NCHS Data Brief ■ No. 169 ■ November 2014

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Trends in Fetal and Perinatal Mortality 

in the United States, 2006–2012 

Elizabeth C.W. Gregory, M.P.H.; Marian F. MacDorman, Ph.D.; and Joyce A. Martin, M.P.H. 

Key findings 

Data from the National 

Vital Statistics System 

• Following declines from 

2000 through 2006, total, early, 

and late fetal mortality rates 

were generally flat from 2006 

through 2012. 

• Fetal mortality rates were 

essentially stable for nonHispanic white (4.91 per 1,000 

in 2012), non-Hispanic black 

(10.67), and Hispanic women 

(5.33) during 2006–2012. 

• The overall perinatal 

mortality rate declined 4% from 

6.51 per 1,000 in 2006 to 6.26 

in 2011, with an 8% decline 

for non-Hispanic black women 

(10.80 in 2011). 

• The perinatal mortality rate 

declined in 14 states, rose in 

1 state, and was unchanged in 

35 states and the District of 

Columbia between 2005–2006 

and 2010–2011. 

Changes in outcomes among live births were seen during 2006–2012. For 

example, the percentage of births delivered at 39 weeks of gestation or more 

rose (1) and preterm birth and infant mortality rates declined (1–3). Limited 

recent data, however, have been available on fetal mortality. This information 

is essential for a more complete understanding of pregnancy health in the 

United States. This report focuses on fetal deaths (spontaneous intrauterine 

deaths) at 20 weeks of gestation or more, sometimes referred to as stillbirths, 

using recently released national data. Trends are examined for fetal mortality 

for 2000–2012, focusing on the period 2006–2012, and for perinatal mortality 

by race and Hispanic origin for 2006–2011 (the latest year available) and by 

state for combined years 2005–2006 and 2010–2011. 

Keywords: stillbirth • race and ethnicity 

After declining from 2000–2006, overall, early, and late fetal 

mortality rates were essentially unchanged for 2006–2012. 

Figure 1. Total, early, and late fetal mortality rates: United States, 2000–2012 

NOTES: Total fetal mortality rate is the number of fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal 

deaths. Early fetal mortality rate is the number of fetal deaths at 20–27 weeks per 1,000 live births and fetal deaths at 20–27 

weeks. Late fetal mortality rate is the number of fetal deaths at 28 weeks of gestation or more per 1,000 live births and fetal 

deaths at 28 weeks of gestation or more. 

SOURCE: CDC/NCHS, National Vital Statistics System. Rate 

Total 

Early fetal 

Late fetal 

Year 

2000 2002 2004 2006 2008 2010 2012 

0 

2 

4 

6 

8 
NCHS Data Brief ■ No. 169 ■ November 2014

The U.S. fetal mortality rate declined 8% from 2000 through 2006 (6.61 to 6.05 per 1,000 births 

and fetal deaths). Declines over this period were seen in both the early fetal mortality rate (see 

Definitions), down 6% from 3.31 per 1,000 to 3.10, and in the late fetal mortality rate (see 

Definitions), down 11% from 3.32 to 2.97 (Figure 1). 

From 2006 through 2012, the overall U.S. fetal mortality rate was generally stable, fluctuating 

only slightly over the period; the 2012 rate of 6.05 was the same as that for 2006. 

The 2012 early fetal mortality rate (3.11) was essentially unchanged from 2006 (3.10), as was the 

late fetal mortality rate (2.96 in 2012 and 2.97 in 2006). 

Early neonatal and perinatal mortality rates declined during 2006–2011. 

In comparison with the stabilization in the late fetal mortality rate noted above, the early neonatal 

mortality rate (see Definitions) declined from 3.55 per 1,000 in 2006 to 3.28 in 2011, a drop of 

8% (Figure 2). 

The perinatal mortality rate (see Definitions) also followed a downward trend, though to a lesser 

degree, declining by less than 1% annually (from 6.51 in 2006 to 6.26 in 2011) for a total decline 

of 4%. 

