Fetal, Infant, and Child Death Review: A Public Health Approach to Reducing Mortality and Morbidity

Fetal, infant, and child death reviews are a longstanding public health effort to understand the circumstances of individual deaths and use individual and aggregate findings to prevent future fatalities and improve overall child health. Child death review (CDR) began in the United States in the late 1970s to better identify children who died of abuse or neglect; fetal and infant mortality review (FIMR) began in the mid-1980s as a response to the stagnant rates of infant mortality. Today, there are >1350 CDR teams and >150 FIMR teams across the United States, including in tribal communities, territories, and freely associated states. Since the 1990s, the Health Resources and Services Administration's Maternal and Child Health Bureau has supported fetal, infant, and child death review work through funding and thought leadership. The Health Resources and Services Administration-funded National Center for Fatality Review and Prevention provides support to CDR and FIMR teams, including a standardized data collection system for use by state and local CDR and FIMR teams. Although distinct processes, CDR and FIMR both use a public health approach to identify system gaps contributing to early death and make recommendations that impact programmatic and policy changes at the local, state, and national levels. Although progress has been made in standardizing data collection and deepening our understanding of fetal, infant, and child deaths, opportunities persist for preventing future deaths.