Fetal Mortality: United States, 2022.

Objectives: This report presents 2022 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 2022 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 43 states and District of Columbia where cause of death was based on the 2003 fetal death report revision and less than 50% of deaths were attributed to Fetal death of unspecified cause (P95).

Results: A total of 20,202 fetal deaths at 20 weeks of gestation or more were reported in the United States in 2022. The 2022 U.S. fetal mortality rate was 5.48 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, 4% lower than in 2021 (5.73) and a new historic low for the United States. The fetal mortality rate in 2022 for deaths occurring at 20-27 weeks of gestation was 2.79, a 5% decline from 2021 (2.95). For deaths occurring at 28 weeks of gestation or more, the rate in 2022 was 2.71, a 3% decline from 2021 (2.80). In 2022, the fetal mortality rate was highest for Native Hawaiian or Other Pacific Islander non-Hispanic (10.36) and Black non-Hispanic (10.05) females and lowest for Asian non-Hispanic females (3.70). Fetal mortality rates were highest for women ages 40 and older, for women who smoked during pregnancy, and for women with multiple gestation pregnancies. Five selected causes accounted for 90.0% of fetal deaths in the 43-state and District of Columbia reporting area.