MMWR Morb Mortal Wkly Rep. 2004 Jun 25;53(24):529-32.
Fetal deaths at > or =20 weeks' gestation account for 49% of all deaths that occur between the 20th week of pregnancy and the first year of life. Although the risk for fetal death has declined substantially since the 1950s, disparities in the risk for fetal death by race/ethnicity exist. One of the national health objectives for 2010 is to reduce deaths among fetuses of > or =20 weeks' gestation to 4.1 deaths per 1,000 live births plus fetal deaths for all racial/ethnic populations (objective no. 16-1a). To assess progress toward meeting this objective, CDC analyzed 1990-2000 data from the National Vital Statistics System (NVSS). The findings indicate substantial reductions in fetal deaths, primarily because of reductions in late fetal deaths (> or =28 weeks' gestation) compared with early fetal deaths (20-27 weeks' gestation). Despite these reductions, racial/ethnic disparities in fetal deaths persist, particularly among non-Hispanic blacks. Prevention strategies should recognize fetal deaths as a public health problem, improve fetal death surveillance and reporting, target etiologic research, and educate practitioners in identifying women at risk.
妊娠20周及以上的胎儿死亡占怀孕第20周与出生后第一年之间发生的所有死亡的49%。尽管自20世纪50年代以来胎儿死亡风险已大幅下降,但按种族/族裔划分的胎儿死亡风险仍存在差异。2010年的一项国家卫生目标是将妊娠20周及以上胎儿的死亡人数降至每1000例活产4.1例死亡加所有种族/族裔人群的胎儿死亡数(目标编号16 - 1a)。为评估实现这一目标的进展情况,美国疾病控制与预防中心(CDC)分析了1990 - 2000年国家生命统计系统(NVSS)的数据。研究结果表明胎儿死亡人数大幅减少,主要是因为与早期胎儿死亡(妊娠20 - 27周)相比,晚期胎儿死亡(妊娠28周及以上)有所减少。尽管有这些减少,但胎儿死亡方面的种族/族裔差异依然存在,尤其是在非西班牙裔黑人中。预防策略应将胎儿死亡视为一个公共卫生问题,改善胎儿死亡监测和报告,针对病因研究,并教育从业者识别有风险的妇女。