Figure 2. Late fetal, early neonatal, and perinatal mortality rates: United States, 2006–2011 

Perinatal 

Early neonatal 

Late fetal 

Year 

2006 2007 2008 2009 2010 2011 

0 

2 

4 

6 

8 

Rate 

NOTES: Late fetal mortality rate is the number of fetal deaths at 28 weeks of gestation or more per 1,000 live births and fetal deaths at 28 weeks of gestation 

or more. Early neonatal mortality rate is the number of infant deaths under age 7 days per 1,000 live births. Perinatal mortality rate is the number of infant 

deaths under age 7 days and fetal deaths at 28 weeks or more per 1,000 live births and fetal deaths at 28 weeks of gestation or more. 

SOURCE: CDC/NCHS, National Vital Statistics System. 

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NCHS Data Brief ■ No. 169 ■ November 2014

Fetal mortality rates were largely unchanged between 2006 and 2011, but 

some declines in early neonatal and perinatal mortality rates were seen. 

From 2006 through 2012, total fetal mortality rates were essentially unchanged among the three 

largest race and Hispanic origin groups: non-Hispanic white, non-Hispanic black, and Hispanic 

women (Figure 3). 

The early neonatal mortality rate declined among both non-Hispanic white (2.87 to 2.63 per 

1,000) and non-Hispanic black (7.15 to 6.22) women from 2006 through 2011; the difference in 

rates for Hispanic women was not statistically significant (2.98 to 2.92). 

The perinatal mortality rate was down 8% among non-Hispanic black women from 2006 through 

2011, primarily as a result of the decline in early neonatal mortality; the risk of perinatal mortality 

did not change significantly for non-Hispanic white and Hispanic women over this time period. 

Figure 3. Total fetal, late fetal, early neonatal, and perinatal mortality rates, by race and Hispanic origin of mother: 

United States, 2006, 2011, and 2012 

Total fetal 

2006 4.81

2012 4.91

 

2006

 5.29

 

2012

 5.33

 

2006

 10.73 

2012 10.67 

Late fetal 

2006 2.48

 

2011
 
 1

2.59

 

2006

 2.79

 

2011
 
 2.66 Non-Hispanic white 2006 4.65

 

2011
 
 4.61 Hispanic 

Early neonatal2 Non-Hispanic black 

2006 2.87

 

2011
 
 1

2.63

 

2006

 2.98

 

2011
 
 2.92

 

2006

 7.15

 

2011
 
 1

6.22 

Perinatal2 

2006 5.34

 

2011
 
 5.21

 

2006

 5.76

 

2011
 
 5.58

 

2006

 11.76 

2011 1

10.80 

0 2 4 6 8 10 12 14 

Rate 

1

Change is significant at 0.05. 


2

2011 is the most recent year for which neonatal death data are available.
 
 

NOTES: Total fetal mortality rate is the number of fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths. Late fetal mortality rate is the 


number of fetal deaths at 28 weeks of gestation or more per 1,000 live births and fetal deaths at 28 weeks of gestation or more. Early neonatal mortality rate is the 


number of infant deaths under age 7 days per 1,000 live births. Perinatal mortality rate is the number of infant deaths under age 7 days and fetal deaths at 28 


weeks of gestation or more per 1,000 live births and fetal deaths at 28 weeks of gestation or more. 


SOURCE: CDC/NCHS, National Vital Statistics System.

 

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NCHS Data Brief ■ No. 169 ■ November 2014

Perinatal mortality rates decreased in 14 states between 2005–2006 and 

2010–2011. 

Perinatal mortality rates declined by 10% or more between 2005–2006 and 2010–2011 in 

Arizona, Connecticut, Georgia, Idaho, Illinois, Kansas, Louisiana, Missouri, New Hampshire, 

North Carolina, and Tennessee. Declines of less than 10% were seen in California, Maryland, and 

Texas (Figure 4). 

