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National Vital Statistics System-Fetal Death (NVSS-FD)

Description

Fetal death refers to the spontaneous intrauterine death of a fetus at any time during pregnancy. Fetal deaths later in pregnancy (at 20 or more weeks of gestation, for example) are also sometimes referred to as stillbirths. In the United States, state laws require the reporting of fetal deaths, and federal law mandates the national collection and publication of fetal death data. Most states report fetal deaths of 20 or more weeks of gestation and/or 350 or more grams birthweight.

Supplier

Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)

Data Years Available

1922-present

Periodicity

Annual

Mode

The dataset includes a nearly-complete census of fetal deaths of 20 or more weeks of gestation and/or 350 or more grams birthweight, with additional reporting of fetal deaths of earlier gestations by several States.

Selected Content

A variety of characteristics, including maternal age, marital status, race, Hispanic origin, state of residence; and gestational age at delivery, birth weight, plurality, sex, medical risk factors, method of delivery, obstetric procedures. Content has changed periodically with revisions to the U.S. Standard Report of Fetal Death (1979, 1989, 2003).

Population covered

Reported fetal deaths occurring in the 50 states, the District of Columbia, New York City, Puerto Rico, and Guam to U.S. residents and nonresidents.

Methodology

The National Center for Health Statistics (NCHS) obtains information on fetal deaths from the registration offices of each of the 50 states, New York City, the District of Columbia, and U.S. Territories. By law, registration of fetal deaths is the responsibility of the institution in which the delivery occurs. If delivery occurs outside of an institution, the responsibility lies with the professional attendant at, or immediately after delivery, generally a physician or midwife. The fetal death report is filed with the local or state registrar in the jurisdiction in which the delivery occurred, within a time period prescribed by state law. State fetal death reports are modeled on a U.S. Standard Report of Fetal Death that is revised periodically. States provide NCHS with fetal death data, mostly in electronic format.

Response rate and sample size

Fetal death information is reported by the 50 states, the District of Columbia and the U.S. Territories. The majority of reporting areas report deaths at 20 weeks of gestation or 350 grams. In 2005, approximately 26 thousand fetal deaths of 20 or more weeks were reported.

Interpretation Issues

The 2003 Revision of the US Standard Report of Fetal Death is currently not fully implemented across states leading to a lack of comparability for some key data items (e.g., prenatal care and maternal educational attainment). There is evidence for under-reporting/misclassification of fetal deaths, especially at the lower range of state reporting, most typically about 20-24 weeks.

References

MacDorman M, Kirmeyer S. The challenge of fetal mortality. NCHS data brief, no 16. Hyattsville, MD: National Center for Health Statistics. 2009. Hetzel SM. History and organization of the vital statistics system. PHS 97-1003. Hyattsville, MD: National Center for Health Statistics. 1997. Division of Data Services. Catalog of electronic data products. PHS 94-1213. Hyattsville, MD. 1994.