# Perinatal mortality

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Not to be confused with [embryo loss](/source/Embryo_loss), [abortion](/source/Abortion), [infant mortality](/source/Infant_mortality), or [maternal mortality](/source/Maternal_mortality).

Medical condition

Perinatal mortality Other names Perinatal death Infant, neonatal, and postneonatal mortality rates: United States, 1940–2005 Specialty Public health

**Perinatal mortality** (**PNM**) is the death of a [fetus](/source/Fetus) or [neonate](/source/Neonate) and is the basis for calculation of the perinatal [mortality rate](/source/Mortality_rate).[1] *Perinatal* means "relating to the period starting a few weeks before birth and including the birth and a few weeks after birth."[2]

Variations in the precise definition of the perinatal mortality exist, specifically concerning the issue of inclusion or exclusion of early fetal and late neonatal fatalities. The [World Health Organization](/source/WHO) defines perinatal mortality as the "number of stillbirths and deaths in the first week of life per 1,000 total births, the perinatal period commences at 22 completed weeks (154 days) of gestation,[3] and ends seven completed days after birth",[4] but other definitions have been used.[5]

The UK figure is about 8 per 1,000 and varies markedly by social class, with the highest rates seen in Asian women. Globally, an estimated 2.6 million neonates died in 2013 before the first month of age, down from 4.5 million in 1990.[6]

## Causes

Further information: [Preterm birth § Specific risks for the preterm neonate](/source/Preterm_birth#Specific_risks_for_the_preterm_neonate)

[Preterm birth](/source/Preterm_birth) is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths.[7] [Infant respiratory distress syndrome](/source/Infant_respiratory_distress_syndrome), in turn, is the leading cause of death in preterm infants, affecting about 1% of newborn infants.[8] [Birth defects](/source/Birth_defect) cause about 21 percent of neonatal death.[7]

Some major **causes of perinatal mortality** rate are:[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

- Maternal diseases

- Pelvic diseases: [endometriosis](/source/Endometriosis), ovarian tumor

- Anatomical defects: Uterine, cervical anomalies

- Endocrine imbalance

- Blood incompatibilities

- Malnutrition

- Toxemias of pregnancy

- APH

- Congenital defects

- [Advanced maternal age](/source/Advanced_maternal_age)

## Fetal mortality

Fetal mortality refers to [stillbirths](/source/Stillbirth) or fetal death.[9] It encompasses any death of a fetus after 20 weeks of gestation or 500 gm. In some definitions of the PNM, early fetal mortality (week 20–27 gestation) is not included, and the PNM may only include late fetal death and neonatal death. Fetal death can also be divided into death before [labor](/source/Childbirth), antenatal (antepartum) death, and death during labor, intranatal (intrapartum) death.

## Neonatal mortality

Neonatal mortality refers to the death of a live-born baby within the first 28 days of life. Early neonatal mortality refers to the death of a live-born [baby](/source/Baby) within the first seven days of life, while late neonatal mortality refers to death after 7 days until before 28 days. Some definitions of the PNM include only the early neonatal mortality. Neonatal mortality is affected by the quality of in-hospital care for the [neonate](/source/Neonate). Neonatal mortality and postneonatal mortality (covering the remaining 11 months of the first year of life) are reflected in the [infant mortality rate](/source/Infant_mortality).

## Perinatal mortality rate

Top ten countries with the highest perinatal mortality rates – 2012[10][11][12] Rank Country PNMR Rank Country PNMR 1 Pakistan 40.7 6 Afghanistan 29.0 2 Nigeria 32.7 7 Bangladesh 28.9 3 Sierra Leone 30.8 8 Democratic Republic of the Congo 28.3 4 Somalia 29.7 9 Lesotho 27.5 5 Guinea-Bissau 29.4 10 Angola 27.4 As per 2014 "Save the Children" report for intrapartum stillbirths and neonatal deaths on first day of birth (per 1,000 total births)

The PNMR refers to the number of perinatal deaths per 1,000 total births. It is usually reported annually.[13] It is a major marker to assess the quality of health care delivery. Varying definitions, registration bias, and differences in the underlying risks of the populations may hamper comparisons between different rates.

