Top 10 Causes of Infant Death in the United States

The leading causes of infant death in the United States have been relatively stable in recent years. The death rate in the U.S. fell from 6.2 per 1,000 births in 2010 to 5.6 per 1,000 births in 2022. However, the Centers for Disease Control and Prevention (CDC) reported 20,538 infant deaths from any cause in 2022, which reflected an increase of 3% over the previous year.

While the top cause of infant death remains congenital defects, there are increases in infant deaths due to maternal complications of pregnancy. This is a focus of concern, particularly among pregnant Black people who face health disparities due to many factors, including access to care.

This article discusses data from the Top 10 causes of U.S. infant death, as listed in the CDC Vital Statistics Rapid Release Surveillance Report. It notes the increase in infant deaths that occurred in the provisional 2022 data, reflecting the first such rise in 20 years.

Congenital Defects

Female doctor examining newborn baby in incubator — Blend Images / ERproductions Ltd / Getty Images

Congenital defects, also known as birth defects, occur while a fetus is still in the womb. Congenital defects can affect the way the body looks or functions and can range in severity from mild to life-threatening.

Some defects, such as cleft palate, can be easily fixed with surgery. Others, such as Down syndrome, spina bifida, or congenital heart defects, may require lifelong care. Some congenital defects are so severe that a child is unable to survive.

In 2022, 4,000 infants died of a congenital defect. The rate was 109.1 per 100,000 live births, with no change from the previous year.

Preterm Birth and Low Birth Weight

Premature Baby in Incubator NICU Equipment with NICU Nurse — Fuse/Getty Images

Preterm birth, also known as premature birth, is a birth that occurs before the 37th week of pregnancy. Low birth weight is defined as a birth weight of less than 2,500 grams (5 pounds, 8 ounces) regardless of the length of gestation.

Premature babies often have trouble fighting infection because their immune systems aren't yet fully formed. This can lead to an increased risk of pneumonia, sepsis (a blood infection), and meningitis (infection of the membrane around the brain and spinal cord).

Low birth weight can increase the risk of death due to immature organ development, particularly increasing the risk of respiratory distress or intraventricular hemorrhage, which is bleeding in and around the ventricles or the fluid-filled spaces of the brain.

In 2022, 2,876 infants died as a result of preterm birth or low birth weight. The rate was 78.4 per 100,000 live births, a slight drop from the previous year.

Sudden Infant Death Syndrome (SIDS)

Baby sleeping in crib — Lucy von Held/Getty Images

Sudden infant death syndrome (SIDS), also referred to as crib death, is the unexplained, sudden death of a seemingly healthy baby under the age of one. Although the cause of SIDS is unknown, it has been considered to be associated with defects in the portion of a baby's brain that regulates breathing and arousal from sleep.

In 2022, 1,458 infants died as a result of SIDS. The rate of 39.8 per 100,000 live births was essentially unchanged from the previous year.

Infant Accidents

A sign pointing to the emergency room. — ERproductions Ltd/Getty Images

In 2022, 1,349 infants died of unintentionally inflicted injuries, a rate of 36.8 per 100,000 live births. This was a 4% change over 2021.

According to statistics from the CDC, a common cause of injury in infants is accidental suffocation. Suffocation primarily affects babies under 1 year of age and cases increased by 20% in infants across the previous decade.

Suffocation also affects certain groups disproportionately, with suffocation rates among Black children (ages overall) significantly higher despite an overall drop in accidental deaths.

Pregnancy Complications

Woman giving birth — Robert Nystrom/Moment/Getty Images

Maternal pregnancy complications can affect the baby's health, with varying degrees of severity.

These may include:

Preeclampsia: Potentially life-threatening high blood pressure
Placenta previa: Occurring when the placenta is situated low in the uterus
Incompetent cervix: When a weak cervix increases the risk of preterm birth

In 2022, 1,209 infants died as a direct result of maternal complications. The rate of 33 per 100,000 live births reflected a 9% spike from the previous year.

Placenta and Umbilical Cord Complications

Mother Looking At Newborn Crying While Doctors Cutting Umbilical Cord — Deborah Morales/EyeEm/Getty Images

The placenta is an organ in the uterus that supplies the fetus with blood and nutrients needed for survival. The umbilical cord connects the mother to the fetus at the placenta, delivering oxygen and nutrients and taking away waste products, such as carbon dioxide.

Sometimes, complications affecting the placenta or umbilical cord can cause infant death.

Complications that affect the placenta and may lead to infant death include:

Placental infarction: Areas of dead tissue that deprive the fetus of blood
Placental insufficiency: A placenta that doesn't grow in a way that supports fetal development

Cord prolapse is a condition in which the umbilical cord drops out of the cervix and wraps around the baby. Nuchal cord occurs when the umbilical cord wraps around the baby's neck.

Placenta and umbilical cord complications accounted for 631 infant deaths in 2022, a rate of 17.2 per 100,000 live births that dropped from the previous year.

Other Causes

The remaining most common causes of infant death in 2022, according to the CDC, were:

Bacterial sepsis (637 deaths, a rise of 14% over 2021 with 17.4 deaths per 100,000 live births)
Respiratory distress (458 deaths, or 12.5 per 100,000 live births)
Diseases of the circulatory system (358 deaths, or 9.8 per 100,000 live births)
Neonatal hemorrhage (336 deaths, or 9.2 deaths per 100,000 live births)

Summary

Often, early and comprehensive prenatal care can help reduce the risk of infant death and improve the overall long-term health of the mother and baby.

That said, more than 20,000 infants died in the United States in 2022, the year for which the most recent data was available at the time of this update. Congenital defects remain the No. 1 reason but maternal health complications saw rising numbers.

Accidental deaths have been dropping overall, with Sudden Infant Death Syndrome (SIDS) claiming more lives than accidents in recent years. Prevention has helped, though certain groups (Black children in particular) have had a higher risk for suffocation accidents than others.

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