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Perinatal Mortality in the United States 2022 and 2023

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Document content

Claudia P. Valenzuela, M.P.H., Elizabeth C.W. Gregory, M.P.H., and Joyce A. Martin, M.P.H.

Perinatal mortality can be an indicator of the quality of health care before, during, and after delivery, and of the health status of the nation (1,2). The National Center for Health Statistics (NCHS) recently transitioned to an expanded measure of perinatal mortality, which includes all fetal deaths at 20 completed weeks or more and infant deaths younger than 7 days (3). This report describes changes from 2022 to 2023 in the perinatal mortality rate (expanded measure), overall, by its components, and by mother’s age, race and Hispanic origin, and state.

Key findings

Data from the National Vital Statistics System

  • The U.S. perinatal mortality rate was 8.36 perinatal deaths per 1,000 live births and fetal deaths in 2023, a nonsignificant change from the rate of 8.27 in 2022.
  • The early fetal mortality rate, one of the components of perinatal mortality, increased by 4% from 2.79 in 2022 to 2.89 in 2023; changes in late fetal and early neonatal mortality were not significant.
  • The perinatal mortality rate increased 7% for females younger than 20.
  • The perinatal mortality rate increased for Hispanic women from 2022 to 2023, but changes among the other race and Hispanic-origin groups were not significant.
  • Compared with 2022, perinatal mortality rates in 2023 were similar for 46 states and the District of Columbia.

From 2022 to 2023, the early fetal mortality rate increased, while changes in the perinatal, late fetal, and early neonatal mortality rates were not significant.

Figure 1. Perinatal, early fetal, late fetal, and early neonatal mortality rates: United States, 2022 and 2023

Grouped bar chart showing 2022 and 2023 rates for each of four measures: perinatal, early fetal, late fetal, and early neonatal mortality. The vertical axis shows the rate per 1,000 and ranges from 0 to 10, with gridlines at 2, 4, 6, and 8. The values printed on the bars are reproduced in the following table.

Rates shown in Figure 1, per 1,000
Measure 2022 2023
Perinatal 8.27 8.36
Early fetal 2.79 2.891
Late fetal 2.71 2.66
Early neonatal 2.81 2.84
  • 1. Significantly different from 2022 (p < 0.05).

NOTES: Perinatal mortality rate is the number of infant deaths younger than age 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more. Early fetal mortality rate is the number of fetal deaths at 20–27 completed weeks of gestation per 1,000 live births and fetal deaths at 20–27 completed weeks of gestation. Late fetal mortality rate is the number of fetal deaths at 28 completed weeks of gestation or more per 1,000 live births and fetal deaths at 28 completed weeks of gestation or more. Early neonatal mortality rate is the number of infant deaths younger than age 7 days per 1,000 live births.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • The perinatal mortality rate was 8.36 per 1,000 live births and fetal deaths in 2023, a nonsignificant change from the 2022 rate of 8.27 (Figure 1, Table 1).
  • The early fetal mortality rate increased by 4%, from 2.79 in 2022 to 2.89 in 2023, while changes in the late fetal (2.71 to 2.66) and early neonatal (2.81 to 2.84) mortality rates were not significant.

Changes in perinatal mortality rates were not significant for women age 20 and older from 2022 to 2023.

  • The perinatal mortality rate increased 7% for females younger than 20, from 10.62 per 1,000 live births and fetal deaths in 2022 to 11.39 in 2023. Changes for other maternal age groups were not significant (Figure 2, Table 2).
  • For both years, age-specific perinatal mortality rates decreased with age for females younger than 20 (11.39 in 2023) through 25–29 (7.72) and 30–34 (7.70) and then increased. The rate was highest among women age 40 and older in both years (12.42 in 2023).

Figure 2. Perinatal mortality rate, by age of mother: United States, 2022 and 2023

Grouped bar chart showing 2022 and 2023 perinatal mortality rates for six maternal age groups. The vertical axis shows the rate per 1,000 and ranges from 0 to 14, with gridlines at 2, 4, 6, 8, 10, and 12. The values printed on the bars are reproduced in the following table.

