Infant deaths have risen for the first time in 20 years

In this undated photo, the toes of a baby peek out of a blanket at a hospital in McAllen, Texas. (AP Photo/Eric Gay, File)

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

The spike is a somber manifestation of the state of maternal and child health in the United States. Infant and maternal mortality, inextricably linked, are widely considered to be markers of a society’s overall health, and America’s rates are higher than those in other industrialized countries.

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The rates are particularly poor among Black and Native American mothers, who are roughly three times as likely to die during and after pregnancy, compared with white and Hispanic mothers. Their infants face up to double the risk of dying, compared with white and Hispanic babies.

Overall life expectancy has declined in the United States in recent years, too, affecting white Americans as well as people of color. The declines were driven in part by the COVID-19 pandemic.

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

The report did not delve into the cause of the increase, but most of the babies born in 2022 were conceived in 2021, when maternal deaths rose 40% because of the pandemic and many pregnant women were taken ill.

“Seeing an increase that hits the statistical significance mark indicates that this was a bigger jump than we’ve had in the last 20 years, and that is something we need to keep an eye on to see if it’s just a one-year anomaly or the start of increasing rates,” Ely said.

One of the more disturbing findings in the new report was an increase in infant mortality among babies born to women ages 25 to 29. The rate increased to 5.37 per 1,000 live births last year, up from 5.15 deaths per 1,000 live births in 2021. The cause is not known.

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

Dr. Elizabeth Cherot, an OB-GYN who is president and CEO of the March of Dimes, said she was surprised and disappointed by the new infant mortality figures, and she called for taking a much closer look at the data to try to identify the underlying causes.

“We were making strides, but these trends are clearly going in the wrong direction,” she said.

The rise occurred at the tail end of the pandemic, after a year that had a sharp increase in maternal mortality and maternal illness, she added. Pregnancy complications are now more prevalent, as more women begin pregnancies with underlying medical conditions like high blood pressure, obesity and diabetes.

Serious complications that pose a risk to both mother and baby, such as preeclampsia, also have become more common. But it is difficult to pin the rise in infant mortality on any one factor, she added, without examining the data in more detail.

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