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Complete Health Indicator Report of Infant and Fetal Death

Definition

An '''infant death''' is the death of a live-born infant within the first year of life. A '''fetal death''' is what is commonly called a stillbirth. The technical definition is "a death prior to the complete expulsion or extraction from its mother of a product of conception; the fetus shows no signs of life such as breathing or beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles."

Numerator

'''Infant Death''': Number of infant deaths (death < 1 year of age) '''Fetal Death''': Number of fetal deaths of 20 or more weeks gestation

Denominator

'''Infant Death''': Number of live births '''Fetal Death''': Number of live births plus fetal deaths of 20 or more weeks gestation

Why Is This Important?

Fetal mortality - the intrauterine death of a fetus at any gestational age - is a major but often overlooked public health issue. Much of the public concern surrounding reproductive loss has focused on infant mortality, due in part to a lesser knowledge of the incidence, etiology, and prevention strategies for fetal mortality.^[https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf 1]^

How Are We Doing?

Prior to 1997, there were more infant deaths in New Jersey each year than there were fetal deaths of 20 or more weeks gestation. While the infant mortality rate (IMR) has been steadily declining, the fetal mortality rate (FMR) has not and appears to have leveled off. FMR is greater than IMR for each major racial/ethnic group in New Jersey and the disparity between Blacks and other races/ethnicities often noted in discussions of IMR, is also seen in FMR. Delivery weight and gestational age are highly correlated and IMR and FMR follow the same pattern of higher rates among lower weights with a steady decline as weight increases. IMR is higher than FMR for weights less than 1,000 grams (approximately 2.2 lbs). Between 1,000 and 2,499 grams, FMR is higher than IMR. Three of the five leading causes of infant death and fetal death are the same: * maternal complications of pregnancy * complications of the placenta, cord, or membranes * congenital anomalies The first two are more likely to result in fetal death than infant death but the death rate due to congenital anomalies is the same for infant and fetal deaths.

How Do We Compare With the U.S.?

New Jersey's FMR is slightly above that of the U.S. as a whole, but our IMR is consistently lower than the U.S. rate and is declining more rapidly.

What Is Being Done?

The [http://www.nj.gov/health/fhs/ Division of Family Health Services] in the New Jersey Department of Health administers several programs aimed at improving children's health, including reducing infant and fetal mortality. Infant and fetal deaths are reviewed by the [http://www.nj.gov/health/fhs/maternalchild/outcomes/mortality-reviews/ Fetal Infant Mortality Review Team] and recommendations to reduce future deaths are made to public and private sources of care including hospitals, clinics, and health care professionals throughout the state. Information on programs that promote availability and use of prenatal care services may be found at: [http://www.nj.gov/health/fhs/maternalchild/outcomes/] or [http://njparentlink.nj.gov/njparentlink/health/before/] The Department of Health has provided state funding to improve perinatal public health services and birth outcomes in communities. Efforts are continuing to increase public and provider awareness of needs for greater access to maternal preconception care, more awareness of risky preconception and post-conception behavior, and for better general maternal health care. New Jersey was a participant in the [https://www.nichq.org/project/collaborative-improvement-and-innovation-network-reduce-infant-mortality-im-coiin Collaborative Improvement and Innovation Network to Reduce Infant Mortality] (CoIIN-IM). CoIIN was a multiyear national movement engaging federal, state, and local leaders; public and private agencies; professionals; and communities to employ quality improvement, innovation, and collaborative learning to reduce infant mortality and improve birth outcomes. In an effort to improve health outcomes among Black infants and mothers in New Jersey, six maternal and child health agencies across the state were awarded $4.3 million in grant funding in July, 2018, as part of the Department of Health's "[https://nj.gov/health/news/2018/approved/20180711a.shtml Healthy Women, Healthy Families]" initiative. In addition to these funds, the Department devoted $450,000 to implement a doula pilot program in municipalities with high Black IMRs. [https://nj.gov/governor/admin/fl/nurturenj.shtml Nurture NJ] is a multifaceted initiative to eliminate racial disparities in birth outcomes. The [http://www.nj.gov/health/fhs/maternalchild/consortia.shtml Maternal and Child Health Consortia] are non-profit partners that engage in various activities that work closely with the Department of Health to promote quality health services in New Jersey.

Available Services

The Division of Family Health Services (FHS) provides support for pregnant women and newborns through several programs, including the [http://www.nj.gov/health/fhs/wic/ Supplemental Nutrition Program for Women, Infants and Children] (WIC). Perinatal Mood Disorders (e.g., postpartum depression) Helpline: 1-800-328-3838 or [http://www.nj.gov/health/fhs/maternalchild/mentalhealth/getting-help/] [http://njparentlink.nj.gov/njparentlink/ NJ Parent Link], an interdepartmental website, is New Jersey's online Early Childhood, Parenting, and Professional Resource Center offering "one-stop shopping" for State services and resources.