Rates shown in Figure 2, per 1,000
Age of mother 2022 2023
Younger than 20 10.621 11.3912
20–24 8.793 8.643
25–29 7.634 7.724
30–34 7.485 7.705
35–39 8.716 8.636
40 and older 12.331 12.421
  • 1. Significantly different from other age groups (p < 0.05).
  • 2. Significantly different from 2022 (p < 0.05).
  • 3. Significantly different from other age groups except 35–39 (p < 0.05).
  • 4. Significantly different from other age groups except 30–34 (p < 0.05).
  • 5. Significantly different from other age groups except 25–29 (p < 0.05).
  • 6. Significantly different from other age groups except 20–24 (p < 0.05).

NOTE: Perinatal mortality rate is the number of infant deaths younger than age 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more in a specified age group.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

The perinatal mortality rate increased for Hispanic women from 2022 to 2023.

  • The perinatal mortality rate increased 4% for Hispanic women, from 7.26 in 2022 to 7.57 in 2023 (Figure 3, Table 3).
  • No significant changes in perinatal mortality rates were observed for women of the remaining race and Hispanic-origin groups from 2022 to 2023: American Indian and Alaska Native non-Hispanic (subsequently, American Indian and Alaska Native) (10.92 to 10.63), Asian non-Hispanic (subsequently, Asian) (5.71 to 6.03), Black non-Hispanic (subsequently, Black) (15.05 to 15.04), Native Hawaiian or Other Pacific Islander non-Hispanic (subsequently Native Hawaiian or Other Pacific Islander) (13.69 to 14.09), and White non-Hispanic (subsequently, White) (6.70 to 6.76).
  • For both years, the perinatal mortality rate was highest for Black and Native Hawaiian or Other Pacific Islander women, followed by American Indian and Alaska Native, Hispanic, White, and Asian women.

Figure 3. Perinatal mortality rate, by race and Hispanic origin of mother: United States, 2022 and 2023

Grouped bar chart showing 2022 and 2023 perinatal mortality rates for six race and Hispanic-origin groups. The vertical axis shows the rate per 1,000 and ranges from 0 to 16, with gridlines at 4, 8, and 12. On the horizontal axis, the first five groups (American Indian and Alaska Native, Asian, Black, Native Hawaiian or Other Pacific Islander, and White) are labeled collectively as non-Hispanic; the sixth group is Hispanic. The values printed on the bars are reproduced in the following table.

Rates shown in Figure 3, per 1,000
Race and Hispanic origin of mother 2022 2023
American Indian and Alaska Native, non-Hispanic 10.921 10.631
Asian, non-Hispanic 5.711 6.031
Black, non-Hispanic 15.052 15.042
Native Hawaiian or Other Pacific Islander, non-Hispanic 13.693 14.093
White, non-Hispanic 6.701 6.761
Hispanic5 7.261 7.5714
  • 1. Significantly different from other race and Hispanic-origin groups (p < 0.05).
  • 2. Significantly different from other race and Hispanic-origin groups except Native Hawaiian or Other Pacific Islander (p < 0.05).
  • 3. Significantly different from other race and Hispanic-origin groups except Black (p < 0.05).
  • 4. Significantly different from 2022 (p < 0.05).
  • 5. People of Hispanic origin may be of any race.

NOTES: Perinatal mortality rate is the number of infant deaths younger than age 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more in a specified race and Hispanic-origin group.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Perinatal mortality rates were similar for most U.S. jurisdictions in 2023 compared with 2022.

  • Perinatal mortality rates increased by 14% in New Jersey (6.59 to 7.53), 16% in Alabama (9.44 to 10.96), and 18% in Colorado (7.32 to 8.61), decreased 10% in Michigan (9.31 to 8.41), and were essentially unchanged in 46 states and the District of Columbia in 2023 compared with 2022 (Figure 4, Table 4).
  • Perinatal mortality rates for 2023 ranged from a low of 5.34 in New Hampshire to a high of 14.02 in Mississippi.

Figure 4. Perinatal mortality rate, by state for 2023, and change in rate from 2022 to 2023: Each state and the District of Columbia

Map of the 50 states and the District of Columbia. Each jurisdiction is labeled with its 2023 perinatal mortality rate and is shaded into one of three categories of change in rate from 2022 to 2023: significant increase, no significant change, or significant decrease. The map states: U.S. rate was 8.36 per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more. The rate printed for each jurisdiction and its shading category are reproduced in the following table.

