Racial and Ethnic Disparities in Fetal Deaths - United States, 2015-2017

Abstract

The spontaneous death or loss of a fetus during pregnancy is termed a fetal death. In the United States, national data on fetal deaths are available for losses at ≥20 weeks' gestation.* Deaths occurring during this period of pregnancy are commonly known as stillbirths. In 2017, approximately 23,000 fetal deaths were reported in the United States (1). Racial/ethnic disparities exist in the fetal mortality rate; however, much of the known disparity in fetal deaths is unexplained (2). CDC analyzed 2015-2017 U.S. fetal death report data and found that non-Hispanic Black (Black) women had more than twice the fetal mortality rate compared with non-Hispanic White (White) women and Hispanic women. Fetal mortality rates also varied by maternal state of residence. Cause of death analyses were conducted for jurisdictions where >50% of reports had a cause of death specified. Still, even in these jurisdictions, approximately 31% of fetal deaths had no cause of death reported on a fetal death report. There were differences by race and Hispanic origin in causes of death, with Black women having three times the rate of fetal deaths because of maternal complications compared with White women. The disparities suggest opportunities for prevention to reduce the U.S. fetal mortality rate. Improved documentation of cause of death on fetal death reports might help identify preventable causes and guide prevention efforts.

FIGURE 1

Fetal mortality rates, by selected maternal characteristics — United States,^§ 2015–2017 * Fetal deaths per 1,000 births plus fetal deaths. ^† Black women and White women were non-Hispanic; Hispanic women could be of any race. ^§ Maternal bridged race/Hispanic origin excludes Rhode Island in 2015 because the state was unable to provide data on maternal race and Hispanic origin on the fetal death report.

FIGURE 2

Fetal mortality rates,^, by state — United States, 2015–2017 Abbreviation: DC = District of Columbia. * Fetal deaths per 1,000 live births plus fetal deaths. † Rates for states that reported fewer than 20 fetal deaths are not presented. The rate for Rhode Island is not presented because the state was unable to provide data on maternal race and Hispanic origin on the fetal death report in 2015.

FIGURE 3

Fetal mortality rates, by cause of death categories and maternal race/ethnicity among states where >50% of fetal deaths had a documented cause^§,^¶ — United States,** 2015–2017 * Deaths per 1,000 live births plus fetal deaths. ^† White women and Black women were non-Hispanic; Hispanic women could be of any race. ^§ 2015: 39 states and the District of Columbia. Excludes California, Connecticut, Georgia, Mississippi, New Jersey, New York, North Carolina, North Dakota, Tennessee, West Virginia, and Wisconsin. 2016: 38 states and the District of Columbia. Excludes California, Connecticut, Georgia, Hawaii, Mississippi, New Jersey, New York, North Dakota, Tennessee, Vermont, West Virginia, and Wisconsin. 2017: 38 states and the District of Columbia. Excludes California, Connecticut, Georgia, Michigan, Mississippi, New York, North Dakota, Rhode Island, Tennessee, Vermont, Virginia, and Wisconsin. ^¶ Thirty-one percent of records are assigned to an unspecified cause of death. If reporting or diagnostic improvements resulted in more specified causes of death, fetal mortality rates for the cause of death categories could change markedly. These potential changes may differ by race/Hispanic origin. ** Excludes Rhode Island in 2015 because the state was unable to provide data on maternal race and Hispanic origin on the fetal death report.