A Decade Under the Microscope: Analyzing Fetal Death Rates in the United States (2005-2021), a CDC Wonder Analysis

Abstract

Background: Availability of the CDC WONDER database provides us the opportunity to analyze fetal demise data from the last decade and uncover any underlying patterns. To the best of our knowledge, these trends in the U.S. population have not been explored recently. Objectives: The purpose of this study was to determine the directionality of trends and the regional differences in intrauterine fetal deaths in the United States from 2005 to 2021. Methods: Data from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research) database were inspected from 2005 to 2021 for fetal mortality in the U.S. Comparisons with respect to year, sex, race/ethnicity and geographic region were performed. Results: Between 2005 and 2021, 406240 total fetal deaths occurred. Total fetal deaths per year have gradually decreased over a span of 17 years from 2005 (25894) to 2021 (21105). On Comparison of the Census Regions, Census Divisions and States, the highest number of fatal deaths was in the South (168595; 41.5%), South Atlantic (90827; 22.4%) and California (43368; 10.7%), respectively. From the numbers provided, we determined that the Non-Hispanic white racial and ethnic group had the highest number of fetal deaths (148091; 36.5%). Of the fetal deaths on record, 52.7% were identified as male and 47.3% as female. 241714 (59.5%) of the fetuses weighed 1499g or less. 91.7% of the fetuses were from singleton pregnancies. 97.8% of the fetal fatalities were in hospitals. The highest number of deaths (21929; 5.4%) was at 21 weeks gestational age. 79.8% of the demised fetuses were delivered vaginally. 6.9%, 4.8%, 5.1%, 0.6% of the pregnant women were diabetic, chronic hypertensive, gestational hypertensive and eclamptic, respectively.