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Surveillance and Research work group suggests ten prioritized indicators that states can use to monitor programs or activities for improving the preconception health status of women of reproductive age. During 1999-2013, state-specific NAS incidence rates increased significantly for women aged 45-64 and for non-Hispanic white females. The incidence of triplet and higher-order multiple births rose fourfold during the 1980s and 1990s (1-3).

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