Rates printed on the Figure 4 map, per 1,000, and change in rate, 2022 to 2023, shown by map shading
Area 2023 rate Change in rate, 2022 to 2023
Alabama10.96Significant increase
Alaska7.73No significant change
Arizona9.28No significant change
Arkansas11.49No significant change
California7.25No significant change
Colorado8.61Significant increase
Connecticut7.63No significant change
Delaware8.68No significant change
District of Columbia9.81No significant change
Florida9.86No significant change
Georgia10.74No significant change
Hawaii8.86No significant change
Idaho7.77No significant change
Illinois9.14No significant change
Indiana9.38No significant change
Iowa6.82No significant change
Kansas8.03No significant change
Kentucky8.27No significant change
Louisiana8.22No significant change
Maine6.77No significant change
Maryland9.60No significant change
Massachusetts5.58No significant change
Michigan8.41Significant decrease
Minnesota7.50No significant change
Mississippi14.02No significant change
Missouri8.43No significant change
Montana7.01No significant change
Nebraska8.05No significant change
Nevada10.02No significant change
New Hampshire5.34No significant change
New Jersey7.53Significant increase
New Mexico6.27No significant change
New York7.48No significant change
North Carolina9.35No significant change
North Dakota6.50No significant change
Ohio9.83No significant change
Oklahoma9.21No significant change
Oregon7.25No significant change
Pennsylvania7.72No significant change
Rhode Island7.10No significant change
South Carolina8.75No significant change
South Dakota10.54No significant change
Tennessee8.23No significant change
Texas7.19No significant change
Utah9.51No significant change
Vermont5.51No significant change
Virginia8.17No significant change
Washington7.61No significant change
West Virginia6.24No significant change
Wisconsin7.94No significant change
Wyoming7.47No significant change

NOTE: Perinatal mortality rate is the number of fetal deaths at 20 completed weeks of gestation or more and infant deaths younger than 7 days per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Summary

The perinatal mortality rate was stable from 2022 to 2023 at 8.36 per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more. The early fetal mortality rate increased 4%, from 2.79 in 2022 to 2.89 in 2023, while the late fetal and early neonatal mortality rates did not change significantly. The perinatal mortality rate increased 7% in 2023 for females younger than 20; however, changes for the other maternal age groups were not significant. Rates for Hispanic women increased by 4% from 2022 to 2023, while changes among the other race and Hispanic-origin groups were not significant. Perinatal rates increased by 14% to 18% in three states and declined by 10% in one state from 2022 to 2023; rates in the remaining jurisdictions were essentially unchanged. For both years, perinatal mortality rates were highest for Black and Native Hawaiian or Other Pacific Islander women and those age 40 and older.

Definitions

Perinatal death
Infant deaths younger than 7 days and fetal deaths at 20 completed weeks of gestation or more.
Perinatal mortality rate
Number of infant deaths younger than 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more.
Early fetal death
A fetal death at 20–27 completed weeks of gestation.
Early fetal mortality rate
Number of fetal deaths at 20–27 completed weeks of gestation per 1,000 live births and fetal deaths at 20–27 completed weeks of gestation.
Late fetal death
A fetal death at 28 completed weeks of gestation or more.
Late fetal mortality rate
Number of fetal deaths at 28 completed weeks of gestation or more per 1,000 live births and fetal deaths at 28 completed weeks of gestation or more.
Early neonatal death
Death of a live-born infant younger than 7 days.
Early neonatal mortality rate
Number of infant deaths younger than 7 days per 1,000 live births.

Data sources and methods

This report uses data from the Fetal Death Data File and the Linked Birth/Infant Death Data File from the National Vital Statistics System (NVSS). The national vital statistics Fetal Death Data File includes information from all reports of fetal death filed in the 50 states, the District of Columbia, and the U.S. territories. This report includes data from the 50 states and the District of Columbia. Although reporting requirements for fetal deaths vary somewhat by state, fetal mortality rates from NVSS generally represent fetal deaths of 20 completed weeks of gestation or more (1). Fetal death data from NVSS are available by a wide range of maternal and infant characteristics (4). The Linked Birth/Infant Death Data File provides information on infant deaths and live births in the United States (5). Fetal Death and Linked Birth/Infant Death data sets are available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.