Health Program Information

Maternal and Child Health: [http://www.nj.gov/health/fhs/maternalchild/] Special Child Health and Early Intervention Services: [http://www.nj.gov/health/fhs/sch/] WIC: [http://www.nj.gov/health/fhs/wic/]


Related Indicators

Related Health Status Outcomes Indicators:



Data Tables


Infant and Fetal Death Rates by Year, New Jersey, 2000-2021

Perinatal Death TypeYearRate per 1,000Lower LimitUpper LimitNumer- ator
Record Count: 63
Infant Death19908.91,093
Infant Death19918.81,070
Infant Death19928.41,011
Infant Death19938.4995
Infant Death19947.8919
Infant Death19956.7776
Infant Death19966.9792
Infant Death19976.4727
Infant Death19986.4728
Infant Death19996.8770
Infant Death20006.35.86.7723
Infant Death20016.46.06.9745
Infant Death20025.75.26.1651
Infant Death20035.75.26.1662
Infant Death20045.75.26.1648
Infant Death20055.24.85.6590
Infant Death20065.34.85.7604
Infant Death20075.14.75.5590
Infant Death20085.34.85.7591
Infant Death20095.14.75.5559
Infant Death20104.84.45.2513
Infant Death20115.04.65.4528
Infant Death20124.44.04.8454
Infant Death20134.54.15.0464
Infant Death20144.44.04.8455
Infant Death20154.84.35.2487
Infant Death20164.13.74.5421
Infant Death20174.54.14.9452
Infant Death20183.93.54.3392
Infant Death20194.33.94.7427
Infant Death20204.13.74.5400
Fetal Death19907.6945
Fetal Death19917.5913
Fetal Death19926.8826
Fetal Death19936.5766
Fetal Death19946.3750
Fetal Death19956.5755
Fetal Death19966.5753
Fetal Death19976.5742
Fetal Death19986.7764
Fetal Death19997.4848
Fetal Death20006.66.17.0766
Fetal Death20017.06.57.5818
Fetal Death20026.86.37.3786
Fetal Death20036.46.06.9756
Fetal Death20046.46.06.9742
Fetal Death20056.25.76.6703
Fetal Death20066.86.37.3783
Fetal Death20076.96.47.4809
Fetal Death20086.66.17.0743
Fetal Death20097.06.57.5772
Fetal Death20106.76.27.2721
Fetal Death20116.45.96.8675
Fetal Death20126.66.17.1693
Fetal Death20136.76.27.2694
Fetal Death20146.76.27.2696
Fetal Death20156.45.96.8654
Fetal Death20166.8699
Fetal Death20177.2731
Fetal Death20186.96.47.4701
Fetal Death20196.76.27.2673
Fetal Death20206.76.27.2659
Fetal Death20216.25.86.7636

Data Notes

The infant death rate is the number of deaths of live-born infants under 1 year of age per 1,000 live births. The fetal death rate is the number of fetal deaths of 20 or more weeks gestation per 1,000 live births plus fetal deaths of 20 or more weeks gestation. Only fetal deaths from the latter half of pregnancy (20 or more weeks gestation) are required to be reported to the NJDOH. Fetal deaths early in pregnancy can occur before a mother even knows she's pregnant, therefore a full count is impossible and each states' reporting requirements are based on a minimum gestational age and/or minimum weight.[https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf ^2^].   Confidence intervals are not available for the pre-2000 rates or the 2016-2017 fetal death rates derived from CDC WONDER.

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • Fetal Death Certificate Database, Office of Vital Statistics and Registration, New Jersey Department of Health
  • Linked Infant Death-Birth Database, Center for Health Statistics, New Jersey Department of Health


Infant and Fetal Death Rates by Race/Ethnicity, New Jersey, 2020

Perinatal Death TypeRace/EthnicityRate per 1,000Lower LimitUpper LimitNumer- ator
Record Count: 10
Infant DeathWhite2.52.03.0108
Infant DeathBlack9.17.410.7114
Infant DeathHispanic3.62.94.397
Infant DeathAsian2.51.63.526
Infant DeathNew Jersey4.13.74.5400
Fetal DeathWhite5.04.35.6217
Fetal DeathBlack12.910.914.8164
Fetal DeathHispanic6.85.87.8186
Fetal DeathAsian7.05.48.672
Fetal DeathNew Jersey6.76.27.2659

Data Notes

The infant death rate is the number of deaths of live-born infants under 1 year of age per 1,000 live births. The fetal death rate is the number of fetal deaths of 20 or more weeks gestation per 1,000 live births plus fetal deaths of 20 or more weeks gestation. Only fetal deaths from the latter half of pregnancy (20 or more weeks gestation) are required to be reported to the NJDOH. Fetal deaths early in pregnancy can occur before a mother even knows she's pregnant, therefore a full count is impossible and each states' reporting requirements are based on a minimum gestational age and/or minimum weight.[https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf ^2^]

