The number of American babies who died before their first birthday increased last year, significantly increasing the nation’s infant mortality rate for the first time in two decades, according to preliminary figures released Wednesday by the National Center for Health Statistics.
This rise is a grim manifestation of the state of maternal and child health in the United States. Infant and maternal mortality, inextricably linked, are widely considered an indicator of the overall health of a society, and U.S. rates are higher than those in other industrialized countries.
Rates are particularly low among black and Native American mothers, who are about three times more likely to die during and after pregnancy than white and Hispanic mothers. Their infants are twice as likely to die as white and Hispanic babies.
Overall life expectancy has also declined in the United States in recent years, affecting white Americans as well as people of color. These declines are partly due to the Covid-19 pandemic.
The increase in infant mortality comes after a century of public health improvements, during which rates have declined steadily and gradually almost every year, with a few exceptions, said Danielle M. Ely, a statistician at the health at NCHS and lead author of the report.
The report did not delve into the cause of the increase, but most babies born in 2022 were conceived in 2021, when maternal deaths increased by 40% due to the pandemic and many pregnant women fell ill .
“Seeing an increase that reaches statistical significance indicates that this is a larger jump than we’ve seen in the last 20 years, and that’s something we need to watch to see s “This is simply a one-year anomaly or the start of rates increasing,” Dr. Ely said.
One of the most worrying findings of the new report is the increase in infant mortality among babies born to women aged 25 to 29. The rate increased to 5.37 per 1,000 live births last year, compared to 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 typically experience higher infant mortality rates, such as women under 20, those 20 to 24, and women 40 years and older.
Dr. Elizabeth Cherot, obstetrician-gynecologist and president and CEO of the March of Dimes, said she was surprised and disappointed by the new infant mortality figures and called for a closer look at the data to try to identify the problem. underlying causes.
“We have made progress, but these trends are clearly going in the wrong direction,” she said.
This increase occurred at the end of the pandemic, after a year marked by a sharp increase in maternal mortality and maternal illness, she added. Pregnancy complications are now more common as more women begin pregnancy with underlying medical conditions like high blood pressure, obesity and diabetes.
Serious complications that pose a risk to both mother and baby, such as pre-eclampsia, have also become more common. But it’s difficult to attribute the increase in infant mortality to a single factor, she added, without examining the data in more detail.
“We were just coming out of Covid,” Dr. Cherot said. “We were doing a lot of telemedicine. Did that change anything? Have the protocols changed? Was access a bigger issue? We know that mental health can also have an impact. A lot has changed in the last three years.
For families who lose a baby, the death can be life-changing.
Erika Nolting Young’s baby died less than two hours after birth. Ms. Young, 37, a business strategy consultant in Rancho Palos Verdes, Calif., had a normal, healthy pregnancy, with no signs that anything was wrong.
She expected to give birth on August 17, 2022, and when labor didn’t start spontaneously, she planned to induce it a week later. But just hours before Ms. Young and her husband, Kris, were supposed to go to the hospital, they received a call saying the maternity ward was full and there weren’t enough nurses, and that she should therefore wait.
The hospital called her the next day and began induction with a medication that caused intense labor and rapid progression to full dilation.
During the last stage of labor, monitors detected a deceleration in the baby’s heart rate, then a sudden deceleration again.
The baby was born “really gray and limp,” Ms. Young recalled. “They threw her on my chest for a split second and her eyes were closed. I immediately knew something was wrong.
Doctors tried to save the newborn, a girl named Sommer, but she died soon after, Ms Young said: “We came home to a house with a baby’s room and no baby. » The Youngs still don’t know what caused Sommer’s death.
Some 20,538 infants like Sommer died in 2022, which is a 3% increase from the 19,928 babies who died in 2021. The infant mortality rate – defined as the number of babies who die before the age of year per 1,000 live births – has also increased. by a statistically significant 3% last year, to 5.6 infant deaths per 1,000 live births, compared to 5.44 deaths per 1,000 live births in 2021, according to the new report.
The mortality rate for babies aged 4 weeks to one year increased by 4 percent, while neonatal mortality rates – those of babies less than a month old – increased by 3 percent.
Rates increased significantly in both premature babies born before 37 weeks of gestation and those born extremely early, at less than 34 weeks of gestation.
Overall, statistically significant increases in mortality rates were only seen among male infants, whose survival rates were always slightly lower than those of female infants.
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 which was not statistically significant.
In contrast, infant mortality rates for white, American Indian and Alaska Native babies increased statistically significantly last year.
Among white infants, this figure increased to 4.52 deaths per 1,000 live births, compared to 4.36 deaths per 1,000 live births in 2021. Among American Indian and Alaska Native babies, the figure increased to 9, 06 deaths per 1,000 live births, compared to 7.46 deaths per 1,000 live births in 2021. 2021.
The two most common causes of infant death last year were bacterial sepsis, caused by the body’s sudden reaction to infection, and maternal health complications.
Because infant deaths are relatively rare events involving small numbers of babies, statistically significant changes are not easy to observe from year to year at the state level. Nevada is the only state to experience a statistically significant decline in infant mortality, while four states – Georgia, Iowa, Missouri and Texas – experienced a statistically significant increase in infant mortality last year .
Texas banned abortions after six weeks of pregnancy in 2021, the first of four states to do so. But in interviews Wednesday, experts said the data was unclear on whether, or to what extent, that may have played a role in infant deaths the following year. The remaining states implemented bans in 2022, after the Supreme Court overturned Roe v. Wade.