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

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• Fetal death, defined as fetal loss at ≥20 weeks gestation, is also known as stillbirth.
• In 2017, the U.S. reported approximately 23,000 fetal deaths.
• Existing racial/ethnic disparities in fetal mortality rates are not fully understood.

Purpose of the Study:

• To analyze U.S. fetal death data from 2015-2017.
• To investigate racial/ethnic disparities in fetal mortality rates and causes of death.
• To identify potential opportunities for prevention.

Main Methods:

• Analysis of U.S. fetal death report data (2015-2017).
• Comparison of fetal mortality rates across racial/ethnic groups.
• Examination of causes of death, with a focus on maternal complications.

Main Results:

• Non-Hispanic Black women had more than double the fetal mortality rate compared to non-Hispanic White and Hispanic women.
• Fetal mortality rates varied by maternal state of residence.
• Black women had three times the rate of fetal deaths due to maternal complications compared to White women.
• Approximately 31% of fetal deaths lacked a specified cause of death, even in jurisdictions with high reporting rates.

Conclusions:

• Significant racial disparities exist in U.S. fetal mortality rates and causes of death.
• Maternal complications contribute disproportionately to fetal deaths among Black women.
• Improved documentation of cause of death on fetal death reports is essential for identifying preventable causes and guiding public health interventions.