Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Dec;95(12):2213-7.
doi: 10.2105/AJPH.2004.043885.

Stillbirths in the United States, 1981-2000: an age, period, and cohort analysis

Cande V Ananth  1 , Shiliang Liu, Wendy L Kinzler, Michael S Kramer
Affiliations

Stillbirths in the United States, 1981-2000: an age, period, and cohort analysis

Cande V Ananth et al. Am J Public Health. 2005 Dec.

Abstract

Objectives: We examined age, period, and cohort (APC) effects on temporal trends in stillbirths among Black and White women in the United States.

Methods: We conducted a cohort study of Black and White women who delivered a singleton live-born or stillborn infant during 1981 through 2000. We analyzed stillbirth rates at 20 or more weeks of gestation within 7 age groups, 4 periods, and 10 "central" birth cohorts after adjusting for confounders.

Results: In both racial groups, women younger than 20 years or 35 years or older were at increased risk of stillbirth; risks decreased over successive periods in all age groups. Birth cohort had no impact on stillbirth trends among Blacks and only a small, nonsignificant effect among Whites. Analyses of various APC combinations showed that Blacks were at a 1.2- to 2.9-fold increased risk for stillbirth relative to Whites. Attributable fractions for stillbirth because of age, period, and cohort effects were 16.5%, 24.9%, and 0.1%, respectively, among Black women and 14.5%, 36.2%, and 2.1%, respectively, among White women.

Conclusions: Strong effects of age and period were observed in stillbirth trends, but these factors do not explain the persistent stillbirth disparity between Black and White women.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
Adjusted maternal age-specific trends in rates of stillbirth at 20 or more weeks of gestation (per 1000 births), by period, for (a) Black and (b) White women in the United States, 1981 to 2000. Note. Rates were adjusted for maternal birth cohort, gravidity, maternal education, marital status, and prenatal care.
FIGURE 2—
FIGURE 2—
Adjusted maternal age-specific trends in rates of stillbirth at 20 or more weeks of gestation (per 1000 births), by birth cohort for (a) Black and (b) White women in the United States, 1981 to 2000. Note. Rates were adjusted for period of delivery, gravidity, maternal education, marital status, and prenatal care.
FIGURE 3—
FIGURE 3—
Adjusted odds ratios of stillbirths in relation to (a) maternal age, (b) period of delivery, and (c) maternal birth cohort: Black and White women in the United States, 1981 to 2000. Note. Odds ratios were adjusted for gravidity, maternal education, marital status, and prenatal care. The reference categories were 25 to 29 years for maternal age, 1996 to 2000 for period, and 1953 for central birth cohort.
See this image and copyright information in PMC

References

    1. Martin JA, Hoyert DL. The national fetal death file. Semin Perinatol. 2002;26:3–11. - PubMed
    1. Hsieh HL, Lee KS, Khoshnood B, Herschel M. Fetal death rate in the United States, 1979–1990: trend and racial disparity. Obstet Gynecol. 1997;89:33–39. - PubMed
    1. Raymond EG, Cnattingius S, Kiely JL. Effects of maternal age, parity, and smoking on the risk of stillbirth. Br J Obstet Gynaecol. 1994;101:301–306. - PubMed
    1. Fretts RC, Boyd ME, Usher RH, Usher HA. The changing pattern of fetal death, 1961–1988. Obstet Gynecol. 1992;79:35–39. - PubMed
    1. Skjaerven R, Wilcox AJ, Lie RT, Irgens LM. Selective fertility and the distortion of perinatal mortality. Am J Epidemiol. 1988;128:1352–1363. - PubMed