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • Fetal Death Certificate Database, Office of Vital Statistics and Registration, New Jersey Department of Health
  • Linked Infant Death-Birth Database, Center for Health Statistics, New Jersey Department of Health


Infant and Fetal Death Rates by Delivery Weight, New Jersey, 2018-2020

Perinatal Death TypeDelivery WeightRate per 1,000Lower LimitUpper Limit
Record Count: 12
Infant Death< 500 g800.6757.9843.3
Infant Death500-999 g199.6178.8220.4
Infant Death1,000-1,499 g33.125.540.7
Infant Death1,500-2,499 g8.26.99.4
Infant Death2,500-3,999 g1.31.21.5
Infant Death4,000+ g1.10.71.6
Fetal Death< 500 g720.5695.1745.8
Fetal Death500-999 g191.0172.6209.4
Fetal Death1,000-1,499 g70.259.880.7
Fetal Death1,500-2,499 g14.512.816.2
Fetal Death2,500-3,999 g1.31.11.4
Fetal Death4,000+ g**

Data Notes

The infant death rate is the number of deaths of live-born infants under 1 year of age per 1,000 live births. The fetal death rate is the number of fetal deaths of 20 or more weeks gestation per 1,000 live births plus fetal deaths of 20 or more weeks gestation. Only fetal deaths from the latter half of pregnancy (20 or more weeks gestation) are required to be reported to the NJDOH. Fetal deaths early in pregnancy can occur before a mother even knows she's pregnant, therefore a full count is impossible and each states' reporting requirements are based on a minimum gestational age and/or minimum weight.[https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf ^2^]

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • Fetal Death Certificate Database, Office of Vital Statistics and Registration, New Jersey Department of Health
  • Linked Infant Death-Birth Database, Center for Health Statistics, New Jersey Department of Health


Infant and Fetal Death Rates by Leading Causes of Death, New Jersey, 2020

Perinatal Death TypeCause of DeathRate per 1,000Lower LimitUpper Limit
Record Count: 10
Infant DeathCongenital Anomalies0.70.60.9
Infant DeathMaternal Complications of This Pregnancy0.20.20.3
Infant DeathPlacenta, Cord, and Membrane Complications0.10.10.2
Infant DeathShort Gestation/LBW0.50.40.6
Infant DeathSIDS0.40.30.6
Fetal DeathCongenital Anomalies0.60.50.8
Fetal DeathFetal Death of Unspecified Cause2.32.02.6
Fetal DeathMaternal Complications of This Pregnancy0.80.61.0
Fetal DeathMaternal Complications That May Be Unrelated to This Pregnancy0.40.30.6
Fetal DeathPlacenta, Cord, and Membrane Complications1.91.62.2

Data Notes

The infant death rate is the number of deaths of live-born infants under 1 year of age per 1,000 live births. The fetal death rate is the number of fetal deaths of 20 or more weeks gestation per 1,000 live births plus fetal deaths of 20 or more weeks gestation. Only fetal deaths from the latter half of pregnancy (20 or more weeks gestation) are required to be reported to the NJDOH. Fetal deaths early in pregnancy can occur before a mother even knows she's pregnant, therefore a full count is impossible and each states' reporting requirements are based on a minimum gestational age and/or minimum weight.[https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf ^2^].   These are the 5 leading causes of infant death and the 5 leading causes of fetal death. Three causes appear in both Top 5 lists. Infant deaths cannot be due to fetal death of unspecified cause. Fetal deaths cannot be due to SIDS.

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • Fetal Death Certificate Database, Office of Vital Statistics and Registration, New Jersey Department of Health
  • Linked Infant Death-Birth Database, Center for Health Statistics, New Jersey Department of Health

References and Community Resources

1. Gregory ECW, Valenzuela CP, Hoyert DL. [https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf Fetal mortality: United States, 2020]. National Vital Statistics Reports; vol 71 no 4. Hyattsville, MD: National Center for Health Statistics. 2022. 2. Gregory ECW, Valenzuela CP, Hoyert DL. [https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-04.pdf Fetal mortality: United States, 2020]. National Vital Statistics Reports; vol 71 no 4. Hyattsville, MD: National Center for Health Statistics. 2022. Page 18. Hoyert DL, Gregory ECW. [https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-07.pdf Cause-of-death data from the fetal death file, 2018?2020]. National Vital Statistics Reports; vol 71 no 7. Hyattsville, MD: National Center for Health Statistics. 2022. [https://wonder.cdc.gov/fetal.html Fetal Deaths], as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program, on CDC WONDER Online Database.

Page Content Updated On 08/22/2023, Published on 10/18/2023
The information provided above is from the Department of Health's NJSHAD web site (https://nj.gov/health/shad). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 29 March 2024 2:10:24 from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad ".

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