A report released Thursday by the Centers for Disease Control and Prevention examined recent rates of fetal death after at least 20 weeks of gestation, and shows that the fetal mortality rate ticked up by less than 1% – from 5.7 fetal deaths per 1,000 live births in 2019 to 5.74 deaths per 1,000 live births in 2020. The data for 2020 is considered provisional and based on reports processed by federal health officials as of Aug. 25 of last year.
The small increase detected based on those figures was not statistically significant, according to the report. And though the study did not examine the COVID-19 status of fetal death cases, the findings indicate the disease did not have a large impact on fetal mortality despite its potential to fuel poor health outcomes.
The CDC, for example, has warned that pregnant women who contract COVID-19 are at higher risk of stillbirth – considered the loss of a baby at 20 weeks of pregnancy or later – compared with women without COVID-19, and research has shown that this risk increased even more when the delta coronavirus variant was dominant in 2021. A study published last April in JAMA Pediatrics also found that COVID-19 during pregnancy was associated with a higher risk of poor maternal outcomes and neonatal complications.
Such health risks have prompted officials to urge women who are pregnant or plan to become pregnant to get vaccinated against COVID-19. Yet according to CDC tracking data as of Jan. 8, just 42% of pregnant people in a sampling of states had been fully vaccinated either prior to pregnancy, during pregnancy or during both phases.
Notably, a separate study published by the CDC earlier this month found COVID-19 vaccination during pregnancy was not associated with a higher risk of preterm birth.
The new study shows that the provisional fetal mortality rate in 2020 follows a 5% overall decline in that rate over the previous five years, when it fell from 5.98 deaths per 1,000 live births in 2014 to 5.7 per 1,000 in 2019.
From 2019 to 2020, rates remained largely unchanged and varied by an insignificant amount year over year across racial and ethnic groups included in the study. White women saw a change from 4.71 per 1,000 in 2019 to 4.73 per 1,000 in 2020 after experiencing a 4% decline from 2018 to 2019, while the rate of fetal death among Hispanic women rose by about 1%, from 4.79 deaths per 1,000 live births in 2019 to 4.86 per 1,000 in 2020. That rate had declined by 5% from 2018 to 2019.
Black women were the only racial and ethnic group where fetal mortality saw any sort of decrease from 2019 to 2020, with the rate falling by less than 1% from 10.41 deaths per 1,000 live births in 2019 to 10.34 per 1,000 in 2020. By comparison, the fetal death rate among Black women declined by a statistically insignificant amount of about 2% from 2018 to 2019.
Among states, California was the only one to see a significant increase in its fetal mortality rate from 2019 to 2020, experiencing a 7% rise from 4.84 deaths per 1,000 live births to 5.20 deaths. North Carolina and Pennsylvania saw rate decreases of 12% and 14%, respectively.
The fetal mortality rate overall has declined by 75% from 1942 through 2014, with study authors noting many year-to-year fluctuations occurred during that period and the ensuing five years.
“On an annual basis, lack of change and nonsignificant increases and declines in fetal mortality rates are common,” the study says.
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