The challenge of fetal mortality.

Data from the Fetal Death Data File and Linked Birth/Infant Death Data Set, National Vital Statistics System. The magnitude of fetal mortality is considerable: About 1 million fetal deaths occur at any gestational age in the United States each year, including almost 26,000 at 20 weeks of gestation or more; Even when limited to fetal deaths of 20 weeks of gestation or more, nearly as many fetal deaths as infant deaths occur in the United States each year; After decades of decline, the U.S. fetal mortality rate (fetal deaths of 20 weeks of gestation or more) did not decrease from 2003 to 2005; Fetal mortality rates are substantially higher for non-Hispanic black and American Indian or Alaska Native women than for non-Hispanic white women; Compared with the U.S. average, fetal mortality rates are higher for teenagers and for women aged 35 years and over, for twin and higher-order pregnancies, and for women with more than two previous pregnancies. Fetal mortality is a major, but often overlooked, public health problem. Fetal mortality refers to spontaneous intrauterine death at any time during pregnancy. Fetal deaths later in pregnancy are sometimes referred to as stillbirths (at 20 weeks of gestation or more, or 28 weeks or more, for example). Much of the public concern regarding reproductive loss has concentrated on infant mortality, as less is known about fetal mortality. However, the impact of fetal mortality on U.S. families is considerable.This report examines fetal death data from the National Vital Statistics System (NVSS). Vital statistics fetal death data are generally presented for fetal deaths of 20 weeks of gestation or more. Other data sources provide estimates of fetal deaths for all periods of gestation. For example, the National Survey of Family Growth estimates about 1 million fetal losses per year in the United States, with the vast majority of these occurring before 20 weeks of gestation. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.