Previous NCHS reports used perinatal mortality Definition I, which includes fetal deaths at 28 completed weeks of gestation or more and infant deaths younger than 7 days (6,7). This report uses an expanded measure of perinatal mortality, known as Definition III, which includes all fetal deaths at 20 completed weeks or more and infant deaths younger than 7 days (3). Due to the change in measure, the results in this report should not be compared with previously published reports that use Definition I.

Race and Hispanic origin are reported separately on the report of fetal death. The race and Hispanic-origin groups shown in this report follow the 1997 Office of Management and Budget standards and differ from the bridged-race categories in reports before 2018 (1,8). These groups are: American Indian and Alaska Native, Asian, Black, Native Hawaiian or Other Pacific Islander, White, and Hispanic.

The differences between rates noted in the text are statistically significant at the 0.05 level unless otherwise noted. Some state-specific rates are based on small numbers, which may limit the ability to detect statistically significant differences by year.

About the authors

Claudia P. Valenzuela, Elizabeth C.W. Gregory, and Joyce A. Martin are with the National Center for Health Statistics, Division of Vital Statistics.

References

  1. MacDorman MF, Gregory ECW. Fetal and perinatal mortality: United States, 2013. Natl Vital Stat Rep. 2015 Jul;64(8):1–24.
  2. World Health Organization. Neonatal and perinatal mortality: Country, regional and global estimates. 2006. Available from: https://apps.who.int/iris/handle/10665/43444.
  3. Gregory ECW, Valenzuela CP, Hoyert DL, Martin JA. Change in the primary measure of perinatal mortality for vital statistics. Natl Vital Stat Rep. 2025 Jun;74(5):1–10.
  4. National Center for Health Statistics. Fetal death public-use file (published annually). Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.
  5. National Center for Health Statistics. Linked birth/infant death public-use file (published annually). Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.
  6. Valenzuela CP, Gregory ECW, Martin JA. Decline in perinatal mortality in the United States, 2017–2019. NCHS Data Brief. 2022 Jan;(429):1–8. DOI: https://dx.doi.org/10.15620/cdc:112643.
  7. Valenzuela CP, Gregory ECW, Martin JA. Perinatal mortality in the United States, 2020–2021. NCHS Data Brief. 2023 Dec;(489):1–8. DOI: https://dx.doi.org/10.15620/cdc:134756.
  8. Office of Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Fed Regist 62(210):58782–90. 1997.

Figure tables

Data table for Figure 1. Perinatal, early fetal, late fetal, and early neonatal mortality rates: United States, 2022 and 2023
Specified group Rate per 1,000
2022 2023
Perinatal 8.27 8.36
Early fetal 2.79 2.891
Late fetal 2.71 2.66
Early neonatal 2.81 2.84
  • 1. Significantly different from 2022 (p < 0.05).

NOTES: Perinatal mortality rate is the number of infant deaths younger than age 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more. Early fetal mortality rate is the number of fetal deaths at 20–27 completed weeks of gestation per 1,000 live births and fetal deaths at 20–27 completed weeks of gestation. Late fetal mortality rate is the number of fetal deaths at 28 completed weeks of gestation or more per 1,000 live births and fetal deaths at 28 completed weeks of gestation or more. Early neonatal mortality rate is the number of infant deaths younger than age 7 days per 1,000 live births.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Data table for Figure 2. Perinatal mortality rate, by age of mother: United States, 2022 and 2023
Age Rate per 1,000
2022 2023
Younger than 20 10.621 11.3912
20–24 8.793 8.643
25–29 7.634 7.724
30–34 7.485 7.705
35–39 8.716 8.636
40 and older 12.331 12.421
  • 1. Significantly different from other age groups (p < 0.05).
  • 2. Significantly different from 2022 (p < 0.05).
  • 3. Significantly different from other age groups except 35–39 (p < 0.05).
  • 4. Significantly different from other age groups except 30–34 (p < 0.05).
  • 5. Significantly different from other age groups except 25–29 (p < 0.05).
  • 6. Significantly different from other age groups except 20–24 (p < 0.05).

