Fetal Death, Measures of

The World Health Organization defines a fetal death as the death of a production of conception prior to complete expulsion or extraction from its mother, regardless of length of pregnancy. Factors that indicate a fetal death after separation from the mother include no breathing or evidence of life by the fetus, pulsation of umbilical cord, or voluntary muscle movement. The distinction between fetal and infant deaths is based on the place of death; a fetal death occurs in utero.

Fetal death can be measured in terms of time of death: death prior to labor, antepartum mortality, and death during labor. According to the National Center for Health Statistics, measures are operationalized in terms of gestational age: A death at or after 20 weeks is considered a fetal death. An early fetal death is at 20 to 27 weeks, while a late fetal death is at or greater than 28 weeks.

In the United States, fetal death reporting requirements vary by state. The 1992 Revision of Model State Vital Statistics Act and Regulations recommends that each fetal death of weight 350 g or more or, for unknown weight, 20 weeks of gestation or greater should be reported. However, the standards are not consistent. Thirteen areas (including states, cities, and territories) specify the requirements for fetal death as stated in the above act. Eleven areas report any expulsion or extraction of the product of human conception as a fetal death, while others base the requirements only on gestational age or use a different combination of gestational age and weight.