Fetal Mortality: United States, 2023

Area of Science:

• Public Health
• Reproductive Health
• Perinatal Epidemiology

Background:

• Fetal mortality remains a significant public health concern globally.
• Understanding demographic and risk factor associations is crucial for targeted interventions.
• Timely data on fetal mortality trends informs public health policy and research.

Purpose of the Study:

• To present detailed 2023 fetal mortality data for the United States.
• To examine trends and disparities in fetal mortality by maternal characteristics and gestational age.
• To identify key risk factors associated with fetal death.

Main Methods:

• Descriptive analysis of all reported fetal deaths (≥20 weeks gestation) in the U.S. for 2023.
• Examination of trends by comparing 2023 data with 2022 rates.
• Analysis of fetal mortality rates by maternal race/ethnicity, age, tobacco use, plurality, and gestational age.

Main Results:

• The 2023 U.S. fetal mortality rate was 5.53 per 1,000 births, similar to 2022.
• A 4% increase in fetal mortality was observed for gestations of 20-27 weeks.
• Rates were highest for Native Hawaiian/Other Pacific Islander and Black non-Hispanic women, and for mothers <15 or ≥40 years, smokers, and those with multiple gestations.

Conclusions:

• While the overall U.S. fetal mortality rate was stable, specific subgroups experienced concerning increases.
• Significant racial/ethnic and age-related disparities persist.
• Maternal smoking and multiple gestations are key risk factors requiring continued attention.