Fetal death rate in the United States, 1979-1990: trend and racial disparity

Abstract

Objective: To examine the impact of changes in birth weight distribution in individual groups and in birth weight-specific fetal death rates on the decline in the crude fetal death rate in the United States.

Methods: Data on live births and fetal deaths in the U.S. for the period 1979-1990 were examined by birth weight group and race using Kitagawa's method for analysis of the crude fetal death rate.

Results: In the period 1979-1990, all racial groups had a decrease in the crude fetal death rate, more so in whites and others (about 22%) than in blacks (10%). In the white population, 73.4% of the total reduction in the crude fetal death rate was attributable to the improvement in birth weight-specific fetal death rates, and the remaining portion of the reduction was due to a favorable change in birth weight distribution. In the black population, the reduction in the crude fetal death rate was entirely attributable to the improvement in the birth weight-specific fetal death rates. However, in other groups, a favorable change in the birth weight distribution was the major determinant. Although black births represented 16.5% of all births in the U.S., they accounted for 26-29% of the crude fetal death rate. Disparity in the crude fetal death rates for blacks and whites is explained almost entirely by differences in birth weight distribution.

Conclusions: A further decrease in the crude fetal death rate in the U.S. requires a decrease in low birth weights, particularly in blacks.