The perinatal mortality rate rose in South Dakota between 2005–2006 and 2010–2011; changes 

for all other states and the District of Columbia were not statistically significant. 

Figure 4. Percent change in perinatal mortality rate, by state: United States, 2005–2006 and 2010–2011 

WA 

OR 

CA 

NV 

ID 

MT 

WY 

UT 

CO 

AZ 

NM 

AK 

TX 

OK 

KS 

NE 

SD 

ND 

MN 

IA 

MO 

AR 

LA 

MS 

TN 

KY 

IN 

WI 

MI 

OH 

NY 

ME 

IL 

AL GA 

FL 

SC 

NC 

VA WV 

PA 

HI 

MD 

DE 

NJ 

CT RI 

MA NH 

VT 

DC 

Less than 10% decline 

10% or more decline 

Increase 

No significant change 

U.S. rate declined 5% 

NOTE: Perinatal mortality rate is the number of infant deaths under age 7 days and fetal deaths at 28 weeks of gestation or more per 1,000 live births and fetal 


deaths at 28 weeks of gestation or more.

 

SOURCE: CDC/NCHS, National Vital Statistics System.

 

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NCHS Data Brief ■ No. 169 ■ November 2014

Large differences in perinatal mortality rates were seen across the 

United States in 2010–2011. 

In 2010–2011, perinatal mortality rates in the United States ranged from a low of 3.65 per 1,000 

in Vermont to a high of 8.91 in Mississippi (Figure 5). 

Several states had rates under 5.0 (Alaska, Iowa, New Hampshire, New Mexico, and Vermont) for 

2010–2011; three states (Alabama, Delaware, and Mississippi) and the District of Columbia had 

rates higher than 8.0. 

Figure 5. Perinatal mortality rate, by state: United States, 2010–2011 

WA 

OR 

CA 

NV 

ID 

MT 

WY 

UT 

CO 

AZ 

NM 

AK 

TX 

OK 

KS 

NE 

SD 

ND 

MN 

IA 

MO 

AR 

LA 

MS 

TN 

KY 

IN 

WI 

MI 

OH 

NY 

ME 

IL 

AL GA 

FL 

SC 

NC 

VA WV 

PA 

HI 

MD 

DE 

NJ 

CT RI 

MA NH 

VT 

DC 

5.00–5.99 

Less than 5.00 

6.00–6.99 

7.00–7.99 

8.00–8.99 U.S. rate is 6.22 per 1,000 

NOTE: Perinatal mortality rate is the number of infant deaths under age 7 days and fetal deaths at 28 weeks of gestation or more per 1,000 live births and fetal 


deaths at 28 weeks of gestation or more.

 

SOURCE: CDC/NCHS, National Vital Statistics System.
 
 

Summary 

Total, early, and late fetal mortality rates were generally flat in the United States from 2006 

through 2012. Over this same period, fetal mortality rates were also essentially unchanged among 

each of the three largest race and Hispanic origin groups: non-Hispanic white, non-Hispanic 

black, and Hispanic women. The perinatal mortality rate declined 4% from 2006 through 2011, 

a result of a decrease in early neonatal mortality. The perinatal mortality rate fell 8% for nonHispanic black women; declines among non-Hispanic white and Hispanic women were not 

statistically significant. 

The continued decline in the perinatal mortality rate is noteworthy. The rate is down 10% since 

2000 (4), and the pace of decline for the most current period, 2006–2011, is consistent with that 

for 2000–2005. The U.S. fetal mortality rate, however, did not improve during 2006–2012. 

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NCHS Data Brief ■ No. 169 ■ November 2014

Definitions 

Fetal death: Death prior to delivery of a product of human conception, irrespective of the duration 

of pregnancy, and which is not an induced termination of pregnancy (5). 

Stillbirth: A fetal death that occurs later in pregnancy (at 20 weeks of gestation or more, or 28 

weeks or more, for example). 

