RACIAL VARIATION IN SPONTANEOUS FETAL DEATHS AT 20 WEEKS OR OLDER IN UPSTATE NEW-YORK, 1980-86

THE DISTRIBUTION OF spontaneous fetal deaths (at age 20 weeks or more) by maternal race has received considerably less study than other adve rse pregnancy outcomes. The purpose of this study was twofold-(a) to d escribe spontaneous fetal deaths among white, black, and American Indi an women and (b) to determine if there was any variation by Internatio nal Classification of Diseases, Ninth Revision (ICD-9) cause of death, gestational age at death, or maternal age at loss among these groups of mothers. Using the fetal death certificate registry maintained by t he New York State Department of Health, 8,592 spontaneous fetal deaths at age 20 weeks or more were identified among upstate (exclusive of N ew York City) mothers between 1980 and 1986. By race it was 7,300 for white women, 1,257 for black women, and 27 for American Indian women. Spontaneous fetal death rates varied by maternal race as listed on vit al records-black, 13.5 per 1,000 total births, white, 8.3, and America n Indian, 8.1. The three leading causes of death (ICD-9 779, 762, and 761) did not vary by maternal race. Gestational age at death, imputed from last menstrual period, did vary by maternal race. Fetal deaths to white and black mothers were observed to occur most often between 24 weeks of pregnancy (39 percent) and 32 weeks (43 percent), while Ameri can Indian fetal deaths generally occurred later (more than 33 weeks) in pregnancy (41 percent). Most spontaneous fetal deaths occurred to m others ages 20-29 regardless of race. Black teenage mothers, however, experienced the largest proportion of losses (23 percent) compared wit h white (10 percent) and American Indian (11 percent) teenage mothers.