NOTE: Perinatal mortality rate is the number of infant deaths younger than age 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more in a specified age group.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Data table for Figure 3. Perinatal mortality rate, by race and Hispanic origin of mother: United States, 2022 and 2023
Race and Hispanic origin Rate per 1,000
2022 2023
American Indian and Alaska Native, non-Hispanic 10.921 10.631
Asian, non-Hispanic 5.711 6.031
Black, non-Hispanic 15.052 15.042
Native Hawaiian or Other Pacific Islander, non-Hispanic 13.693 14.093
White, non-Hispanic 6.701 6.761
Hispanic5 7.261 7.5714
  • 1. Significantly different from other race and Hispanic-origin groups (p < 0.05).
  • 2. Significantly different from other race and Hispanic-origin groups except Native Hawaiian or Other Pacific Islander (p < 0.05).
  • 3. Significantly different from other race and Hispanic-origin groups except Black (p < 0.05).
  • 4. Significantly different from 2022 (p < 0.05).
  • 5. People of Hispanic origin may be of any race.

NOTE: Perinatal mortality rate is the number of infant deaths younger than age 7 days and fetal deaths at 20 completed weeks of gestation or more per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more in a specified race and Hispanic-origin group.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

Data table for Figure 4. Perinatal mortality rate, by state for 2022 and 2023, and change in rate from 2022 to 2023: Each state and the District of Columbia
Area Rate per 1,000 Change from 2022 to 2023
2022 2023 Percent
Alabama9.4410.9616
Alaska8.397.73†
Arizona9.569.28†
Arkansas10.8611.49†
California7.307.25†
Colorado7.328.6118
Connecticut6.937.63†
Delaware9.668.68†
District of Columbia10.699.81†
Florida9.809.86†
Georgia10.9310.74†
Hawaii9.538.86†
Idaho7.077.77†
Illinois8.839.14†
Indiana9.039.38†
Iowa6.856.82†
Kansas8.968.03†
Kentucky8.218.27†
Louisiana8.198.22†
Maine8.886.77†
Maryland8.719.60†
Massachusetts5.905.58†
Michigan9.318.41-10
Minnesota7.897.50†
Mississippi13.2614.02†
Missouri8.298.43†
Montana7.127.01†
Nebraska7.448.05†
Nevada8.8810.02†
New Hampshire6.105.34†
New Jersey6.597.5314
New Mexico6.186.27†
New York7.827.48†
North Carolina9.119.35†
North Dakota6.866.50†
Ohio9.369.83†
Oklahoma9.589.21†
Oregon7.417.25†
Pennsylvania8.187.72†
Rhode Island7.367.10†
South Carolina8.238.75†
South Dakota8.3510.54†
Tennessee8.958.23†
Texas6.967.19†
Utah8.419.51†
Vermont5.625.51†
Virginia8.228.17†
Washington7.097.61†
West Virginia7.946.24†
Wisconsin8.237.94†
Wyoming9.377.47†

† Change not significant (p = 0.05).

NOTE: Perinatal mortality rate is the number of fetal deaths at 20 completed weeks of gestation or more and infant deaths younger than 7 days per 1,000 live births and fetal deaths at 20 completed weeks of gestation or more.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.

For more NCHS Data Briefs, visit: https://www.cdc.gov/nchs/products/databriefs.htm.

Keywords: perinatal death • trends • race and ethnicity • maternal age • National Vital Statistics System

Suggested citation

Valenzuela CP, Gregory ECW, Martin JA. Perinatal mortality in the United States, 2022 and 2023. NCHS Data Brief. 2025 Jul;(530):1–10. DOI: https://dx.doi.org/10.15620/cdc/174602.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

National Center for Health Statistics

Brian C. Moyer, Ph.D., Director
Amy M. Branum, Ph.D., Associate Director for Science

Division of Vital Statistics
Paul D. Sutton, Ph.D., Director
Andrés A. Berruti, Ph.D., M.A., Associate Director for Science

For e-mail updates on NCHS publication releases, subscribe online at: https://www.cdc.gov/nchs/updates/.

For questions or general information about NCHS:
Tel: 1–800–CDC–INFO (1–800–232–4636)
TTY: 1–888–232–6348
Internet: https://www.cdc.gov/nchs
Online request form: https://www.cdc.gov/info

ISSN 1941–4927 Print ed.
ISSN 1941–4935 Online ed.

CS361253

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