MMWR Morb Mortal Wkly Rep. 2020 Sep 18;69(37):1277-1282. doi: 10.15585/mmwr.mm6937a1.
The spontaneous death or loss of a fetus during pregnancy is termed a fetal death. In the United States, national data on fetal deaths are available for losses at ≥20 weeks' gestation.* Deaths occurring during this period of pregnancy are commonly known as stillbirths. In 2017, approximately 23,000 fetal deaths were reported in the United States (1). Racial/ethnic disparities exist in the fetal mortality rate; however, much of the known disparity in fetal deaths is unexplained (2). CDC analyzed 2015-2017 U.S. fetal death report data and found that non-Hispanic Black (Black) women had more than twice the fetal mortality rate compared with non-Hispanic White (White) women and Hispanic women. Fetal mortality rates also varied by maternal state of residence. Cause of death analyses were conducted for jurisdictions where >50% of reports had a cause of death specified. Still, even in these jurisdictions, approximately 31% of fetal deaths had no cause of death reported on a fetal death report. There were differences by race and Hispanic origin in causes of death, with Black women having three times the rate of fetal deaths because of maternal complications compared with White women. The disparities suggest opportunities for prevention to reduce the U.S. fetal mortality rate. Improved documentation of cause of death on fetal death reports might help identify preventable causes and guide prevention efforts.
妊娠期间胎儿自然死亡或丢失称为胎儿死亡。在美国,≥20 孕周妊娠丢失的胎儿死亡数据可获得。*这一时期发生的死亡通常称为死产。2017 年,美国报告约有 23000 例胎儿死亡(1)。胎儿死亡率存在种族/民族差异;然而,已知的胎儿死亡差异很大,原因尚不清楚(2)。CDC 分析了 2015-2017 年美国胎儿死亡报告数据,发现与非西班牙裔白人(白人)和西班牙裔妇女相比,非西班牙裔黑人(黑人)妇女的胎儿死亡率高出两倍以上。胎儿死亡率也因产妇居住地的州而异。对报告中超过 50%有死亡原因的司法管辖区进行了死因分析。尽管如此,即使在这些司法管辖区,仍有约 31%的胎儿死亡报告未报告死因。死因分析存在种族和西班牙裔起源差异,与白人妇女相比,黑人妇女因产妇并发症导致的胎儿死亡发生率高出三倍。这些差异表明有机会通过预防来降低美国的胎儿死亡率。提高胎儿死亡报告中死因的记录质量可能有助于确定可预防的原因,并指导预防工作。