Child mortality has risen for the first time in twenty years

The number of American babies who died before their first birthday rose last year, causing the country’s infant mortality rate to rise significantly for the first time in two decades, according to preliminary figures released Wednesday by the National Center for Health Statistics.

The spike is a bleak manifestation of the health status of mothers and children in the United States. Infant and maternal mortality, which are inextricably linked, are widely considered indicators of a society’s overall health, and U.S. rates are higher than those in other industrialized countries.

The rates are particularly bad among black and Native American mothers, who are roughly three times as likely to die during and after pregnancy, compared to white and Hispanic mothers. Their babies face a doubling of the risk of death, compared to white and Hispanic babies.

Overall life expectancy has also fallen in the United States in recent years, affecting both white Americans and people of color. The declines were partly caused by the Covid-19 pandemic.

The increase in infant mortality comes after a century of public health improvements, with rates falling consistently and gradually almost every year with few exceptions, said Danielle M. Ely, a health statistician at the NCHS and lead author of the report.

The report did not elaborate on what caused the increase, but most babies born in 2022 were conceived in 2021, when maternal mortality rose 40 percent due to the pandemic and many pregnant women fell ill.

“Seeing an increase that reaches the statistical significance threshold indicates that this was a bigger jump than we’ve had in the last twenty years, and that’s something we need to keep an eye on to see if it’s just an anomaly of a year is or the start of rising rates,” said Dr. Ely.

One of the most disturbing findings was an increase in infant mortality among babies born to women aged 25 to 29. This rate rose to 5.37 per 1,000 live births last year, compared to 5.15 deaths per 1,000 live births in 2021.

The numbers did not change for women in other age groups, even for those who generally experience higher infant mortality rates, such as women under age 20, women age 20 to 24, and women age 40 and older.

Some 20,538 babies died in 2022, representing a 3 percent increase from the 19,928 babies who died in 2021. statistically significant 3 percent last year, to 5.6 infant deaths per 1,000 live births, up from 5.44 deaths per 1,000 live births in 2021, according to the new report.

The death rate of babies between four weeks and a year old rose by 4 percent, while the newborn death rate – that of babies under a month old – rose by 3 percent.

The rates rose significantly in both premature babies born before the 37th week of pregnancy and in those born extremely preterm, at less than 34 weeks’ gestation.

Overall, the statistically significant increases in mortality rates were only observed among male infants, whose survival rates have always been slightly lower than those among females.

Black infants have the highest mortality rate in the United States, up slightly last year to 10.86 deaths per 1,000 live births, compared to 10.55 deaths per 1,000 live births in 2021, an increase that was not statistically significant.

In contrast, infant mortality rates for both white and Native American and Alaska Native babies increased by statistically significant amounts last year.

Among white babies, the rate rose to 4.52 deaths per 1,000 live births, from 4.36 deaths per 1,000 live births in 2021. Among Native American and Alaska Native babies, the rate rose to 9.06 deaths per 1,000 live births, from 7.46 deaths per 1,000 live births in 2021. 2021.

The two leading causes of infant deaths that became more common last year were bacterial sepsis, caused by the body’s overwhelming response to infection, and maternal health complications.

Because infant deaths are relatively rare and involve small numbers of infants, statistically significant changes cannot easily be observed from year to year at the state level. Nevada was the only state with a statistically significant decrease in infant mortality, while four states – Georgia, Iowa, Missouri and Texas – had a statistically significant increase in infant mortality last year.

Texas banned abortions after six weeks of pregnancy in 2021, which may have played a role in the increased number of infant deaths the following year by preventing abortion of acutely ill fetuses.