Temporal trend in fetal mortality according to two death avoidability classifications.
Rebeca Danielly Barros Xavier, Mirella Bezerra Rodrigues Vilela, Cristine Vieira do Bonfim and 3 others
PMID 39331785WHAT IT FOUND
Fetal mortality in Recife stayed flat from 2010 to 2021.
Most deaths were classified as avoidable, mainly by care during pregnancy. The list used changed how many deaths were counted as avoidable.
Key findings
01Fetal mortality in Recife was 8.6 per 1,000 total births in 2010 and 9.3 in 2021, with a stationary trend.
02Most fetal deaths were classified as avoidable: 1,814 (72.9%) by LBE-OF and 2,091 (84.0%) by LBE < 5, with adequate care during pregnancy the largest subgroup.
03According to LBE-OF, avoidable fetal mortality had an annual percent change of 2.1 and ill-defined fetal mortality had an annual percent change of -12.3; according to LBE < 5, avoidable fetal mortality was stationary.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used secondary records, which may contain incomplete entries or gaps in coverage. Forty of 2,490 fetal deaths had missing gestational age and birth weight and were excluded from early and late trend analysis. The analysis units were years for the whole city, not individual patients, so it describes population trends rather than individual care experiences. The two avoidability lists classified different proportions of deaths, so trends depend on the list used. The study describes trends and classifications; it does not test specific care interventions.
Declared interests
The paper reports funding from Fundação de Amparo à Ciência e Tecnologia de Pernambuco (APQ-0389-4.06/20) through the SUS Research Program (PPSUS/PE-2020). No competing interests are listed in the supplied text.
The easy way to misread this
Do not read the stable total fetal mortality rate as proof that maternity care is adequate. Most deaths were classified as avoidable, mainly by care during pregnancy, and the study did not test specific interventions.