Health Indicator Report of Infant and Fetal Death
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/nvsr64/nvsr64_08.pdf 2]^
NotesThe 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. Confidence intervals are not available for the pre-2000 rates or the 2016-2017 fetal death rates derived from CDC WONDER.
- 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
Data Interpretation IssuesOnly 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/nvsr64/nvsr64_08.pdf ^1^]
DefinitionAn '''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
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 ServicesThe 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 InformationMaternal 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/]
Page Content Updated On 10/12/2021, Published on 10/12/2021