Academic Journal
Changes in state-level definitions of fetal death and the reporting of fetal death and periviable live births in the United States, 1996-2021: A panel study.
| Τίτλος: | Changes in state-level definitions of fetal death and the reporting of fetal death and periviable live births in the United States, 1996-2021: A panel study. |
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| Συγγραφείς: | Bustos B; Department of Health, Society, and Behavior, Joe C. Wen School of Population and Public Health, University of California, Irvine, CA, USA. Electronic address: vazqueb3@hs.uci.edu., Stolte A; Department of Sociology, University of Virgina, Charlottesville, VA, USA., Gemmill A; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA., Casey JA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA., Sarnak D; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA., Catalano R; School of Public Health, University of California, Berkeley, Berkeley, CA, USA., Bruckner TA; Department of Health, Society, and Behavior, Joe C. Wen School of Population and Public Health, University of California, Irvine, CA, USA; Center for Population, Inequality, and Policy, University of California, Irvine, CA, USA. |
| Πηγή: | Annals of epidemiology [Ann Epidemiol] 2026 Apr; Vol. 116, pp. 110056. Date of Electronic Publication: 2026 Feb 17. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 9100013 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2585 (Electronic) Linking ISSN: 10472797 NLM ISO Abbreviation: Ann Epidemiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier, c1990- |
| Ιατρικοί όροι (MeSH): | Live Birth*/epidemiology , Fetal Mortality*/trends , Fetal Death* , Fetal Viability*, United States/epidemiology ; Infant Mortality/trends ; Humans ; Female ; Pregnancy ; Infant, Newborn ; Gestational Age |
| Περίληψη: | Background: The World Health Organization's 2030 Sustainable Development Goals include reducing the risk of fetal death. Even in high-income countries such as the United States (US), fetal deaths remain under-counted, with reporting showing variable quality across place and time. In the US, a uniform national definition of fetal death does not exist. Scant work characterizes whether, and to what extent, definitional changes in fetal death in US states over time affect fetal death reporting as well as counting of live births among similarly very frail (i.e., periviable [born <26 weeks]) infants. We aimed to (i.) identify state-level changes in fetal death reporting guidelines or definitions for all 50 US states from 1995 to 2020 and (ii.) examine whether counts of fetal deaths, periviable births, and neonatal deaths among periviable births shifted in the years following such changes. Methods: We retrieved data for all 50 US states from 1996 to 2021 for this descriptive analysis (n = 642,551 fetal deaths, n = 420,000 periviable births, n = 195,663 neonatal deaths among periviable births). We reviewed the fetal death user guides for state changes in reporting guidelines and conducted an internet search to find other state changes in the definition of fetal death. Next, we modeled fixed-effects linear regressions to examine associations between changes in fetal death reporting guidelines and our three outcomes. Results: Over the test period, 12 states changed their definition of fetal death. Regression results show increases in the counts of fetal deaths, periviable births, and neonatal deaths among periviable births following changes in reporting guidelines. These increases followed any change in reporting guidelines-whether perceived as a more inclusive or more restrictive change. Results hold across a range of alternative specifications. Conclusions: Our findings cohere with the notion that any state-level change in fetal death definitions corresponds with broader efforts to improve data collection and reporting protocols among not only fetal deaths but also periviable births. The fact that we observe such associations should encourage strategies to control for such "data breaks" for scientists and officials concerned with fetal death and/or periviable birth. (Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors declare no competing interests. |
| Grant Information: | R01 HD103736 United States HD NICHD NIH HHS |
| Contributed Indexing: | Keywords: Fetal death definition; Fetal death reporting; Neonatal death; Periviable births |
| Entry Date(s): | Date Created: 20260219 Date Completed: 20260708 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13242943 |
| DOI: | 10.1016/j.annepidem.2026.110056 |
| PMID: | 41713713 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1873-2585 |
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| DOI: | 10.1016/j.annepidem.2026.110056 |