FETAL DEATH RATE IN THE UNITED-STATES, 1979-1990 - TREND AND RACIAL DISPARITY

Objective: To examine the impact of changes in birth weight distributi on in individual groups and in birth weight-specific fetal death rates on the decline in the crude fetal death rate in the United States. Me thods: 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 (1 0%). In the white population, 73.4% of the total reduction in the crud e fetal death rate was attributable to the improvement in birth weight -specific fetal death rates, and the remaining portion of the reductio n was due to a favorable change in birth weight distribution. In the b lack population, the reduction in the crude fetal death rate was entir ely attributable to the improvement in the birth weight-specific fetal death rates. However, in other groups, a favorable change in the birt h 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 ra tes for blacks and whites is explained almost entirely by differences in birth weight distribution. Conclusion: A further decrease in the cr ude fetal death rate in the U.S. requires a decrease in low birth weig hts, particularly in blacks. Copyright (C) 1997 by The American Colleg e of Obstetricians and Gynecologists.