4. Infant mortality rates increase in England and Wales in 2016

There were 2,651 infant deaths that occurred in England and Wales in 2016. The infant mortality rate was 3.8 deaths per 1,000 live births, an increase from 3.7 deaths per 1,000 live births in 2015. The increased infant mortality rate can be attributed to the 2.8% increase in the number of infant deaths in 2016 compared with 2015, along with the 0.2% decrease in the number of live births over this period.

The infant mortality rate has been following a downward trend since the 1990s, until 2015, where the rate began to increase.

However, over the past 30 years, the rate of decline of the infant mortality rate has varied, with the decrease between 1996 and 2006 being half as much as was recorded between 1986 and 1996. In contrast, the decrease in the past 10 years was higher than that of the decade before (Figure 1). Since 1986, when the rate was 9.6 deaths per 1,000 live births, there has been a 60.4% fall in the infant mortality rate in England and Wales.

Figure 1: Infant, neonatal, postneonatal and perinatal mortality rates, 1986 to 2016 England and Wales Source: Office for National Statistics Notes: Deaths occurring in a calendar year. Perinatal – stillbirths and early neonatal deaths. Neonatal – deaths of those aged under 28 days. Postneonatal – deaths of those aged between 28 days and 1 year. Infant – deaths of those aged under 1 year. Rates – perinatal deaths per 1,000 total births. Neonatal, postneonatal and infant deaths per 1,000 live births. Stillbirth – the Stillbirth Definition Act 1992 changed the definition of a stillbirth from a baby being born after 28 weeks completed gestation to a baby being born after 24 weeks (which did not breathe or show any other signs of life). This means that data for 1993 onwards are not directly comparable with data for stillbirths before the introduction of the Act. Download this chart Figure 1: Infant, neonatal, postneonatal and perinatal mortality rates, 1986 to 2016 Image .csv .xls

Several different factors are associated with increased risk of infant death and these vary according to age at death. Evidence in the Marmot Review: Fair Society, Healthy Lives (PDF, 16.2MB) noted that factors, including births outside marriage, maternal age under 20 years and deprivation, were independently associated with an increased risk of infant mortality. The review went on to say that, “low birthweight in particular, is associated with poorer long-term health outcomes and the evidence also suggests that maternal health is related to socioeconomic status.”

Over the last three decades, the neonatal mortality rate (deaths of those aged under 28 days) has been declining, until 2015, when the rate started to increase. There has also been a fall in the postneonatal mortality rate (deaths of those aged between 28 days and 1 year) since 1986 but the rate has remained at 1.1 deaths per 1,000 live births since 2014. The neonatal and postneonatal mortality rates have fallen by 49.1% and 74.4% respectively since 1986.

In 2016, there were 3,112 stillbirths and 1,515 deaths at age under 7 days, resulting in a perinatal mortality rate of 6.6 deaths per 1,000 total births, compared with 6.5 deaths per 1,000 in the previous year. The number of stillbirths decreased from 3,147 in 2015 but deaths at age under 7 days increased from 1,436 in 2015. Since 1993, following the change to the stillbirth definition, the perinatal mortality rate has fallen by just over one-quarter.