PNMRs vary widely and may be below 10 for certain developed countries and more than 10 times higher in developing countries.[14] The WHO has not published contemporary data.

## Effects of neonatal nutrition on neonatal mortality

Probiotic supplementation of preterm and low birthweight babies during their first month of life can reduce the risk of blood infections, bowel sickness, and death in low- and middle-income settings. However, supplementing with Vitamin A does not reduce the risk of death and increases the risk of *bulging fontanelle,* which may cause brain damage.[15]

## See also

- [Maternal death](/source/Maternal_death)

- [Miscarriage](/source/Miscarriage)

- [Neonatal intensive care unit](/source/Neonatal_intensive_care_unit)

- [Neonaticide](/source/Neonaticide)

- [Stillbirth](/source/Stillbirth)

## References

1. **[^](#cite_ref-1)** ["Perinatal mortality rate (PMR) — MEASURE Evaluation"](https://web.archive.org/web/20160914045625/http://www.cpc.unc.edu/measure/prh/rh_indicators/specific/nb/perinatal-mortality-rate-pmr). *www.cpc.unc.edu*. 9 September 2020. Archived from [the original](http://www.cpc.unc.edu/measure/prh/rh_indicators/specific/nb/perinatal-mortality-rate-pmr) on 14 September 2016. Retrieved 2 August 2016.

1. **[^](#cite_ref-2)** *Concise medical dictionary*. Jonathan Law, E. A. Martin (10th ed.). Oxford. 2020. [ISBN](/source/ISBN_(identifier)) [978-0-19-187376-8](https://en.wikipedia.org/wiki/Special:BookSources/978-0-19-187376-8). [OCLC](/source/OCLC_(identifier)) [1142355883](https://search.worldcat.org/oclc/1142355883).{{[cite book](https://en.wikipedia.org/wiki/Template:Cite_book)}}: CS1 maint: location missing publisher ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_location_missing_publisher)) CS1 maint: others ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_others))

1. **[^](#cite_ref-3)** ["UpToDate"](https://www.uptodate.com/contents/perinatal-mortality/print).

1. **[^](#cite_ref-4)** ["WHO – Maternal and perinatal health"](https://web.archive.org/web/20131203064838/http://www.who.int/maternal_child_adolescent/topics/maternal/maternal_perinatal/en/). *www.who.int*. Archived from [the original](https://www.who.int/maternal_child_adolescent/topics/maternal/maternal_perinatal/en/) on December 3, 2013.

1. **[^](#cite_ref-pmid9431331_5-0)** Richardus JH, Graafmans WC, Verloove-Vanhorick SP, Mackenbach JP (January 1998). "The perinatal mortality rate as an indicator of quality of care in international comparisons". *[Medical Care](/source/Medical_Care_(journal))*. **36** (1): 54–66. [doi](/source/Doi_(identifier)):[10.1097/00005650-199801000-00007](https://doi.org/10.1097%2F00005650-199801000-00007). [PMID](/source/PMID_(identifier)) [9431331](https://pubmed.ncbi.nlm.nih.gov/9431331).

1. **[^](#cite_ref-GBD204_6-0)** ["Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340604). *Lancet*. **385** (9963): 117–71. 17 December 2014. [doi](/source/Doi_(identifier)):[10.1016/S0140-6736(14)61682-2](https://doi.org/10.1016%2FS0140-6736%2814%2961682-2). [PMC](/source/PMC_(identifier)) [4340604](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340604). [PMID](/source/PMID_(identifier)) [25530442](https://pubmed.ncbi.nlm.nih.gov/25530442).

1. ^ [***a***](#cite_ref-marchofdimes_7-0) [***b***](#cite_ref-marchofdimes_7-1) [March of Dimes / Neonatal Death](http://www.marchofdimes.org/loss/neonatal-death.aspx) [Archived](https://web.archive.org/web/20141024114718/http://www.marchofdimes.org/loss/neonatal-death.aspx) 2014-10-24 at the [Wayback Machine](/source/Wayback_Machine) Retrieved on November 10, 2014

1. **[^](#cite_ref-8)** Rodriguez RJ, Martin RJ, and Fanaroff, AA. *Respiratory distress syndrome and its management.* Fanaroff and Martin (eds.) Neonatal-perinatal medicine: Diseases of the fetus and infant; 7th ed. (2002):1001–1011. St. Louis: Mosby.

