Infant mortality

Introduction

The level of infant mortality is an important indicator of the nation’s health.  Infant mortality is defined as the number babies dying before the age of one year for every 1,000 live births.

In England, rates have been falling over recent years and are at an all-time low.  The infant mortality rate decreased in 2014 to 3.9 deaths per thousand live births, compared with 4.0 in 2013.

Immaturity-related conditions, for example, respiratory and cardiovascular disorders, were the most common cause of infant deaths in 2013 at 44% (a fall of 1% from 2012). Congenital anomalies accounted for 28% of all infant deaths (34% in 2012). Congenital anomalies accounted for 32% of all postneonatal deaths and 27% of all neonatal deaths (compared to 43% and 30% in 2012 respectively).

Key inequalities and risk factors

Writing in the British Medical Journal (Gardosi. J. et al. 2013) suggest a number of risk factors for infant mortality including maternal age, ethnic origin, place of birth, maternal mental health, maternal obesity, pre-existing hypertension, diabetes, cardiac disease, previous stillbirths, smoking in pregnancy, alcohol consumption, diet and nutrition.

The Marmot Review: Fair Society, Healthy Lives noted that factors, including births outside marriage, maternal age under the age of 20 and deprivation, were also independently associated with an increased risk of infant mortality.

Low birthweight is an enduring aspect of childhood morbidity, a major factor in infant mortality and has serious consequences for health in later life (NICE). There are social inequalities in low birthweight in England and Wales and these inequalities are likely to affect childhood and adult health inequalities in the future. The rate of infant mortality for very low birth weight babies in 2011 (less than 1500 grams) was 172.1 per 1,000 live births (Office for National Statistics, 2012). This compared with a rate of 1.4 deaths per 1,000 live births among babies of normal birth weight (2500 grams and over).

The infant mortality rate is highest among babies of mothers aged below 20 years and those aged 40 years and over.  Babies of mothers aged 20 years and under tend to have the highest rates of post neonatal mortality. Stillbirth and perinatal mortality rates tend to be higher in babies of mothers aged 40 years and over.

Consideration of the needs of certain women at higher risk of stillbirths and infant deaths compared to mothers born in the UK, e.g. mothers born in Africa, the Middle East and Asia, and mothers with three or more previous children.

Other risk factors include:

• single mothers and mothers who register their baby alone
• families in routine and manual socio-economic groups

Facts, figures and trends

Infant mortality

Infant mortality describes the number of deaths to children aged less than one year and is presented as a rate per 1,000 live births. The figure is averaged over three years because the numbers are small and likely to vary year on year.

The infant mortality rate is lower in Bracknell Forest that the national and regional figures:

Sources: Infant mortality and still birth profiles, Public Health England 2011-2013, Office of National Statistics 2012-2014

In Bracknell Forest infant mortality rates showed an increase between 2002-4 and 2005-7, at just under 5 per 1,000 live births in 2005-7. Since 2005-7 this rate has been decreasing to the rate of 2.6 seen in 2011-13. Rates have remained lower than the England average and comparable to that of local authorities with similar levels of deprivation.

Source: Office for National Statistics, 2015

Neonatal mortality

Neonatal mortality describes the number of deaths which happen in babies who are less than 28 days old.  Figures are shown as a rate per 1,000 live births and averaged over three years worth of data. This is because the numbers are small and likely to vary year on year.

Neonatal mortality in Bracknell Forest is comparable to the national average:

Source: Infant mortality and still birth profiles, Public Health England 2011-2013, Office for National Statistics 2012-2014

Still births

Still birth rate describes the rate of still births per 1,000 total births. A still born baby is a baby who is born dead after 24 completed weeks of pregnancy. The figure is averaged over three years worth of data. This is because the numbers are small and likely to vary year on year.

There has been no statistically significant change in the rate of stillbirths since 2001 (between 5.3 and 4.1 per 1,000 births).The still birth rate in Backnell Forest is lower than the national average:

Source: Infant mortality and still birth profiles, Public Health England 2011-2013, Office of National Statistics 2012-2014

Want to know more?

Improving access to good antenatal healthcare, including the range of antenatal screening programmes, is essential in order to identify needs and risks to mothers and babies at an early stage.

There are a range of biological and social risk factors linked to infant mortality (see above). These include birth weight, mother’s age, country of birth and socio-economic position of the family and the number of births a woman has had previously (parity).

National Child and Maternal Health Intelligence Network – Dynamic Report for Bracknell Forest gives high level statistical data and analysis on infant mortality

Public health interventions to reduce smoking in pregnancy and reduce obesity and improve maternal nutrition are likely to play a significant role in reducing the incidence of low birth weight babies thus contributing to a reduction in overall infant mortality rates. GPs are well placed to discuss the negative impact on health outcomes for mother and baby and can offer appropriate lifestyle advice and referral to local weight management services.

Each Baby Counts project (Royal College of Obstetricians and Gynaecologists) – commits to reducing avoidable incidents during labour and at term resulting in stillbirth, early neonatal death or severe brain injury by 50 per cent by 2020.  From March 2016 data will be collated from local investigations of such serious events in the hope of identifying themes which may help shape changes in practice around the country.

Antenatal Care (NICE, 2008) – an outline of best practice in antenatal care covering advice and information during pregnancy, including antenatal and newborn screening programmes, screening for clinical conditions such as gestational diabetes and pre-eclampsia, screening for infections, lifestyle advice, provision of care and management of pregnancy symptoms and breastfeeding.

Healthy Lives, Healthy People: Our strategy for public health in England (HM Government, 2010) – Stresses the importance of improving maternal health as a means of giving children a better start in life, reduce infant mortality and the numbers of low birth-weight babies. It also highlights the importance of early intervention and prevention and initiatives.

The Healthy Child Programme (HCP,  2009) – emphasis on the achievement of increased rates of breastfeeding initiation and continuation, which will contribute specifically to improving breastfeeding and obesity outcomes.

Maternity and Early Years – making a good start to family life (Department of Health, 2010) – the case for helping families to give their baby the best possible start in life and sets out a vision of integrated maternity and early years services at the centre of a wider network of family support.

Maternity Matters: choice, access and continuity of care in a safe service (Department of Health, 2007) – concept of choice around the type of care that women receive, together with improved access to services and continuity of midwifery care and support.

This page was created on 7 March 2014. It was last updated on 25 May 2016.

Cite this page:

Bracknell Forest Council. (2016). JSNA – Infant Mortality. Available at: jsna.bracknell-forest.gov.uk/bracknell-forest-profile/demography/infant-mortality (Accessed: dd Mmmm yyyy)

 

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