Infant Mortality

Infant Mortality in United States

United States

Losing an infant is devastating for parents, families and communities and can result in extreme and persistent sadness among parents. In 2019, nearly 21,000 infants died in the United States. According to the Centers for Disease Control and Prevention (CDC), the leading causes were congenital abnormalities, low birthweight and preterm birth, maternal pregnancy complications, sudden infant death syndrome (SIDS) and unintentional injuries.

The infant mortality rate is consistently higher in the United States than in other developed countries. Research indicates that socioeconomic inequality in the United States is likely a primary contributor to its higher infant mortality rate. 

Maternal risk factors for infant mortality include maternal obesity (BMI≥30) and use of alcohol or tobacco during pregnancy.

Significant disparities persist in infant mortality among different racial and ethnic groups, with the most striking difference between babies born to Black women and babies born to white or Asian women. 

Other populations with higher rates of infant mortality include:

• Mothers younger than 25 years or older than 40 years, compared with those ages 25-40.
• Those living in high-poverty counties compared with those in low- and middle-poverty counties.
• Those living in rural counties compared with those in urban counties. 

Considerable progress has been made in the U.S. over the past 50 years to reduce infant mortality; however, more needs to be done to eliminate disparities and ensure continued progress. It is important to implement a variety of strategies to reduce infant mortality. Key prenatal and postnatal strategies include:

• Improving access to and use of ongoing prenatal care.
• Reducing maternal smoking and alcohol consumption.
• Reducing maternal obesity.
• Improving preconception health of all women.
• Improving sleep practices among infants and newborns. Injuries such as suffocation cause many infant deaths annually. The CDC and American Academy of Pediatrics provide information on eliminating sleep hazards for your baby.
• Increasing minimum wage, as it is associated with a reduction in low birthweight births and infant deaths.

Healthy People 2030 has an objective to reduce infant mortality. It also has a number of related objectives including reducing preterm births, increasing the proportion of women who have a healthy weight before pregnancy and increasing the proportion of women who receive early and adequate prenatal care.

Bekkering, Holly J., and Roberta L. Woodgate. 2019. “The Parental Experience of Unexpectedly Losing a Child in the Pediatric Emergency Department.” OMEGA - Journal of Death and Dying, September, 0030222819876477. https://doi.org/10.1177/0030222819876477.

Ely, Danielle M., and Anne K. Driscoll. 2021. “Infant Mortality in the United States, 2019: Data From the Period Linked Birth/Infant Death File.” National Vital Statistics Reports 70 (14). https://www.cdc.gov/nchs/data/nvsr/nvsr70/NVSR70-14.pdf.

Ely, Danielle M., Elizabeth C. W. Gregory, and Patrick Drake. “Infant Mortality by Maternal Prepregnancy Body Mass Index: United States, 2017-2018.” National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System 69, no. 9 (August 2020): 1–11. https://stacks.cdc.gov/view/cdc/93222.

Komro, Kelli A., Melvin D. Livingston, Sara Markowitz, and Alexander C. Wagenaar. 2016. “The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight.” American Journal of Public Health 106 (8): 1514–16. https://doi.org/10.2105/AJPH.2016.303268.

Lorenz, J. M., C. V. Ananth, R. A. Polin, and M. E. D’Alton. 2016. “Infant Mortality in the United States.” Journal of Perinatology 36 (10): 797–801. https://doi.org/10.1038/jp.2016.63.

Mohamoud, Yousra A., Russell S. Kirby, and Deborah B. Ehrenthal. 2019. “Poverty, Urban-Rural Classification and Term Infant Mortality: A Population-Based Multilevel Analysis.” BMC Pregnancy and Childbirth 19 (1): 40. https://doi.org/10.1186/s12884-019-2190-1.

Moon, Rachel Y., Rebecca F. Carlin, and Ivan Hand. 2022. “Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment.” Pediatrics 150 (1): e2022057990. https://doi.org/10.1542/peds.2022-057990.

Singh, Gopal K., and Stella M. Yu. 2019. “Infant Mortality in the United States, 1915-2017: Large Social Inequalities Have Persisted for Over a Century.” International Journal of MCH and AIDS (IJMA) 8 (1): 19–31. https://doi.org/10.21106/ijma.271.