1. **[^](#cite_ref-9)** ["NVSS – Fetal Deaths"](https://www.cdc.gov/nchs/nvss/fetal_death.htm). *www.cdc.gov*. 8 November 2017.

1. **[^](#cite_ref-10)** ["Ending Newborn Deaths"](https://web.archive.org/web/20210630213818/https://www.savethechildren.net/sites/default/files/libraries/ENDING-NEWBORN-DEATHS.pdf) (PDF). Archived from [the original](https://www.savethechildren.net/sites/default/files/libraries/ENDING-NEWBORN-DEATHS.pdf) (PDF) on 2021-06-30. Retrieved 2020-04-06.

1. **[^](#cite_ref-11)** ["Million babies die a year – charity – IOL"](http://www.iol.co.za/lifestyle/family/birth/million-babies-die-a-year-charity-1.1653041#.Uw791uNUCKU).

1. **[^](#cite_ref-12)** ["Nigeria, Pakistan, India lead the world in infant deaths – PM NEWS Nigeria"](http://www.pmnewsnigeria.com/2014/02/25/nigeria-pakistan-india-lead-the-world-in-infant-deaths/). *[P.M. News](/source/P.M._News)*. Lagos, Nigeria. 25 February 2014.

1. **[^](#cite_ref-13)** ["Miscarriage Risk by Week and What Affects Your Risks of Miscarriage"](https://web.archive.org/web/20200615022940/https://www.checkpregnancy.com/miscarriage-statistics/). 23 August 2015. Archived from [the original](http://www.checkpregnancy.com/miscarriage-statistics/) on 15 June 2020. Retrieved 2 August 2016.

1. **[^](#cite_ref-14)** ["Centre for International Health"](https://web.archive.org/web/20010522010328/http://www.cih.uib.no/journals/EJHD/ejhdv14-n3/ejhd-14-3-page-335.htm). Archived from [the original](http://www.cih.uib.no/journals/EJHD/ejhdv14-n3/ejhd-14-3-page-335.htm) on May 22, 2001.

1. **[^](#cite_ref-15)** Imdad, Aamer; Rehman, Faseeha; Davis, Evans; Ranjit, Deepika; Surin, Gamael S. S.; Attia, Suzanna L.; Lawler, Sarah; Smith, Abigail A.; Bhutta, Zulfiqar A. (2021). ["Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356300). *Campbell Systematic Reviews*. **17** (1) e1141. [doi](/source/Doi_(identifier)):[10.1002/cl2.1141](https://doi.org/10.1002%2Fcl2.1141). [ISSN](/source/ISSN_(identifier)) [1891-1803](https://search.worldcat.org/issn/1891-1803). [PMC](/source/PMC_(identifier)) [8356300](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356300). [PMID](/source/PMID_(identifier)) [37133295](https://pubmed.ncbi.nlm.nih.gov/37133295). [S2CID](/source/S2CID_(identifier)) [240864559](https://api.semanticscholar.org/CorpusID:240864559).

## External links

Classification D MeSH: D066087 DiseasesDB: 24405

- [WHO 2005 report](https://www.who.int/whr/2005/media_centre/facts_en.pdf)

- [European Perinatal Health Report 2010](http://www.europeristat.com/images/doc/Peristat%202013%20V2.pdf) [Archived](https://web.archive.org/web/20220119073110/https://europeristat.com/images/doc/Peristat%202013%20V2.pdf) 2022-01-19 at the [Wayback Machine](/source/Wayback_Machine)

