Selina Nath1, Pia Hardelid1, Ania Zylbersztejn1. 1. Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
Abstract
BACKGROUND: Infant mortality has been rising in England since 2014. We examined potential drivers of these trends. METHODS: We used aggregate data on all live births, stillbirths and linked infant deaths in England in 2006-2016 from the Office for National Statistics. We compared trends in infant mortality rates overall, excluding births at <24 weeks of gestation, by quintile of SES and gestational age. RESULTS: Infant mortality decreased from 4.78 deaths/1000 live births in 2006 to 3.54/1000 in 2014 (annual decrease of 0.15/1000) and increased to 3.67/1000 in 2016 (annual increase of 0.07/1000). This rise was driven by increases in deaths at 0-6 days of life. After excluding infants born at <24 weeks of gestation, infant mortality continued to decrease after 2014. The risk of infant death was 94% higher in the most versus least deprived SES quintile, which reduced to a 55% higher risk after adjusting for gestational age. CONCLUSIONS: The observed increase in infant mortality rates since 2014 is wholly explained by an increasing number of deaths at 0-6 days of age among babies born at <24 weeks of gestation. Policies focused on improving maternal health to reduce preterm birth could substantially reduce the socio-economic gap in infant survival.
BACKGROUND:Infantmortality has been rising in England since 2014. We examined potential drivers of these trends. METHODS: We used aggregate data on all live births, stillbirths and linked infantdeaths in England in 2006-2016 from the Office for National Statistics. We compared trends in infantmortality rates overall, excluding births at <24 weeks of gestation, by quintile of SES and gestational age. RESULTS:Infantmortality decreased from 4.78 deaths/1000 live births in 2006 to 3.54/1000 in 2014 (annual decrease of 0.15/1000) and increased to 3.67/1000 in 2016 (annual increase of 0.07/1000). This rise was driven by increases in deaths at 0-6 days of life. After excluding infants born at <24 weeks of gestation, infantmortality continued to decrease after 2014. The risk of infantdeath was 94% higher in the most versus least deprived SES quintile, which reduced to a 55% higher risk after adjusting for gestational age. CONCLUSIONS: The observed increase in infantmortality rates since 2014 is wholly explained by an increasing number of deaths at 0-6 days of age among babies born at <24 weeks of gestation. Policies focused on improving maternal health to reduce preterm birth could substantially reduce the socio-economic gap in infant survival.
Authors: Nhung T H Trinh; Sophie de Visme; Jérémie F Cohen; Tim Bruckner; Nathalie Lelong; Pauline Adnot; Jean-Christophe Rozé; Béatrice Blondel; François Goffinet; Grégoire Rey; Pierre-Yves Ancel; Jennifer Zeitlin; Martin Chalumeau Journal: Lancet Reg Health Eur Date: 2022-03-01
Authors: Alice Harpur; Jon Minton; Julie Ramsay; Gerry McCartney; Lynda Fenton; Harry Campbell; Rachael Wood Journal: BMC Public Health Date: 2021-05-27 Impact factor: 3.295