We would like to thank Drs Vlachadis, Tsamadias, and Economou for their interest in our work and for their complimentary Letter to the Editor.

We could not agree more that the reported findings in our work should not be applied outside the population of the United States, and we would encourage others to collect comparable data in similar populations. It must be remembered that the data reported in our work reported patients analyzed as a whole but were also divided further into low-risk and high-risk groups. It would appear from their letter that Dr Vlachadis et al, when comparing the number of fetal deaths with neonatal deaths in the adjacent column in any of the accompanying data tables, that simple numeric comparisons of the 2 columns might suggest that a different gestational age would be best in resulting in fewer neonatal deaths compared with fetal deaths.

However, it would seem as if what was not appreciated from the discussion of our paper was the fact that it must be remembered that if delivery would have occurred at 37 weeks, that all the subsequent fetal deaths would have been avoided. It is precisely this observation, which accounts for the reason that the National Center for Health Statistics no longer simply looks as a fetal death rate as the number of deaths that occur in each week but has described what they call the prospective fetal death rate, that takes into account all subsequent fetal deaths that occur as well.

We hope that ongoing analysis, both in the United States and abroad, will advance the discussion of what the best gestational age for delivery might be, especially in the term group beyond 37 weeks. It is clear from not only our data but also from the United States national data as well that the number of fetal deaths and the risk of fetal death continue to increase beyond 37 weeks’ gestation. Recognizing that fact will only serve to further the discussion as to determining what is best for the patient and her fetus.