v t e Women's health Reproductive health Reproductive tract External female genitalia (vulva) Clitoris Clitoral hood Labia minora Labia majora Vagina Cervix Uterus Fallopian tube Ovary Reproductive system disease Maternal health Pregnancy Unintended pregnancy Gravidity and parity Obstetrics Antenatal care Adolescent pregnancy Complications of pregnancy Hyperemesis gravidarum Ectopic pregnancy Miscarriage Obstetrical bleeding Gestational diabetes Hypertension Preeclampsia Eclampsia Childbirth Midwifery Preterm birth Multiple births Oxytocin Obstructed labor Cesarian section Retained placenta Obstetrical fistulae Vesicovaginal fistula Rectovaginal fistula Episiotomy Husband stitch Postpartum care Postpartum confinement Maternal deaths Perinatal mortality Stillbirths Abortion Mother-to-child transmission Sterilization Compulsory sterilization Breastfeeding and mental health Reproductive life plan Infertility Childlessness Assisted reproductive technology In vitro fertilization Parenting Adoption Fostering Contraception and family planning Intrauterine devices Oral contraceptives Condoms Male contraceptive Contraceptive prevalence Contraceptive security Planned Parenthood Fertility awareness Menstruation Culture and menstruation Feminine hygiene Menarche Menstrual cycle Menstrual aids Cloth menstrual pad Menstrual cup Tampon Sanitary pad Dysmenorrhea Menorrhagia Amenorrhoea Menopause Hormone replacement therapy Sexual health Sexually transmitted infections Safe sex HIV Human papilloma virus HPV vaccine Pelvic inflammatory disease Female genital mutilation Clitoridectomy Infibulation Breast binding Breast health Breast ironing Child marriage Dyspareunia Forced marriage Gynaecological disorders Vaginitis Leblouh Polygamy Sexual intercourse Orgasm Puberty Sex differences Sex education Non-reproductive health Violence against women Abuse during childbirth Domestic violence Pregnancy Intimate partner violence Misogyny Sexual harassment Sexual assault Rape Femicide Gender discrimination Non-communicable diseases Cancer Lung cancer Breast cancer Uterine cancer Endometrial cancer Cervical cancer Papanicolaou test Ovarian cancer Cardiovascular disease Dementia Alzheimer's disease Bone health Osteoporosis Hip fracture Anaemia Mental health Anxiety Depression Major depressive disorder Urinary tract Urethra Urinary tract infection Urinary incontinence Sociocultural factors Poverty Disadvantaged Gender equality Healthcare inequality Gender disparities in health Social determinants of health Reproductive justice Women's empowerment Politics, research and advocacy United Nations The Convention on the Elimination of All Forms of Discrimination against Women Declaration on the elimination of violence against women International Day of the Girl Child Commission on the Status of Women UN Women United States Office of Research on Women's Health Women's Health Initiative International Center for Research on Women Nurses' Health Study Black Women's Health Study Cartwright Inquiry Society for Women's Health Research Women's health by country China Ethiopia India Family planning Russia Birth control in the United States Category Commons WikiProject

