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Perinatal mortality

Nikolaos Zacharias, MD, FACOG
Section Editor
Leonard E Weisman, MD
Deputy Editor
Melanie S Kim, MD


Mortality rates in the perinatal period are used to evaluate the outcome of pregnancy and monitor the quality of perinatal (prenatal and neonatal) care. The perinatal mortality rate encompasses late fetal and early neonatal mortality.


The use of standard terminology facilitates comparisons of mortality rates among states and countries. A 2016 clinical report from the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn established standard terminology for fetal, infant, and perinatal deaths, based on standards set by the World Health Organization (WHO) and the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC) [1]. The following definitions are recommended and used in this review. Standard definitions for reporting reproductive health statistics are published by the NCHS [2].

Live birth — Live birth is defined as complete expulsion or extraction from the mother of a product of human conception, irrespective of the duration of pregnancy, which shows any evidence of life (ie, heartbeats, umbilical cord pulsations, breathing, or voluntary muscle movement), regardless of whether the umbilical cord has been cut or the placenta is attached. Heartbeats should be distinguished from transient cardiac contractions and breathing distinguished from fleeting respiratory efforts or gasps.

Fetal death (stillbirth) — A fetus is defined from weeks after conception until term while in the uterus. Death of the fetus occurs prior to complete expulsion or extraction from the mother, irrespective of the duration of the pregnancy, which is not an induced pregnancy termination. Fetal death is indicated by no signs of life after delivery (eg, heartbeats, umbilical cord pulsations, breathing, or voluntary muscle movement, as noted above). Heartbeats should be distinguished from transient cardiac contractions, and breathing from fleeting respiratory efforts or gasps. (See "Fetal death and stillbirth: Incidence, etiology, and prevention".)

The NCHS reports fetal deaths that occur ≥20 weeks gestation, which are also referred to as "stillbirth." For statistical purposes, the NCHS further subdivides fetal death as "early" (20 to 27 weeks gestation) or "late" (≥28 weeks gestation). The WHO defines stillbirth as at or after 28 weeks gestation. Pregnancies resulting in fetal demise before 20 weeks are categorized as miscarriages.

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Literature review current through: Nov 2017. | This topic last updated: Jun 15, 2017.
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