Infant Mortality

The national picture

There were 2,517 infant deaths (deaths under 1 year) in England and Wales in 2014, compared with 2,686 in 2013 and 6,037 in 1984

In 2014, the infant mortality rate was 3.6 deaths per 1,000 live births, the lowest ever recorded in England and Wales

In 2014, the infant mortality rates for very low birthweight babies (under 1,500 grams) and low birthweight babies (under 2,500 grams) were 156.0 and 30.9 deaths per 1,000 live births respectively (1) 

Risk factors

Nationally there are marked social inequalities in infant death rates, which although declining are nevertheless higher than other European countries. This is partly explained by the relatively high levels of babies born preterm or with low birth weights in the UK affected by smoking, obesity and other lifestyle factors which increase risk (2).

Low birth weights are associated with less advantaged socio-economic groups, as is smoking prevalence and teenage pregnancy as shown in table 1 (3)

National Statistics Socio-economic Classification

Infant mortality rate (deaths per 1,000 live births) Perinatal mortality rate (deaths per 1,000 total births)
Table 1 Socio economic classification and infant and perinatal mortality England rate. Source: ONS statistics 2016

Higher managerial, administrative and professional occupations (Groups 1.1, 1.2 and 2)

2.1 5.1
Intermediate occupations (Groups 3 and 4) 3.0 6.0

Routine and manual occupations Groups 5 to 7

5.3 8.3

Other groups at higher risk of infant mortality include babies born to:

  • Mothers with multiple births (twins, triplets or more)
  • Mothers from Black ethnic groups
  • Mothers not born in the UK
  • Single mothers and mothers who register their baby alone
  • Mothers who smoke
  • Mothers who are obese (4)

Smoking in pregnancy increases infant mortality by about 40%. More than a quarter of the risk of sudden unexpected death in infancy is attributable to smoking (5)

Being overweight increases the risk of complications for pregnant women and their babies. The higher a women’s BMI, the higher the risks.

If the BMI is over 30, increased risks include:

  • Miscarriage –1 in 4
  • Gestational diabetes - 3x more likely to develop than less BMI
  • Pre-eclampsia - (BMI over 35) Risk is twice that of a women of BMI under 25
  • Shoulder dystocia - baby’s shoulder becoming stuck during labour
  • Heavier baby - (weighing more that 4kg/8lb 14oz)
  • Increased likelihood of an induction, aided delivery (forceps) and an emergency caesarean section.
  • Premature baby - born before 37 weeks
  • Stillbirth -from an overall risk of 1 in 200 in the UK to 1 in 100 for BMI of 30 or more.
  • Foetal abnormality - Neural Tube defects like spina bifida. If the BMI is over 40, the risk is 3x the risk of a woman with a BMI below 30 (6)

Most (92%) stillbirths occur before labour begins. In a majority of stillbirth registrations (54%) no explanation is recorded. Where a cause is recorded, the major reasons are asphyxia (a deficiency of supply of oxygen to the body), anoxia (total deprivation of supply of oxygen) or trauma. These collectively explain 25% of stillbirths. Congenital abnormalities and chromosomal disorders, which can both lead to low growth, account for a further 15% (7)

 

References

(1) British association for child and adolescent public health, National Children’s Bureau and the Royal College of Paediatrics and Child Health 2014 

(2) (Smoking and reproduction). (Department of Health (2007) Review of the health inequalities infant mortality PSA target. London: Department of Health)

(3) Centre for Maternal and Child Enquiries and Royal College of Obstetricians and Gynaecologist (2010): Management of Women with Obesity in Pregnancy

(4) Public Health England: Noo about Maternal Obesity

(5) Public Health England  2014 Key Facts on Infant Mortality and Stillbirths

(6) Health Inequalities/Department of Health 2007 Implementation Plan for Reducing Health Inequalities in Infant Mortality: A good practice guide

(7) Public Health England  2014 Key Facts on Infant Mortality and Stillbirths

 


Last updated Friday, 3rd November 2017