Fall in infant deaths after consecutive rises in rates

Author: Caroline White

The death rate among infants in England and Wales has fallen after consecutive rises between 2014 and 2017, show the latest figures* from the Office for National Statistics (ONS).

But the birth rate in England and Wales has also been falling, and there’s been no change in death rates among newborns, the figures indicate.

In 2018, the infant death rate fell to 3.8 deaths per 1000 live births in England and Wales, compared with 3.9 in 2017. This is still higher than the lowest recorded rate of 3.6 in 2014.

Some 2488 infants under the age of 12 months died in England and Wales in 2018. This is the lowest number since records began in 1980, but birth rates have been falling in recent years too.

Rates were significantly higher in the 10% most deprived areas compared with the 10% least deprived in England and Wales.

The sharpest decrease has been among mothers aged 40 and older, falling from 5.8 deaths per 1000 live births in 2010 to 4.8 in 2018.

The infant death rate was highest among babies of Pakistani ethnicity. Since 2006, rates have fallen for babies born in all ethnic groups with the exception of Bangladeshi and Indian ethnicities.

In 2018, the death rate among newborns remained the same as in 2017, at 2.8 deaths per 1000 live births in England and Wales.

The recent increase in the proportion of live births under 24 weeks has contributed to a recent increase in this rate, from 2.5 deaths per 1000 live births in 2014 to 2.8 deaths in 2017.

“The earlier a baby is born, in terms of completed weeks of pregnancy, the higher the risk of infant death. One factor affecting the neonatal mortality rate is the number of babies born before 24 weeks’ gestation,” commented Gemma Quayle, ONS Vital Statistics Outputs Branch.

“Our latest analysis shows this number has increased in recent years. Taking a closer look at these trends is increasingly relevant for policy-makers and health practitioners in order to monitor progress against the government ambition to halve 2010’s stillbirth and neonatal mortality rates by 2025,” she added.

The overall decline in infant mortality rates in recent decades is likely to reflect general improvements in healthcare and more specific improvements in midwifery and neonatal intensive care.

The government has a target to halve stillbirth and neonatal death rates by 2025 compared with 2010.

In 2018, the stillbirth rate in England reached its lowest level on record, at 4.0 stillbirths per 1,000 births, down from 5.1 stillbirths in 2010. But achieving the ambition would mean reducing the stillbirth rate to 2.6 stillbirths per 1000 births by 2025.

If the total number of births were to remain constant until 2025, this would require the number of stillbirths to fall from 2520 in 2018 to 1633 in 2025, a decrease of 887.

The death rate among newborns would also need to fall to 1.5 deaths per 1000 live births by 2025. If the number of live births were to remain constant until 2025, this would require the number to fall from 1742 in 2018 to 938 in 2025, a decrease of 804.

Almost half of deaths among newborns in England and Wales are caused by immature respiratory and cardiovascular systems. Congenital anomalies, such as heart and neural tube defects, account for nearly a third (30%) of the total, followed by infections, which account for another 10%. In England, 1.4 newborn deaths per 1000 live births were caused by immaturity-related conditions alone in 2018.

*Child and infant mortality rates in England and Wales 2018. Office for National Statistics, 20 February 2020.