CDC Report (2023): Infant Deaths Increased In 2022 (For The First Time In 2 Decades)

 

Is Infant Death Increasing Or Decreasing?

Recent data from the CDC (US Centers for Disease Control and Prevention) shows that infant deaths* are slightly increasing. The number increased from 5.40 deaths per 1,000 live births in the first quarter (Q1) of 2021 to 5.59 deaths per 1,000 live births at the end of the last quarter (Q4) of 2022. (1)

 

 

There’s also a slight increase in neonatal mortality** from 3.56 in 2021 Q1 to 3.58 in 2022 Q4.

Postneonatal mortality*** also increased from 1.85 in 2021 Q1 to 2.02 in 2022 Q4.

 

*Infants are defined in the report as babies under one year of age

**Neonates are defined in the report as newborns 0-27 days old

***Postneonates are defined in the report as babies from 28 days through 11 months

 

 

According to the CDC, the recently released provisional data shows the largest percentage increase for infant mortality/deaths in over two decades. (2)

Experts are understandably disappointed, even alarmed, especially considering how they worked hard to keep the numbers low in the past decades. (2)

March of Dimes (a nonprofit organization for maternal and infant health advocacy) President and CEO Dr. Elizabeth Cherot expressed disappointment over the recent report, especially the steady decline of the past 10 years. (2)

Here’s what Dr. Cherot wrote about this issue: (2)

“We know the health of mom and baby are intertwined. Today’s data underscores that our failure to better support moms before, during, and after birth is among the factors contributing to poor infant health outcomes.”

 

Why Did Infant Mortality Increase?

Among the 10 leading causes of death from 2021 to 2022 (see the full list and their corresponding data below), the following had the highest increase: (3)

• Maternal complications (from 30.4 to 33.0 infant deaths per 100,000 live births)
• Bacterial sepsis of newborns (from 15.3 to 17.4 infant deaths per 100,000 live births)

 

Although birth defects and preterm births remain the leading causes of US infant deaths for the same period, their rates didn’t change significantly from 2021 to 2022. (4)

Maternal complications can include the following: (4)(5)

• Preterm labor
• Amniotic fluid ruptures even before labor begins
• The cervix opens too early
• Preeclampsia (serious blood pressure condition and high protein levels in the urine) 
• Infections
• Gestational diabetes (pregnancy high blood sugar levels)

 

Some of these pregnancy complications can increase a baby’s risk of death due to infection, miscarriage, or preterm birth. (4)

Meanwhile, neonatal bacterial sepsis happens when a newborn (less than 28 days old) suffers a life-threatening response to an infection. (6)

Sepsis can happen due to different reasons, including: (6)

• Infection contracted in the womb 
• Infection during delivery
• Infection from exposure to bacteria from unsterilized medical equipment (e.g., tubes, IVs, catheters, etc.) or the environment

 

Dr. Tracey Wilkinson, an associate professor of pediatrics at Indiana University School of Medicine, believes that the recent increase in infant mortality rates can also be due to the termination of the constitutional right to abortion. (7)

However, other experts caution that the data on the relationship between the abortion ban and infant deaths was unclear. (8)

In addition, Dr. Pat Gabbe, clinical professor of pediatrics at Ohio State University Wexner Medical Center, explains that the COVID-19 pandemic may have contributed to the increase in infant mortality. (7)

Aside from pregnant moms hesitating to visit hospitals for pregnancy complications in fear of contracting the virus, possible job loss and the resulting economic instability may have increased their stress levels. (7)

According to Dr. Gabbe, stress can increase a baby’s risk of being born too small or too early, which also increases their risk of death. (7)

Note that although the pandemic may have contributed to the increase in infant mortality rates, these weren’t linked to vaccines. You might recall that many people were skeptical about getting the COVID-19 vaccines out of fear that they could cause death or other complications. (9)

None of these top 10 leading causes of infant mortality listed in the CDC report are linked to vaccines.

Surprisingly, even in the US, the March of Dimes estimates that as many as 6.9 million women (plus around 500,000 births) live in places with low or no access to maternity care. (7)

Of this number, as many as 2.2 million women of childbearing age (plus almost 150,000 babies) live in places that the March of Dimes labeled in their 2022 report as “maternity care deserts.” (7)

These are defined as counties with zero birthing centers or hospitals offering OB-GYN care and have zero OB providers per 10,000 births. (7)

These women and babies can have a higher risk of maternal and neonatal complications due to the lack of maternity-focused facilities. (10)

Dr. Wilkinson explains that standard hospitals and healthcare facilities can probably deliver a “straightforward, non-complicated pregnancy.” However, things can be difficult for complicated deliveries because the medical staff might lack the expertise to handle the situation for the mom and/or her newborn baby. (7)

According to the March of Dimes report, Ohio had the highest number (97,000+) of women affected by overall care access reductions, while about 92,000+ experienced maternity care access improvement in Florida. (7)

APA (American Academy of Pediatrics) president Dr. Sandy Chung said that the infant mortality rate and the recent increases were “shockingly high,” especially considering that the US is a country with “significant resources.” (10)

She calls the country’s current infant mortality rate as “unacceptable.” (10)

 

What Are The Leading Reasons For Infant Deaths In The United States?

