The infant mortality rate in the United States rose in 2022, the first jump in 20 years, according to data released Thursday by the US Centers for Disease Control and Prevention.
More than 20,500 babies died in 2022 before the age of 1, final records show. Overall, there were 5.6 infant deaths for every 1,000 live births, a 3% increase from the year before.
Infant mortality in the US has been generally trending down since at least 1995, when consistent tracking started, but rates are still much higher in the US than they are in many peer nations. There have been some small upticks over that time, but 2022 was the first time there was a statistically significant increase since 2002, according to the CDC’s National Center for Health Statistics.
Experts say that any increase is cause for concern.
“Infant health is one of the most important public health indicators that we have,” said Amanda Jean Stevenson, a demographer and assistant professor of sociology at the University of Colorado Boulder, who was not involved with the new report but saw provisional data previously released by the CDC. “The fact that [infant mortality rates] are not continuing to decrease is a very big deal. Even flat infant mortality rates are not good. We need to see these numbers going down – and fast – because they are far too high.”
The leading causes of infant mortality in the US stayed consistent between 2021 and 2022, according to the CDC report. Congenital malformations led to nearly 1 in 5 deaths. Another 14% was caused by disorders related to short gestation and low birth weight, followed by sudden infant death syndrome, unintentional injuries and maternal complications.
The rate of infant deaths from maternal complications jumped 9% between 2021 to 2022, from about 30 infant deaths for every 100,000 live births to more than 33 per 100,000 live births. None of the other leading causes of infant death increased significantly.
Infant health is tied strongly to maternal health, experts say, and the US has long struggled with high rates of death among women during pregnancy, childbirth or postpartum. Despite recent declines, the US continues to have a higher rate of maternal death than other high-income nations, a recent report showed.
“We can certainly expect that maternal complications overall are increasing because the standard of care for pregnancy-related complications is not being met in many states,” Stevenson said.
Covid-19 also probably played a significant role in the rise in infant mortality in 2022, Stevenson said. Infections in pregnant women who were exposed to the coronavirus during the major surges in 2021 could have affected infants who would be born in 2022.
A large study from last year found that pregnant individuals who got Covid-19 were nearly four times more likely to be admitted to an intensive care unit than those who weren’t infected. They were 15 times more likely to be ventilated and seven times more likely to die. They also had higher risks of preeclampsia, blood clots and problems caused by high blood pressure. Babies born to moms who had Covid-19 were at higher risk of preterm birth and low birth weights.
American Indian and Alaska Native women have been disproportionately affected by Covid-19, and infant mortality rates for this group rose dramatically between 2021 and 2022.
The infant mortality rate was highest among Black infants in 2022, with nearly 11 deaths for every 1,000 live births. But the rate among American Indian and Alaska Native infants surged more than 20% in one year, to more than 9 deaths for every 1,000 live births. The mortality rate among White infants increased more than average but remained lower than in most other racial and ethnic groups, with about 4.5 deaths for every 1,000 live births.
The reproductive health landscape in the US also shifted dramatically in the second half of 2022, after the US Supreme Court’s Dobbs decision revoked the federal right to an abortion.
Recent research has drawn some connections between infant mortality and abortion restrictions, finding that infant deaths spiked in Texas after the state passed a law in September 2021 that banned nearly all abortions beyond about six weeks of pregnancy.
Making this link at the national level is more complicated, Stevenson said.
“A national-level change across the whole year due to a change that would have only been observable in the second half of the year and only in some states would be surprising,” she said. “But I have been surprised before by the magnitude of impacts that restrictions on abortion and contraception can have on infant outcomes.”
Of the 14 states that have enacted near-total bans on abortion since the Dobbs decision, all but two had an higher-than-average infant mortality rate in 2022, CDC data shows.