U.S. fetal death rate declines nationally, though racial/ethnic disparities remain

The rate of fetal deaths in the U.S. declined significantly from 1990 to 2003, but the rate remains higher among racial and ethnic minorities than among whites, according to a CDC report released on Wednesday, the Washington Times reports.

For the report, Marian MacDorman and colleagues analyzed data from the National Center for Health Statistics from 1990 to 2003. During the time period, the overall number of fetal deaths per 1,000 live births declined steadily by an average of 1.4% annually (Harper, Washington Times, 2/22).

The report says that mortality rates for fetuses at 20 weeks' gestation or more declined substantially, while mortality rates among fetuses at 20 to 27 weeks' gestation have not declined (MacDorman et al., "Fetal and Perinatal Mortality, United States, 2003," 2/21).

According to the report, the fetal death rate for white and Asian women is about five deaths per 1,000 births, compared with 12 deaths per 1,000 births among black women and six deaths per 1,000 births among American Indian and Hispanic women.

Fetal deaths were highest among women who were older than age 45 and younger than age 15.

The report also looked at perinatal deaths, defined as the death of a fetus at term or an infant younger than seven days old.

The perinatal death rate between 1985 and 2003 declined from about 11 deaths per 1,000 births in 1995 to about seven deaths per 1,000 births in 2003. Asian women had the lowest rates followed by whites, Hispanics and American Indians.

Among American Indians, the rate was about five perinatal deaths per 1,000 births. Black women had a rate of 12 perinatal deaths per 1,000 births.

Reasons for the disparities remain uncertain, but the report indicated contributing factors such as differences in health, income and access to quality health care; stress; and racism (Harper, Washington Times, 2/22).

The report is available online. Note: You must have Adobe Acrobat to view the report.