Still based on the CDC data, the following are the leading reasons for infant mortality in 2022: (3)

1. Congenital malformations (or birth defects): 4,000
2. Short gestation or preterm births and low birth weight (without other classifications or causes): 2,876
3. Sudden infant death syndrome (SIDS): 1,458
4. Accidents (unintentional injuries): 1,349
5. Maternal complications of pregnancy: 1,209
6. Bacterial sepsis of newborn: 637
7. Complications of placenta, cord, & membranes: 631
8. Respiratory distress of newborn: 458
9. Diseases of the circulatory system: 358
10. Neonatal hemorrhage: 336

 

 

Based on this data, experts such as March of Dimes’ Dr. Cherot express worry, especially considering the double-digit (14%) increase in the rate of bacterial sepsis. (10)

It’s also estimated that nursery products may be responsible for 160 children’s deaths annually, plus thousands of injuries, including those treated in the emergency room or requiring further treatment. (11)

Read our article on toy-related deaths or injuries because some infant fatalities were due to choking on small toys or suffocating on stuffed toys.

 

The US Infant Death Rate By Year

 

Based on provisional data from the CDC, the following are the most recent infant mortality rates: (1)(3)

• 2022: 5.60 infant deaths per 1,000 live births (3% higher than 2021)
• 2021: 5.44 infant deaths per 1,000 live births

 

The neonatal mortality rate also increased by 3%: (1)(3)

• 2022: 3.58 neonatal deaths per 1,000 live births
• 2021: 3.49 neonatal deaths per 1,000 live births

 

The postneonatal mortality rate increased by 4%: (1)(3)

• 2022: 2.02 postneonatal deaths per 1,000 live births
• 2021: 1.95 postneonatal deaths per 1,000 live births

 

The CDC data reported above shows the relative mortality rates based on 1,000 live births. However, the actual numbers are high. (1)(3)

Based on CDC provisional data, there were 20,538 infant deaths out of 3,667,758 live births in the US in 2022. (3)

These 2022 numbers are higher by 3% than the 2021 data, reporting 19,928 infant deaths out of 3,664,292 live births. (3)

These stats are broken down into the following for 2022 (out of 3,667,758 live births): (3)

• Neonatal deaths: 13,120 
• Postneonatal deaths: 7,418 

 

These are the stats for 2021 (out of 3,664,292 live births): (3)

• Neonatal deaths: 12,797
• Postneonatal deaths: 7,131

 

Based on CDC data, experts also predict that the mortality rate might continue to increase in 2023 due to the continued limited or lack of access to prenatal and maternity care. (3)(7)

Dr. Gabbe calls for commitment to turning the numbers back and decreasing infant mortality rates. (7)

 

Infant Death Rates Based On Specific Factors

Note: You can refer to Table 1 (under Vital Statistics Surveillance Report) below for side-by-side comparisons of the data we detail below.

 

 

By Gestational Age

As you can see in Table 1 above, based on the CDC data from 2021 to 2022, there weren’t significant increases in the mortality rates for the following (measured as deaths per 1,000 live births): (3)

• Early-term babies (born at 37 to 38 weeks): from 3.14 to 3.22
• Full-term babies (born at 39 to 40 weeks): from 1.59 to 1.66
• Late-term babies (born at 41 weeks or more): from 1.62 to 1.86

 

As might be expected, because they’re close to full term, late preterm babies (born at 34 to 36 weeks) didn’t have a significant increase in mortality rates: from 8.11 to 8.28. (3)

Surprisingly, the results also showed that the rates didn’t significantly increase for extremely preterm babies (less than 28 weeks): from 353.76 to 363.17. (3)

However, the rates from 2021 to 2022 increased for other preterm babies as follows: (3)

• Preterm babies (those born less than 37 weeks of gestation): from 33.59 to 34.69
• Early preterm babies (born less than 34 weeks of gestation): from 103.08 to 107.61

 

By Gender

As shown in Table 1 above, here are the mortality rates (per 1,000 live births) from 2021 to 2022 according to the babies’ gender: (3)

• Female babies (no significant increase): from 5.02 to 5.12
• Male babies (increase): 5.83 to 6.06

 

By Maternal Age

Still referring to Table 1 above, the CDC explains that the changes in infant mortality rates (measured as infant deaths per 1,000 live births) by their moms’ age from 2021 to 2022 are as follows: (3)

• Moms younger than age 20: from 9.22 to 9.89
• Moms aged 20 to 24: from 6.87 to 7.12
• Moms aged 25 to 29: from 5.15 to 5.37
• Moms aged 30 to 34: from 4.48 to 4.58
• Moms aged 35 to 39: 4.92 to 4.97
• Moms aged 40 and older: from 6.74 to 6.71

 

