U.S. infant mortality rate rose last year by largest increase in two decades

The U.S. infant mortality rate rose 3 percent last year — the largest increase in two decades — and Iowa is among four states where the rate soared, according to the U.S. Centers for Disease Control and Prevention.

White and Native American infants, infant boys and babies born at 37 weeks or earlier had significant death rate increases. The report, published Wednesday, also noted larger increases for two of the leading causes of infant deaths — maternal complications and bacterial meningitis.

“It’s definitely concerning, given that it’s going in the opposite direction from what it has been,” said Marie Thoma, a University of Maryland researcher who studies maternal and infant mortality.

Dr. Eric Eichenwald, a Philadelphia-based neonatologist, called the new data “disturbing,” but said experts at this point can only speculate as to why a statistic that generally has been falling for decades rose sharply in 2022.

RSV and flu infections rebounded last fall after two years of pandemic precautions, filling pediatric emergency rooms across the country. “That could potentially account for some of it,” said Eichenwald, who chairs an American Academy of Pediatrics committee that writes guidelines for medical care of newborns.

Infant mortality is the measure of how many babies die before they reach their first birthday. Because the number of babies born in the United States varies from year to year, researchers instead calculate rates to better compare infant mortality over time.

The U.S. infant mortality rate has been worse than other high-income countries, which experts have attributed to poverty, inadequate prenatal care and other possibilities. But even so, the U.S. rate generally gradually has improved because of medical advances and public health efforts.

The national rate rose to 5.6 infant deaths per 1,000 live births in 2022, up from 5.44 per 1,000 the year before, the new report said.

Nevada was the only state where the infant mortality rate significantly declined. More than 30 states saw at least slight rises in the rates in 2022, but four states had statistically significant increases — Georgia (13 percent), Iowa (30 percent), Missouri (16 percent) and Texas (8 percent).

Iowa’s infant death rate per 1,000 live births rose from 3.99 to 5.20 — a 30 percent jump. Iowa saw 147 babies die in 2021, and recorded 36,835 births. The next year, the deaths rose to 190 as the number of births slightly declined, to 36,506.

In numbers only, Georgia had 116 more infant deaths than the year before, and Texas had 251 more. Nationwide, infant deaths surpassed 20,500 in 2022 — 610 more than the year before.

“It would appear that some of the states could be having a larger impact on the (national) rate,” Ely said, adding that smaller increases elsewhere also have an effect — and that it’s hard to parse out exactly what places, policies or other factors are behind the national statistic.

“These tragedies are unacceptable,” Iowa Republican U.S. Sen. Chuck Grassley told reporters Wednesday during a conference call. “More needs to be done to improve outcomes for moms and babies.”

The U.S. Senate last month unanimously passed a bipartisan bill introduced by Grassley to ensure certain stillbirth prevention initiatives can qualify for existing federal funding. Republican U.S. Rep. Ashley Hinson, of Marion, joined others in introducing companion legislation to be considered in the U.S. House.

Grassley said he’s also working to pass legislation to modernize maternal health care through telehealth services to support women of color and women living in rural America. The legislation also aims to reduce maternal mortality and high-risk pregnancies by identifying and better understanding social determinants of health in pregnant and postpartum women.

“This bill also improves whole-person care through community-based efforts and by expanding the maternal health workforce,” Grassley said.

Congress last year also reauthorized the Maternal, Infant and Early Childhood Home Visiting Program through 2027. The program provides resources and skills to at-risk mothers during and after pregnancy to raise children who are physically, socially and emotionally healthy.

“Know that I’m going to continue to keep a close eye on the data as we craft pro-women, pro-family polices to reduce infant and maternal mortality in the United States,” Grassley said.

The infant mortality rate increase may seem small, but it’s the first statistically significant jump in the rate since the increase between 2001 and 2002, said Danielle Ely, the CDC report's lead author. She also said researchers could not establish whether the 2022 rise was a one-year statistical blip — or the beginning of a more lasting trend.

Overall in the United States, the death rate fell 5 percent in 2022 — a general decrease that's been attributed to the waning impact of the COVID-19 pandemic, especially on people 65 and older. U.S. maternal deaths also fell last year.

Tom Barton of The Gazette’s Des Moines Bureau contributed to this report.