Child Death Review (CDR) and Fetal and Infant Mortality Review (FIMR)

Local and state multidisciplinary reviews of infant deaths provide invaluable information about the circumstances surrounding infant deaths. These in-depth reviews bring together a variety of information from many sources and provide a venue for communities to recognize system shortcomings and create strategies to improve these systems. The two largest multidisciplinary review programs are Child Death Review (CDR) and the Fetal and Infant Mortality Review (FIMR).

What are Child Death Review Teams?
Child Death Review (CDR) Teams are generally made up of a multidisciplinary group of people, often including medical and law enforcement personnel, who meet to thoroughly review child deaths. The purpose of most CDR Teams is to better understand how and why children die in order that they may prevent other deaths and improve the health and safety of children.

Although the purpose and objectives of CDR are consistent across the United States, CDR systems vary by the level (state or local) at which cases are reviewed and acted upon. And there is a wide variation in the types of deaths that are reviewed (by age, manner, cause, and location) and the timeframes from death to review.

The National MCH Center for Child Death Review* is a national resource center for state and local CDR programs. It is funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (MCHB). The mission of the National MCH Center for Child Death Review is to promote, support and enhance CDR methodology and activities at the state, community and national level. It builds public and private partnerships to incorporate CDR findings into efforts that improve child health. The Center offers a wide range of services to state and local CDR teams including technical assistance, training and support for teams; CDR support resources and tools; a national CDR reporting system; coordination with other review teams; collaboration with state and national child health, safety and protection programs and organizations; and promotion of CDR to national public and private organizations.

What is a Fetal and Infant Mortality Review?

Fetal and Infant Mortality Review (FIMR) is a process by which a multidisciplinary community team is brought together to examine individual cases of infant and fetal deaths in an effort to identify critical community strengths and weaknesses as well as unique health and social issues associated with poor outcomes. The goal of the FIMR process is use the findings from the review process to improve community resources and health service delivery systems for women, infants, and families.

What Happens with FIMR information?

The FIMR case review team makes recommendations for new policies, practices, or programs to improve community systems, when appropriate. Community leaders representing government, consumers, key institutions, and health and human services organizations serve on the community action team, which reviews recommendations, prioritizes identified issues, and designs and implements interventions.

The National Fetal and Infant Mortality Review (NFIMR) Program* is a collaborative effort between the MCHB and the American College of Obstetricians and Gynecologists that addresses FIMR issues. It includes a resource center that provides information and advice about implementing the FIMR methods. Topics include confidentiality, liability, data collection, home interview techniques, coalition building, taking recommendations to action, coordinating with other local mortality reviews, and using local FIMR information for regional or state assessment and planning. Referrals to expert consultants are available. Resources can be accessed via the NFIMR website.

SIDS Support and Bereavement*

Association of Maternal & Child Health Programs* (AMCHP) Supports state maternal and child health programs and provides national leadership on issues affecting women and children.

National Data Sources for Trends in Infant Mortality

Infant Mortality Statistics, Birth/Infant Death Data Set from National Center for Health Statistics (NCHS) Vital Statistics Reports

Available reports in PDF format
2002 | 2001  | 2000   | 1999  | 1998

Infant Mortality Statistics from the 2005 Period Linked Birth/Infant Death Data
PDF 744KB. Source: Natl Vital Stat Rep 2008;57(2):1–32.

Recent Trends in Infant Mortality in the United States
PDF 744KB. Source: NCHS Data Brief 2008;(9):1–8.

Infant Mortality Statistics from the 2004 Period Linked Birth/Infant Death Data Set
PDF 787KB. Source: Natl Vital Stat Rep 2007;55(14):1–32.

Infant Mortality Statistics from the 2003 Period Linked Birth/Infant Death Data
PDF 684KB. Source: Natl Vital Stat Rep 2006;54(16):1–29.

Explaining the Infant Mortality Increase
PDF 1.14MB Source: NVSS 2005;53(12);1–23.

National Infant Sleep Position Study*

Pregnancy Risk Assessment Monitoring System (PRAMS)

Peristats (March of Dimes) http://www.marchofdimes.com/peristats/*

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Page last reviewed: 8/5/09
Page last modified: 8/5/09
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion