Racial and ethnic differences in perinatal mortality: the role of fetal death.

Abstract

We investigate whether variations in infant mortality rates among racial/ethnic groups could be explained by variations in fetal mortality rates where relatively higher infant mortality rates may correspond to lower fetal mortality rates due to possible systematic differences in reporting of fetal death compared to live births. Using US perinatal data from 1995 to 1999, we calculated crude mortality rates, birth weight-specific fetal and hebdomadal mortality rates, risks of perinatal death, and the risk of being classified as a fetal death versus other period death among infants born to Non-Hispanic White, Non-Hispanic Black, and Hispanic mothers. Two-fold disparities between Whites and Blacks persist for all mortality categories. Black low birth-weight deliveries, compared to Whites, have perinatal advantages in both fetal and hebdomadal periods. Hispanics were less likely than Whites to be reported as a fetal versus a hebdomadal death. While these data suggest some underreporting of Black fetal deaths, they provide little evidence that Black-White disparities in infant mortality are a function of variations in classifying a death occurring at delivery as either a fetal death or as a live birth-infant death. These data suggest that the lack of a White-Hispanic disparity in fetal mortality rates may be influenced by underreporting.