Fetal Mortality: United States, 2023

Objectives: This report presents 2023 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined.

Methods: Descriptive tabulations of data are presented and interpreted for all fetal deaths reported for the United States for 2023 with a stated or presumed period of gestation of 20 weeks or more. Cause-of-fetal-death data only are restricted to residents of the 38 states and District of Columbia where cause of death was based on the 2003 fetal death report revision for the full year and less than 50% of deaths were attributed to Fetal death of unspecified cause (P95).

Results: A total of 20,005 fetal deaths at 20 weeks of gestation or more were reported in the United States in 2023. The 2023 U.S. fetal mortality rate was 5.53 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, not significantly different from the rate of 5.48 in 2022. The fetal mortality rate in 2023 for deaths occurring at 20-27 weeks of gestation was 2.89, a 4% increase from 2022 (2.79). For deaths occurring at 28 weeks of gestation or more, the rate in 2023 (2.66) was not significantly different from 2022 (2.71). In 2023, the fetal mortality rate was highest for Native Hawaiian or Other Pacific Islander non-Hispanic (10.18) and Black non-Hispanic (9.95) women and lowest for Asian non-Hispanic women (4.14). Fetal mortality rates were highest for females younger than 15 and age 40 and older, for women who smoked during pregnancy, and for women with multiple gestation pregnancies. Five selected causes accounted for 89.9% of fetal deaths in the 38-state and District of Columbia reporting area.