Recalculation of the late fetal death rate in Mexico, 2013-2023 using ICD-11 criteria applied to national vital statistics.

BACKGROUND

Cross-national comparability of fetal mortality indicators is limited by heterogeneous definitions and denominators. Mexico's official fetal death indicators include all gestational ages and use live births as the denominator, diverging from international standards. We recalculated late fetal death rates using ICD-11 criteria and compared them with published national and international data.

METHODS

We conducted a retrospective analysis of national fetal death data from Mexico (2013-2023). Publicly available statistics on fetal deaths and registered live-birth datasets were used. All procedures followed ICD-11 recommendations for international reporting standards. Recalculated rates were compared with official Mexican publications, PAHO/WHO estimates for Mexico, and United States (US) rates.

RESULTS

From 2013 to 2023, 254,567 fetal deaths were recorded in Mexico. The recalculated ICD-11 late fetal death rate averaged 4.9 per 1,000 total births, increasing from 4.5 (2013-2015) to 5.5 (2020-2023). However, this increase should be interpreted with caution, as it is largely driven by a decline in the number of registered live births over the study period. Official Mexican fetal death rates ranged from 10.1 to 15.5 per 1,000. PAHO/WHO estimates for Mexico (2013-2023) were 7.0-7.9 per 1,000, and US rates (2014-2023) were 2.7-2.9 per 1,000. Most fetal deaths occurred before 28 weeks, with increasing proportions among cases ≤499 g. Most deaths were classified as antepartum (84%).

CONCLUSIONS

The recalculated ICD-11 late fetal death rate increased from 2013 to 2023. While national late fetal death rates were lower than historical official rates, they were nearly twice as high as US rates.

TRIAL REGISTRATION: Not applicable.