• Posted November 1, 2023

U.S. Infant Mortality Rate Climbs for First Time in 20 Years

Following nearly two decades of decline, U.S. infant death rates edged up by 3% in 2022, new provisional government numbers reveal.

“This was the first year we saw statistically significant increased rates of infant mortality in about 20 years,” said study author Danielle Ely, a statistician at the U.S. National Center for Health Statistics. Infant mortality measures how many babies die before they reach their first birthday.

The study wasn't designed to say why more babies are dying, but at least one expert suggested that the pandemic, which put a strain on the health care system, could have played a role.

“The U.S. was still in the throes of COVID in 2022, which had myriad and varied impacts across the U.S. and disparate impacts by race, ethnicity, maternal age and geographical region,” explained Dr. Deborah Campbell, a neonatologist at the Children's Hospital at Montefiore in New York City.

“The impact of COVID on pregnancy and delivery care nationwide was dramatic, affecting access to and utilization of maternity care, and pregnant people avoiding pregnancy care and hospital births," she noted.

For the study, researchers looked at birth certificates and infant death data collected through the U.S. National Vital Statistics System for 2021 and 2022. They found that the infant mortality rate in 2022 increased for moms aged 25-29. In addition, the rate also rose for preterm babies, male infants and infants born in Georgia, Iowa, Missouri and Texas.

Infant death rates climbed by more than 20%, from about 7.4 deaths per 1,000 births to more than 9 deaths per 1,000 births, for infants born to American Indian or Alaska Native women. Meanwhile, infant mortality rates for white women increased by about 3%.

Death rates for infants of Black women did not increase by that much, but Black infants still experienced the highest overall rates of infant mortality, Ely noted.

“The infant mortality rate is one of many ways that we measure the overall health of a nation, and increases in this rate can indicate a larger public health issue,” Ely said.

More research is needed to determine whether the 2022 rise is a statistical blip or will become a more lasting trend.

“If this increase is confirmed in coming years, more research will be needed into what is driving these numbers, and prevention efforts targeting those at-risk will also be needed,” Ely said.

The findings were published in the November issue of Vital Statistics Rapid Release Reports.

Calling the new report “concerning,” Campbell added that there isn't enough data yet to explain what is behind the increase.

“There needs to be an in-depth evaluation of the data once finalized, with analysis of contributing/confounding factors as well as any resilience factors that may have protected one versus another ethnic/racial/cultural group,” she said.

More information

The March of Dimes has more on planning for a healthy pregnancy and delivery.

SOURCES: Danielle Ely, PhD, statistician, U.S. National Center for Health Statistics, Rockville, Md.; Deborah Campbell, MD, neonatologist, Children's Hospital at Montefiore, and professor, pediatrics, Albert Einstein College of Medicine, New York City; Vital Statistics Rapid Release Reports, November 2023