Document Detail

Impact of fetal death reporting requirements on early neonatal and fetal mortality rates and racial disparities.
MedLine Citation:
PMID:  22942468     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Racial disparities in infant and neonatal mortality vary substantially across the U.S. with some states experiencing wider disparities than others. Many factors are thought to contribute to these disparities, but state differences in fetal death reporting have received little attention. We examined whether such reporting requirements may explain national variation in neonatal and fetal mortality rates and racial disparities.
METHODS: We used data on non-Hispanic white and non-Hispanic black infants from the U.S. 2000-2002 linked birth/infant death and fetal death records to determine the degree to which state fetal death reporting requirements explain national variation in neonatal and fetal mortality rates and racial disparities. States were grouped depending upon whether they based the lower limit for fetal death reporting on birthweight alone, gestational age alone, both birthweight and gestational age, or required reporting of all fetal deaths. Traditional methods and the fetuses-at-risk approach were used to calculate mortality rates, 95% confidence intervals, and relative and absolute racial disparity measures in these four groups.
RESULTS: States with birthweight-alone fetal death thresholds substantially underreported fetal deaths at lower gestations and slightly overreported neonatal deaths at older gestations. This finding was reflected by these states having the highest neonatal mortality rates and disparities, but the lowest fetal mortality rates and disparities.
CONCLUSIONS: Using birthweight alone as a reporting threshold may promote some shift of fetal deaths to newborn deaths, contributing to racial disparities in neonatal mortality. The adoption of a uniform national threshold for reporting fetal deaths could reduce systematic differences in live birth and fetal death reporting.
Crystal P Tyler; Sue C Grady; Violanda Grigorescu; Barbara Luke; David Todem; Nigel Paneth
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Public health reports (Washington, D.C. : 1974)     Volume:  127     ISSN:  1468-2877     ISO Abbreviation:  Public Health Rep     Publication Date:    2012 Sep-Oct
Date Detail:
Created Date:  2012-09-03     Completed Date:  2012-11-13     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  9716844     Medline TA:  Public Health Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  507-15     Citation Subset:  AIM; IM    
Michigan State University, Department of Epidemiology, East Lansing, MI, USA.
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MeSH Terms
African Americans / statistics & numerical data*
Cohort Studies
Data Collection
European Continental Ancestry Group / statistics & numerical data*
Fetal Death / ethnology*
Fetal Mortality / trends*
Health Status Disparities
Infant Mortality / trends*
Infant, Newborn
Mandatory Reporting*
United States / epidemiology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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