By Maternal Race

The CDC also presented changes in infant mortality rates from 2021 to 2022 based on the mother’s race, as shown in Table 1. (3)

According to the CDC, these are the data for the different (based on infant deaths per 1,000 live births): (3)

• White moms: 4.36 to 4.52 
• Black moms: 10.55 to 10.86
• Hispanic moms: 4.79 to 4.88
• Asian moms: 3.69 to 3.50
• Native Hawaiian or other Pacific Islander moms: 7.76 to 8.50
• American Indian and Alaska Native moms: 7.46 to 9.06

 

 

Based on this data, the CDC explains that even though babies born to black moms had the highest mortality rates, the increase is statistically significant (nearly 4%) for those born to white moms. (3)(7)

University of Minnesota professor of health and racial equity, Rachel Hardeman, explained that marginalization and racism, especially against black people, can also affect these moms’ health outcomes. (10)

The rates for Alaska Native and American Indian women had the highest jump from about 7.4 deaths per 1,000 births to as high as 9+ deaths per 1,000 births, which is a difference of over 20% within one year. (3)

 

By Location Or State Of Residence

In Table 2 below, you can find the changes in the birth and death rates from 2021 to 2022. (3)

According to the CDC, based on this data, the infant death rates didn’t significantly increase in most of the states. The changes were considered “slight” for these locations. (3)

The death rates declined significantly in Nevada. (3)

However, the following states showed significant increases in their infant mortality rates: (3)

• Georgia
• Iowa
• Missouri
• Texas

 

 

How Can You Reduce The Risks Of Infant Mortality?

Some ways to reduce infant mortality risks: (12)

• Have a healthy and safe pregnancy by regularly visiting your OB-GYN for prenatal check-ups to prevent or reduce the risks of pregnancy complications, birth defects, low birth weight, and other post-birth issues.
• Make sure you take prenatal supplements and eat foods rich in iron, choline, iodine, DHA and EPA, fish oil, and other vitamins or nutrients your health provider recommends.
• Follow the safe sleep guidelines, especially about letting your baby sleep in a firm, flat, and clutter-free environment, such as a bassinet or crib and a suitable crib mattress (without loose blankets, pillows, or crib bumpers). This can help reduce the risks of SIDS and accidental suffocation or strangulation.
• Inclined sleepers can be dangerous for babies to sleep in.
• Babyproof your home and install baby gates, wherever needed, to reduce injury risks.
• Regularly take your baby to their pediatrician for follow-up check-ups and whenever they get sick.
• Avoid giving probiotics to premature babies unless you’ve discussed all your options with their healthcare provider. The FDA warns that these can be dangerous to preemies. (13)
• Get help addressing low birth weight and preterm births to reduce the risks of further complications.
• Studies have also shown that pacifiers might help reduce SIDS risks. (14)(15)
• Whenever applicable, use newborn screening or tests to detect hidden conditions, such as SCID (severe combined immune deficiency) and PKU (phenylketonuria; the body can’t digest or process phenylalanine, leading to possible intellectual and developmental disability). (16)
• Monitor product recalls (e.g., baby food recalls, formula recalls, inclined sleepers recall, baby wipes recalls, pacifier recalls, stroller recalls, crib recalls, candy recalls, toy recalls, etc.) to ensure that you keep your baby away from unsafe, contaminated products.
• Take advantage of new technology to help prevent child hot car deaths.

 

 

References

(1) https://www.cdc.gov/nchs/nvss/vsrr/infant-mortality-dashboard.htm

(2) https://www.cdc.gov/nchs/data/vsrr/vsrr033.pdf

(3) https://www.cpsc.gov/s3fs-public/Nursery-Products-Annual-Report-2023.pdf?VersionId=1hFBN.iciNSIXQ4BOcnpk7NtWoFWgJ8g

(4) https://www.fda.gov/media/172606/download

(5) https://pubmed.ncbi.nlm.nih.gov/16216900/

(6) https://pubmed.ncbi.nlm.nih.gov/21505778/

(7) https://www.nichd.nih.gov/health/topics/infant-mortality/topicinfo/reduce-risk

(8) https://www.nichd.nih.gov/health/topics/newborn/conditioninfo/disorders

(9) https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-complications.html

(10) https://www.nbcnews.com/health/health-news/infant-mortality-rose-2022-first-time-two-decades-rcna122995

(11) https://my.clevelandclinic.org/health/diseases/15371-sepsis-in-newborns

(12) https://www.marchofdimes.org/maternity-care-deserts-report#map

(13) https://www.nytimes.com/2023/11/01/health/infant-mortality-rate-rise.html

(14) https://edition.cnn.com/2023/11/01/health/us-infant-mortality-rate-rises-for-first-time-in-more-than-20-years/index.html

(15) https://www.marchofdimes.org/about/news/march-dimes-statement-cdcs-2022-infant-mortality-report

(16) https://www.reuters.com/fact-check/us-infant-mortality-rise-not-linked-vaccines-2023-11-13/