Fetal mortality rate: Number of fetal deaths per 1,000 live births and fetal deaths. Rates based on 

data from the National Vital Statistics System (NVSS) are generally presented for fetal deaths of 

20 weeks of gestation or more. 

Early fetal death: A fetal death that occurs at 20–27 weeks of gestation. 

Early fetal mortality rate: Number of fetal deaths at 20–27 weeks of gestation per 1,000 live births 

and fetal deaths at 20–27 weeks of gestation. 

Late fetal death: A fetal death that occurs at 28 weeks of gestation or more. 

Late fetal mortality rate: Number of fetal deaths at 28 weeks of gestation or more per 1,000 live 

births and fetal deaths at 28 weeks of gestation or more. 

Early neonatal death: Death of a live-born infant under age 7 days. 

Early neonatal mortality rate: Number of infant deaths under age 7 days per 1,000 live births. 

Perinatal death: Infant deaths under age 7 days and fetal deaths at 28 weeks of gestation or more, 

often referred to as perinatal definition I. 

Perinatal mortality rate: Number of infant deaths under age 7 days and fetal deaths at 28 weeks 

of gestation or more per 1,000 live births and fetal deaths at 28 weeks of gestation or more, often 

referred to as perinatal definition I. 

Data sources and methods 

This report contains data from the 2000–2012 Fetal Death Data Files, the 2006–2011 Linked 

Birth/Infant Death Data Sets, and the 2000–2012 Birth Data Files, NVSS. The Fetal Death Data 

Files contain information from all Reports of Fetal Death filed in the 50 states, the District of 

Columbia, and selected U.S. territories. Although reporting requirements for fetal deaths vary 

somewhat by state, fetal mortality rates from NVSS generally represent fetal deaths at 20 weeks 

of gestation or more (2,5). Fetal death data from NVSS are available by a wide range of maternal 

and infant characteristics (5). The Linked Birth/Infant Death Data Sets provide information on 

infant deaths and live births in the United States (3). The Birth Data Files provide information on 

the live births by gestational age and race and Hispanic origin (1). The number of births used to 

calculate rates in this report is from the birth file of the respective year. Fetal Death, Linked 

Birth/Infant Death, and Birth data sets are available from: http://www.cdc.gov/nchs/about/major/ 

dvs/Vitalstatsonline.htm. 

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NCHS Data Brief ■ No. 169 ■ November 2014

About the authors 

Elizabeth C.W. Gregory, Marian F. MacDorman, and Joyce A. Martin are with CDC’s National 

Center for Health Statistics, Division of Vital Statistics. 

References 

1. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2012. National vital 

statistics reports; vol 62 no 9. Hyattsville, MD: National Center for Health Statistics. 2013. 

Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf. 

2. National Center for Health Statistics. Mortality multiple cause micro-data files. Available 

from: http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm. 

3. Mathews TJ, MacDorman MF. Infant mortality statistics from the 2010 period linked 

birth/infant death data set. National vital statistics reports; vol 62 no 8. Hyattsville, MD: National 

Center for Health Statistics. 2013. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr62/ 

nvsr62_08.pdf. 

4. MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 

2006. National vital statistics reports; vol 60 no 8. Hyattsville, MD: National Center for Health 

Statistics. 2012. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_08.pdf. 

5. National Center for Health Statistics. Fetal death public-use data files (published annually). 

Available from: http://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm. 

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Suggested citation 

Gregory ECW, MacDorman MF, Martin JA. 

Trends in fetal and perinatal mortality in the 

United States, 2006–2012. NCHS data brief, 

no 169. Hyattsville, MD: National Center 

for Health Statistics. 2014. 

Copyright information 

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated. 

National Center for Health 

Statistics 

Charles J. Rothwell, M.S., M.B.A., Director 

Jennifer H. Madans, Ph.D., Associate 

Director for Science 

Division of Vital Statistics 

Delton Atkinson, M.P.H., M.P.H., P.M.P., 

Director