A Jump in Infant Mortality

This week, the National Center for Health Statistics (NCHS) released a provisional report showing that infant deaths increased by 3 percent in 2022, the first increase in decades. Let’s examine the data and explore the potential causes. 

Between 2002 and 2021, the infant mortality rate declined 22 percent. But in 2022, the NCHS reports that the infant mortality rate rose to 5.60 infant deaths per 1,000 live births, an increase of 3 percent over the 2021 rate of 5.44 infant deaths. This represents the first statistically significant year-over-year increase since 2001–2002. What’s more, the neonatal mortality rate (infant deaths at less than 28 days) in 2022 was 3.58 per 1,000 live births, a 3 percent increase from 2021’s rate of 3.49, while the post neonatal rate (infant deaths at 28 days through 364 days) increased from 1.95 to 2.02 – 4 percent higher. Most surprising, infant mortality rates for mothers between the ages of 25 and 29 increased significantly, from 5.15 to 5.37, while other age groups that have historically higher rates of infant mortality (especially mothers under 20) did not see a significant increase. 

Two racial groups – American Indian/Alaska Native and White Americans – had statistically significant increases, though every race except Asian Americans saw an increase in infant deaths. The American Indian/Alaska Native rate skyrocketed from 7.46 deaths per 1,000 live births in 2021 to 9.06 in 2022, and the White American rate increased from 4.36 in 2021 to 4.51 in 2022. Black Americans, who for decades have suffered the highest infant mortality rates in the country, saw their infant mortality rate increase from 10.55 to 10.86. The Hispanic American rate, which includes individuals of all races who are of Hispanic origin, increased from 4.79 to 4.88. The Asian American rate decreased from 3.69 to 3.50, a rare bright spot in this report. 

Only one state, Nevada, saw a statistically significant decrease in its infant mortality rates (22 percent), while four states – Georgia, Iowa, Missouri, and Texas – saw statistically significant increases. Georgia increased by 13 percent year over year, Iowa increased 30 percent, Missouri increased 16 percent, and Texas increased 8 percent. As a side note, other states had much higher increases – notably North Dakota at 59 percent and Delaware at 57 percent – while Washington, D.C. had a 20 percent decrease, but these were not deemed statistically significant. 

The causes of the 2022 national jump in infant mortality are not entirely clear. Only two causes of death had statistically significant increases: bacterial sepsis, which increased 14 percent between 2021 and 2022, and “maternal complications of pregnancy,” which increased 9 percent. If that latter cause of death sounds vague, that’s because it is. The maternal complications of pregnancy International Classification of Diseases (ICD-10) code can apply to 10 different diagnoses, including: incompetent cervix, premature rupture of membranes, oligohydramnios, polyhydramnios, ectopic pregnancy, multiple pregnancy, maternal death, malpresentation before labor, “other maternal complications of pregnancy,” and “maternal complication of pregnancy, unspecified.” The data presented in the report are not broken down to the more granular level, so it’s difficult to discern the specifics. 

Not truly knowing the cause of this alarming problem makes it even more difficult to address, but one thing is clear: Something is wrong with infant care in the United States. The U.S. infant mortality rate has long been higher than those of other peer countries, and 2022’s increase is a disturbing move in the wrong direction. This report should serve as a wakeup call to policymakers and health officials to make addressing our infant mortality problem a priority.