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Child Health USA 2013 An illustrated collection of current and historical data, published annually.

Fetal Mortality

Narrative

Fetal mortality is defined as the death of a fetus prior to birth, regardless of gestational age. Based on survey data, more than a million fetal losses are estimated to occur annually in the United States, most of which are early fetal losses, also called miscarriages.1 Only fetal deaths at 20 or more weeks’ gestation—often called stillbirths— are generally reported by states in the National Vital Statistics System. In 2006, the latest year for which national data have been reported, there were 25,972 fetal deaths at 20 or more weeks’ gestation, for a rate of 6.05 fetal deaths per 1,000 live births plus fetal deaths. The number of fetal deaths is similar to the number of infant deaths (28,509 in 2006).2

Similar to trends for infant mortality, fetal mortality rates have generally declined over time. Since 1990, fetal mortality rates at 20 weeks or more have fallen by nearly 20 percent from 7.49 to 6.05 per 1,000 in 2006. Most of this decline is attributed to reductions in fetal mortality at 28 weeks or more, which declined from 4.30 to 2.97 per 1,000 between 1990 and 2006.

As with infant mortality, there are large differences in fetal mortality by race and ethnicity. In 2006, fetal mortality rates at 20+ weeks were more than twice as high among non-Hispanic Black women as for non-Hispanic White women (10.73 versus 4.81 per 1,000). The majority of this disparity (64 percent) was due to higher non-Hispanic Black fetal mortality rates at 20- 27 weeks’ gestation. Relative to non-Hispanic Whites, fetal mortality rates were also higher for non-Hispanic American Indian/Alaska Native and Hispanic women (6.04 and 5.29 per 1,000, respectively).

Causes of fetal death include preterm labor, birth defects, infection, placental problems, such as abruption or inadequate blood flow, and chronic conditions, such as hypertension and diabetes.3,4 Avoiding smoking and substance use, maintaining a healthy weight, and preventing and managing chronic conditions prior to and during pregnancy through preconception and prenatal care, may help to reduce risk of stillbirth.5

1 Ventura SJ, Curtin SC, Abma JC, Henshaw SK. Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990-2008. National vital statistics reports; vol 60 no 7. Hyattsville, MD: National Center for Health Statistics. 2012.

2 MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 2006. National vital statistics reports; vol 60 no 8. Hyattsville, MD: National Center for Health Statistics. 2012.

3 Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA. 2011 Dec 14;306(22):2459-68.

4 March of Dimes . Stillbirth. Accessed: 08/01/2013.

5 March of Dimes . Stillbirth. Accessed: 08/01/2013.

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Graphs

This image is described in the Data section.

Fetal mortality rates graph

This image is described in the Data section.

Fetal mortality rates by maternal race graph

Data

Fetal Mortality Rates,* 1990-2006
Year 20-27 Weeks Gestation (Rate per 1,000 Live Births and Fetal Deaths) 28 Weeks or More Gestation (Rate per 1,000 Live Births and Fetal Deaths) Total (Rate per 1,000 Live Births and Fetal Deaths)
*Fetal deaths with stated or presumed period of gestation of 20 weeks or more; cases of unknown gestational age are proportionally assigned according to the known gestational age distribution. Rates do not sum to the total due to slight differences in the denominator.
Source: MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 2006. National vital statistics reports; vol 60 no 8. Hyattsville, MD: National Center for Health Statistics. 2012.
1990 3.22 4.30 7.49
1991 3.20 4.10 7.30
1992 3.30 4.10 7.40
1993 3.30 3.80 7.10
1994 3.30 3.70 7.00
1995 3.33 3.64 6.95
1996 3.33 3.60 6.91
1997 3.29 3.51 6.78
1998 3.35 3.41 6.73
1999 3.39 3.38 6.74
2000 3.31 3.32 6.61
2001 3.25 3.28 6.51
2002 3.24 3.19 6.41
2003 3.25 3.08 6.32
2004 3.17 3.14 6.28
2005 3.21 3.03 6.22
2006 3.10 2.97 6.05
Fetal Mortality Rates,* by Maternal Race/Ethnicity, 2006
Race/Ethnicity 20-27 Weeks Gestation (Rate per 1,000 Live Births and Fetal Deaths) 28 Weeks or More Gestation (Rate per 1,000 Live Births and Fetal Deaths) Total (Rate per 1,000 Live Births and Fetal Deaths)
*Fetal deaths with stated or presumed period of gestation of 20 weeks or more; cases of unknown gestational age are proportionally assigned according to the known gestational age distribution. Rates do not sum to the total due to slight differences in the denominator.
Source: MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 2006. National vital statistics reports; vol 60 no 8. Hyattsville, MD: National Center for Health Statistics. 2012.
Non-Hispanic White 2.34 2.48 4.81
Non-Hispanic Black 6.14 4.65 10.73
Hispanic 2.51 2.79 5.29
American Indian/Alaska Native (Includes Hispanics) 2.61 3.45 6.04
Asian/Pacific Islander (Includes Hispanics. Separate data for Asians, Native Hawaiians, and Other Pacific Islanders is not available.) 2.62 2.28 4.89