Fetal and Infant Mortality

From the report on Racial/Ethnic Trends in Fetal Mortality -- Unites States, 1990-2000:

--in 2000, fetal deaths accounted for almost half (49%) of all perinatal deaths

--singleton (one fetus) deliveries accounted for 91% of all fetal deaths in 2000

--from 1990 to 2000 early fetal deaths increased (from 27% to 34%) across al racial/ethnic groups (except American Indians/Alaska Natives and Asians/Pacific Islanders); late fetal deaths decreased (for all racial/ethnic groups)

--the increase in early fetal mortality was not restricted to earlier, and thus less viable, gestations (fetal mortality rates, calculated separately for fetal deaths at 20-23 and 24-27 weeks, showed no improvement for either group)

Here are some of the raw numbers:

In 1990, of 69,737 perinatal deaths reported, 29,345 (42%) were fetal deaths; of these, 12,554 were early fetal deaths, and 16,791 were late fetal deaths. In 2000, of 54,964 perinatal deaths reported, 27,003 (49%) were fetal deaths, including 13,497 early fetal deaths and 13,506 late fetal deaths.

An editorial accompanying the report notes that:

Trends in the risk for early and late fetal death suggest that changes in perinatal technologies (e.g., fetal imaging, prevention of perinatal infections, effective treatment of maternal medical conditions such as diabetes and chronic hypertension, and more aggressive management of labor and delivery)[6] might have had more of an impact on fetal survival at later rather than earlier gestational ages. In addition, rates of prenatal-care use increased substantially during the 1990s,[7] and the subsequent improved access to care also might have had more impact on late rather than early fetal mortality (e.g., through the detection of maternal, fetal, or placental abnormalities that might lead to a live-born delivery). The lack of progress in reducing fetal mortality at earlier gestational ages might be related to 1) poor understanding of the factors associated with premature delivery and 2) limited understanding of the causes of fetal death and the role of maternal, fetal, and placental pathology.[8]

Fetal death = an involuntary loss in which the fetus showed no evidence of life (i.e., no heartbeat or respiration) on delivery

Infant death = the delivery of a live-born infant who subsequently died by age 1 year

Perinatal deaths = fetal + infant deaths (i.e., >/=20 weeks' gestation to age 1 year)

Early fetal deaths = 20-27 weeks' gestation

Late fetal deaths = >/=28 weeks' gestation