and likely should not) invoke the flags" because the queries we wrote include all the different types of record revisions across the years and the states. Out of curiosity, we did few test runs with and without the flags and saw that the raw numbers change slightly, but the overall results of the analyses don't change much.

Early neonatal mortality (infant death within 0-6 days of birth)

Infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")

Deaths of infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")
AND CAST(AGER5 AS INTEGER) <4

Infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")
AND CAST(AGER5 AS INTEGER) <4

Infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")
AND CAST(AGER5 AS INTEGER) <4

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")
AND CAST(AGER5 AS INTEGER) <4

Early neonatal mortality of FIRST CHILD (infant death within 0-6 days of birth)

Infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "1" OR ATTEND = "2")

Deaths of infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "1" OR ATTEND = "2")
AND CAST(AGER5 AS INTEGER) <4

Infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")
AND CAST(AGER5 AS INTEGER) <4

Infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")
AND CAST(AGER5 AS INTEGER) <4

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")
AND CAST(AGER5 AS INTEGER) <4

Neonatal mortality (infant death within 0-27 days of birth)

Infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")

Deaths of infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")
AND AGER5 != "5"

Infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")
AND AGER5 != "5"

Infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")
AND AGER5 != "5"

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of fnfants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")
AND AGER5 != "5"

Neonatal mortality of FIRST CHILD (infant death within 0-27 days of birth)

Infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "1" OR ATTEND = "2")

Deaths of infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "1" OR ATTEND = "2")
AND AGER5 != "5"

Infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "1" OR BFACIL = "1")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")
AND AGER5 != "5"

Infants delivered by freestandingn birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by freestandingn birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "2" OR BFACIL = "2")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")
AND AGER5 != "5"

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")

Deaths of infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.NUM]
WHERE BWTR4 = "3"
AND RESTATUS != "4"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (CA_ANEN != "Y" OR UCA_ANEN != "1")
AND (CA_MNSB != "Y" OR UCA_SPINA != "1")
AND CA_CCHD != "Y"
AND (CA_CDH != "Y" OR UCA_HERN != "1")
AND (CA_OMPH != "Y" OR UCA_OMPH != "1")
AND CA_GAST != "Y"
AND CA_LIMB != "Y"
AND (CA_CLEFT != "Y" OR UCA_CLIP != "1")
AND CA_CLPAL != "Y"
AND CA_HYPO != "Y"
AND (CA_DISOR = "N" OR CA_DISOR = "U")
AND (CA_DOWN = "U" OR CA_DOWN = "N" OR UCA_DOWN != "1")
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND TBO_REC = "1"
AND (ATTEND = "3" OR ATTEND = "4")
AND AGER5 != "5"

Apgar Score of 0

Infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")

Infants delivered by hospital physicians with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")
AND APGAR5 = “00"

Infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by hospital midwives with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")
AND APGAR5 = “00"

Infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by freestanding birth center midwives with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")
AND APGAR5 = “00"

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by home midwives with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")
AND APGAR5 = “00"

Apgar Score of 0 for FIRST CHILD

Infants delivered by hospital physicians

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")

Infants delivered by hospital physicians with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "1" OR ATTEND = "2")
AND APGAR5 = “00"

Infants delivered by hospital midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by hospital midwives with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "1" OR BFACIL = "1")
AND (ATTEND = "3" OR ATTEND = "4")
AND APGAR5 = “00"

Infants delivered by freestanding birth center midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by freestanding birth center midwives with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "2" OR BFACIL = "2")
AND (ATTEND = "3" OR ATTEND = "4")
AND APGAR5 = “00"

Infants delivered by home midwives

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")

Infants delivered by home midwives with Apgar=0

SELECT COUNT (*) FROM [iteam-156720:BID.DEN]
WHERE BWTR4 = "3"
AND GESTREC3 = "2"
AND DPLURAL = "1"
AND TBO_REC = "1"
AND (UBFACIL = "4" OR BFACIL = "3" OR BFACIL = "5")
AND (ATTEND = "3" OR ATTEND = "4")
AND APGAR5 = “00"