Introduction:​ The epidemiology of perinatal traumatic fetal injury mortality was explored reviewing existing U.S. fetal and infant mortality data. A traumatic fetal injury is defined as a fetus affected by an in utero traumatic injury insult to itself or the mother dying < 27 days after birth.

Significance:​ There are no known reviews of fetal death registrations portraying information on the full spectrum of traumatic injury mechanisms. The absence of such information has led to the general neglect of the issue.

Methods:​ A retrospective descriptive study used three different techniques to gather information. First, a pilot study manually reviewed Pennsylvania's fetal death certificates from 1995-7 (7,131 certificates). Second, a large sample of state statistics registrars were contacted and all fetal death certificates coded as 760.5 (maternal injury) from 1995-1997 were requested and analyzed. Lastly, the U.S. abbreviated mortality (1979-96) and multiple-cause (MCOD) files (1991 1994) were screened for cases.

Results:​ The pilot study revealed that the ICD-9-CM code 760.5 is a specific indicator and that these death certificates usually contained enough information to code injury mechanisms. The multi-state fetal death cerificate review identified 240 traumatic fetal injury deaths (3.7 per 100,000 live births). Motor vehicle-related incidents made up 82% of cases with known mechanisms. A strong inverse relationship was observed between fetal mortality rate and matemal age. Placental injury was diagnosed in 42% of cases. Among the MOOD data, 149 cases of neonatal death due to maternal injury were discovered (mean = 37 per year, rate = 0.94 per 100,000 live births). The underlying cause of death (UCOD) was listed as matemal injury in 54% of the cases. Adjustments to the estimates from all data sources suggest there are at least 370 cases of perinatal deaths related to fetomaternal motor vehicle crashes per year. CDC reports that an average of 179 infants were killed in motor vehicle traffic-related incidents (1993 to 1995).

Conclusions:​ The major role that motor vehicle-related injuries have on reported traumatic injury deaths was shown as well as estimates for the number of such cases occurring annually in the United States.