v t e Death In medicine Cell death Abortion Necrosis Avascular necrosis Coagulative necrosis Liquefactive necrosis Gangrenous necrosis Caseous necrosis Fat necrosis Fibrinoid necrosis Temporal lobe necrosis Programmed cell death AICD Anoikis Apoptosis Autophagy Intrinsic apoptosis Necroptosis Paraptosis Parthanatos Phenoptosis Pseudoapoptosis Pyroptosis Autolysis Autoschizis Eschar Immunogenic cell death Ischemic cell death Pyknosis Karyorrhexis Karyolysis Mitotic catastrophe Suicide gene Accidental death Autopsy Brain death Brainstem death Clinical death DOA Death by natural causes Death rattle Dysthanasia End-of-life care Euthanasia Animal euthanasia Euthanasia for mental illness Involuntary euthanasia Voluntary euthanasia Lazarus sign Lazarus syndrome Medical declaration of death Organ donation Terminal illness Unnatural death Lists Causes of death by rate Notable deaths by year Expressions related to death Natural disasters People by cause of death Premature obituaries Preventable causes of death Unusual deaths List of ways people dishonor the dead List of ways people honor the dead Mortality Birthday effect Child mortality Adult mortality Excess mortality Gompertz–Makeham law of mortality Infant mortality Karoshi Maternal death Maternal mortality in fiction Memento mori Micromort Mortality rate RAMR Mortality salience Perinatal mortality After death Body Stages Pallor mortis Livor mortis Algor mortis Rigor mortis Putrefaction Decomposition Skeletonization Fossilization Preservation Cryopreservation Cryonics Neuropreservation Embalming Maceration Mummification Plastination Prosection Taxidermy Disposal Burial Natural burial Sky burial Ocean burial Cremation Dismemberment Excarnation Promession Resomation Beating heart cadaver Body donation Cadaveric spasm Coffin birth Death erection Dissection Gibbeting Postmortem caloricity Post-mortem interval Other aspects Carrion Cemetery Consciousness after death Afterlife Tukdam Customs Crematorium Desecration of graves Eternal oblivion Examination Funeral Grief Internet Midwife Mourning Online mourning Obituary Reincarnation Palingenesis Saṃsāra Resurrection Underworld Viewing Vigil Wake Paranormal Ghosts Near-death experience Near-death studies Necromancy Out-of-body experience Reincarnation research Séance Legal Abortion law Administration Capital punishment Cause of death Civil death Coroner Death-qualified jury Death certificate Declared death in absentia Death row Dying declaration Inquest Legal death Murder Necropolitics Prohibition of dying Right to die Suspicious death Trust law Will Fields Death tech Forensic pathology Funeral director Mortuary science Necrobiology Post-mortem chemistry Post-mortem photography Taphonomy Biostratinomy Thanatology Other Apparent death Chinese burial money Coins for the dead Coup de grâce Dark tourism Darwin Awards Death and culture Death anniversary Death anxiety Death deity Personification of death Dying-and-rising god Psychopomp Death camp Death drive Death education Death from laughter Death hoax Death knell Death march Death messenger Death notification Death panel Death poem Death pose Death-positive movement Death squad Death threat Death trajectory Dignified death Extinction Festival of the Dead Fascination with death Hierarchy of death Homicide Immortality Last rites Longevity Martyr Museum of Death Necronym Necrophilia Necrophobia Philosophy of death Predation Sacrifice human Suicide Assisted suicide Thanatosensitivity Category Outline

v t e Conditions originating in the perinatal period / fetal disease Maternal factors complicating pregnancy, labour or delivery placenta Placenta praevia Placental insufficiency Twin-to-twin transfusion syndrome chorion/amnion Chorioamnionitis umbilical cord Umbilical cord prolapse Nuchal cord Single umbilical artery presentation Breech birth Asynclitism Shoulder presentation Growth Small for gestational age / Large for gestational age Preterm birth / Postterm pregnancy Intrauterine growth restriction Birth trauma scalp Cephalohematoma Chignon Caput succedaneum Subgaleal hemorrhage Brachial plexus injury Erb's palsy Klumpke paralysis Affected systems Respiratory Intrauterine hypoxia Infant respiratory distress syndrome Transient tachypnea of the newborn Meconium aspiration syndrome Pleural disease Pneumothorax Pneumomediastinum Wilson–Mikity syndrome Bronchopulmonary dysplasia Cardiovascular Pneumopericardium Persistent fetal circulation Bleeding and hematologic disease Vitamin K deficiency bleeding HDN ABO Anti-Kell Rh c Rh D Rh E Hydrops fetalis Hyperbilirubinemia Bilirubin encephalopathy Neonatal jaundice Velamentous cord insertion Intraventricular hemorrhage Germinal matrix hemorrhage Anemia of prematurity Gastrointestinal Ileus Necrotizing enterocolitis Meconium peritonitis Integument and thermoregulation Erythema toxicum Sclerema neonatorum Nervous system Perinatal asphyxia Periventricular leukomalacia Musculoskeletal Gray baby syndrome muscle tone Congenital hypertonia Congenital hypotonia Infections Vertically transmitted infection Neonatal infection rubella herpes simplex mycoplasma hominis ureaplasma urealyticum Omphalitis Neonatal sepsis Group B streptococcal infection Neonatal conjunctivitis Other Miscarriage Perinatal mortality Stillbirth Infant mortality Neonatal withdrawal Fetal Alcohol Spectrum Disorder

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Adapted from the Wikipedia article [Perinatal mortality](https://en.wikipedia.org/wiki/Perinatal_mortality) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Perinatal_mortality?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.