3202.0: Monday, October 22, 2001 - 4:30 PM

Abstract #29132

Unexamined deaths: Perinatal mortality in the United States, 1995-1997

Wanda D. Barfield, MD, MPH1, Lisa M. Flowers, BA1, Joyce A. Martin, MPH2, Kay M. Tomashek, MD, MPH1, and Solomon Iyasu, MD, MPH1. (1) Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, 2900 Woodcock Blvd, Mailstop K-23, Atlanta, GA 30341, (770)488-5138, wjb5@cdc.gov, (2) Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD

Abstract Text: Infant mortality (death <1 year) is used to gauge a nation’s quality of health care and socioeconomic conditions, but it excludes fetal deaths. Surveillance of perinatal mortality (late fetal plus early neonatal deaths) is needed to provide a better picture of the health of women, fetuses, and newborns. U.S. Fetal Death and Linked Birth/Infant Death data sets were analyzed for 1995-1997. Perinatal mortality rates (per 1,000 live births and fetal deaths) and rate ratios (RR) between blacks and whites were calculated. Components of perinatal mortality--late fetal deaths (³28 weeks’ gestation) and early neonatal deaths (<7 days of age)--were compared within races. Late neonatal (7-27 days) and postneonatal (28-364 days) deaths were also determined. During 1995-1997, the total perinatal mortality rate was 7.6. More perinatal deaths (85,465) occurred than late neonatal (10,992) or postneonatal (29,643) deaths; 47% of perinatal deaths were fetal deaths, and >50% of fetal deaths occurred at 36-41 weeks’ gestation. Blacks had higher perinatal mortality rates than whites (RR=2.1). Among perinatal deaths at ³28 weeks gestation, the ratio of fetal to neonatal deaths was 3.4 for blacks and 2.4 for whites. Most fetal and infant deaths occur during the perinatal period; many among older, potentially viable fetuses. Late fetal deaths are more common among blacks. Perinatal mortality surveillance helps to target interventions to prevent deaths among viable fetuses and reduce racial disparities.

Learning Objectives: At the conclusion of this session, the participant will be able to: 1) Understand the magnitude of perinatal deaths in the U.S. 2) Understand racial disparities in perinatal mortality. 3) Understand the limitations of National Perinatal Surveillance Data.

Keywords: Perinatal Outcomes, Infant Mortality

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA