Alarming Increase: US Infant Mortality Rate Surges After More than Two Decades

The United States experienced a rise in infant mortality rates in 2022, marking the first increase in over twenty years. The National Center for Health Statistics released a report on Wednesday stating that the overall infant mortality rate increased by 3% compared to 2021. The mortality rate for neonatal infants saw a 3% surge, while the post-neonatal mortality rate, pertaining to infants who survived beyond 28 days, rose by 4%.

The infant mortality rate in our resource-rich country has seen alarming increases in deaths caused by maternal complications such as preeclampsia or preterm delivery, which rose by 8% and 14% respectively. Dr. Sandy Chung, President of the American Academy of Pediatrics, expressed her concern in an email to CNN, emphasizing that as pediatricians committed to ensuring the well-being of children, even a single child death is unacceptable.

For public health experts, infant mortality is often a valuable indicator of a country's overall healthcare system, according to Danielle Ely, a health statistician at NCHS and one of the authors of the report. She mentioned that the increase in infant mortality this year could be a temporary anomaly or a sign of an underlying healthcare problem. To determine this, they will need to analyze the data for next year.

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Rachel Hardeman, a health and racial equity professor at the University of Minnesota, suggested that the rise in infant mortality may be attributable to the COVID-19 pandemic's impact on communities and healthcare resources. A study conducted by the US Centers for Disease Control and Prevention in 2021 revealed that although the overall number of infant deaths in 2020 had risen, the mortality rate remained unchanged at 5.44 deaths per 1,000 live births.

According to provisional data from the new report, the rate of infant deaths per 1,000 births has increased to 5.60, resulting in a total of 20,538 infant deaths in 2022.

Dr. Elizabeth Cherot, President and CEO of the nonprofit organization March of Dimes, expressed concern over this negative trend, stating, "This is clearly a step in the wrong direction. Overall, I am feeling discouraged."

The NCHS study revealed an increase in the infant mortality rate for mothers aged 25-29 in 2022. Additionally, mortality rates were higher for preterm babies, male infants, and infants born in Georgia, Iowa, Missouri, and Texas. However, there was a decline in infant mortality rates in Nevada.

Furthermore, the report indicated that different racial groups experienced varying rates of infant mortality. For infants of American Indian or Alaska Native women, mortality rates increased by more than 20%, going from approximately 7.4 deaths per 1,000 births to over 9 deaths per 1,000 births. Moreover, infant mortality rates for White women also saw an increase of around 3%.

According to the report, although the mortality rates for infants of Black women did not increase significantly, Black infants had the highest overall rates of infant mortality. They experienced nearly 11 deaths per 1,000 births, which was more than double the mortality rate of White infants.

Chung, in the report, mentioned that there are significant hurdles in accessing healthcare and treatments for those living in or near poverty, as well as certain racial and ethnic groups. As a result, mothers and babies may seek care when they are already more ill and at higher risk of severe outcomes, including death.

Cherot and Hardeman coined the term "maternity care deserts" to refer to regions characterized by limited accessibility. In these areas, predominantly women of color may have to travel long distances in search of rare labor or delivery units. Moreover, these women encounter a heightened risk of preterm birth, which, combined with barriers to healthcare access, significantly increases the likelihood of infant complications.

Hardeman suggests that racism and marginalization, specifically towards indigenous and Black communities, can significantly impact health outcomes. Educating physicians and other healthcare professionals about the correlation between equity and health, she believes, could gradually diminish racial disparities in infant health.

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Hardeman's previous research revealed that Black infants had a higher survival rate when delivered by Black physicians, especially in difficult birthing situations or when there were maternal complications.

The report indicated that newborn deaths were primarily caused by maternal complications and bacterial sepsis (infection), with a higher occurrence compared to previous years. Cherot, while acknowledging the link between maternal health and infant mortality, emphasized that conditions such as preeclampsia and diabetes have been increasingly common, leading to elevated maternal death rates in comparison to other high-income nations.

The NCHS study solely presents the most recent statistics of infant mortality, lacking any explanation for the potential causes behind the increase. Cherot expresses the wish for researchers to thoroughly analyze the data in order to comprehend the underlying factors contributing to the rise in infant deaths. "I observe a 14% surge in infant mortality resulting from bacterial sepsis," Cherot expresses concern. "When I encounter double-digit percentage increases, it fosters apprehension. There are numerous unanswered questions regarding this data."