Child and infant mortality in England and Wales: 2020

Stillbirths, infant and childhood deaths occurring annually in England and Wales, and associated risk factors.

Hwn yw'r datganiad diweddaraf. Gweld datganiadau blaenorol

This is an accredited National Statistic. Click for information about types of official statistics.

Cyswllt:
Email Gemma Quayle

Dyddiad y datganiad:
17 February 2022

Cyhoeddiad nesaf:
To be announced

1. Main points

  • In 2020, 2,226 infant deaths (aged under one year) and 789 child deaths (aged 1 to 15 years) occurred in England and Wales; these are the lowest numbers of infant and child deaths since records began in 1980.

  • In 2020, the infant mortality rate was 3.6 deaths per 1,000 live births in England and Wales; while this follows a general decline since 1980, the infant mortality rate has remained fairly stable since 2014.

  • In 2020, the neonatal mortality rate (aged under 28 days) was 2.7 deaths per 1,000 live births in England and Wales; this rate has remained stable since 2016.

  • In 2020, the main causes of death among children aged 28 days to 15 years continued to be congenital malformations, deformations and chromosomal abnormalities.

  • In 2020, there were 11 deaths of children aged 28 days to 15 years where the underlying cause was “novel coronavirus (COVID-19)”.

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Delays in birth and death registrations because of the coronavirus pandemic have affected 2020 data, see Section 7: Measuring the data.

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3. Stillbirths and neonatal deaths in England

In the UK, health is a devolved matter. In England, there is an ambition to halve the stillbirth rate and the neonatal mortality rate by 2025, compared with 2010.

The stillbirth ambition is for the rate to decrease to 2.6 stillbirths per 1,000 births by 2025. The 2020 rate was 3.8 stillbirths per 1,000 births (Figure 2), unchanged since 2019. If the number of 2025 births were the same as in 2020, achieving the ambition would mean stillbirths decreasing by 704, to 1,527.

Prior to 2021, the ambition covered all neonatal deaths, and required the neonatal mortality rate to fall to 1.5 deaths per 1,000 live births by 2025. In 2021, the ambition was revised, as outlined in the Safer maternity care progress report 2021.The ambition was changed to 1.0 neonatal deaths per 1,000 live births for babies born at 24 weeks or over. In 2020, this rate continued the recent gradual decline, to 1.3 deaths per 1,000 live births. If 2025 live births were the same as in 2020, achieving the revised ambition would mean reducing neonatal deaths among babies born at 24 weeks and over by 152, to 581.

Figure 2: Progress towards stillbirth and neonatal death ambition since 2010

Stillbirths and neonatal mortality rates, England, 2010 to 2020

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In Wales the stillbirth rate was 4.4 per 1,000 births. The neonatal mortality rates were 2.9 per 1,000 live births for babies of all gestations, and 1.4 per 1,000 live births for babies born at 24 weeks and over.

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4. Neonatal and infant mortality risk factors

Gestational age

Gestational age is associated with neonatal mortality risk. In 2020, the slight decline in the overall neonatal mortality rate (Figure 3) corresponded with a decrease in the proportion of births under 24 weeks gestation that were live births.

Cause of death

Congenital malformations, deformations and chromosomal abnormalities continued to be the leading cause of death among children aged 28 days to 15 years, followed by neoplasms. Immaturity-related conditions continue to account for approximately 50% of neonatal deaths in 2020, with congenital anomalies and antepartum infections together accounting for another 38%.

For children aged 28 days to 15 years, “novel coronavirus (COVID-19)” was the underlying cause of death of 11 children in 2020 and was mentioned on the death certificate of an additional two children. These deaths account for 1% of deaths of children in this age group that occurred in 2020. These figures differ to other mortality statistics on deaths due to and involving COVID-19, which are based on the number of deaths registered in a reference period, rather than when they occurred.

Birthweight

Low birthweight is associated with an increased risk of poor outcomes at birth.

For low birthweight babies, the infant mortality rate was 27.9 deaths per 1,000 live births in 2020, compared with normal birthweight babies where the rate was 0.8 deaths per 1,000 live births.

Ethnicity

Infant mortality rates differ by ethnicity of baby. In 2020, babies from the Black ethnic group continued to have the highest rate, followed by the Asian ethnic group (Figure 4). Small numbers of births and deaths in some ethnic groups can cause rates to fluctuate over time. Future data will confirm whether decreases seen in 2020 for these groups will be sustained.

Maternal age

Infant mortality rates continue to vary by maternal age. In 2020, babies born to mothers aged 30 to 34 years had the lowest risk of infant mortality at 3.0 deaths per 1,000 live births. Babies born to mothers aged 40 years and over had the highest risk at 4.8 deaths per 1,000 live births.

Deprivation

Infant mortality risk varies by socio-economic background. In 2020, the 10% most deprived areas in England had higher infant mortality rates compared with the 10% least deprived areas. These trends were consistent with previous years. Equivalent trends in Wales are more difficult to assess because of fewer infant deaths and resultant fluctuation.

In 2020, babies with a parent from higher managerial, administrative and professional backgrounds had a rate of 2.6 deaths per 1,000 live births. Babies with a parent from routine and manual backgrounds had a rate of 4.8 deaths per 1,000 live births.

Other known risk factors

There are a range of other risk factors (PDF, 1.05MB) associated with infant mortality that we are unable to assess from the data we currently have available. Examples of these include maternal health factors such as smoking, alcohol consumption and obesity.

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5. Child and infant mortality data

Child mortality (death cohort) tables in England and Wales
Dataset | Released 17 February 2022
Live births, stillbirths and linked infant deaths occurring annually in England and Wales, and associated risk factors.

Infant mortality (birth cohort) tables in England and Wales
Dataset | Released 17 February 2022
Annual statistics on births and infant deaths based on babies born in a calendar year that died before their first birthday linked to their corresponding birth notification and their corresponding death registration.

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6. Glossary

Stillbirth

A baby born after 24 or more weeks completed gestation and which did not, at any time, breathe or show signs of life.

Early neonatal

The death of an infant aged under seven days.

Perinatal

A baby who was recorded as either a stillbirth or early neonatal death.

Neonatal

The death of an infant aged under 28 days.

Postneonatal

The death of an infant aged 28 days to 1 year.

Infant

The death of those aged under one year.

Child

The death of those aged 1 to 15 years.

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7. Measuring the data

Child and infant mortality data are based on deaths occurring in 2020. In normal circumstances, deaths of all ages are typically registered within five days. In the case of infant deaths, this delay can be much longer if the death requires coroner investigation. Consequently, our annual death cohort for infant deaths occurring in 2020 includes infant deaths registered before 1 October 2021.

Coronavirus and child and infant mortality statistics

It is possible that registration delays for infant deaths have been longer than normal during the coronavirus (COVID-19) pandemic. Infant deaths that occurred in 2020 may have not yet been captured by the data included in this release.

We are continuing to monitor the implications of any delays in 2020 death registrations on our data coverage. We are also exploring the possibility of using alternative data sources to estimate child and infant deaths in a timelier manner.

Linking infant deaths to their corresponding birth registration and birth notification improves our understanding of the main characteristics of the baby and the baby’s parents. Prior to 2020, over 95% of infant deaths were successfully linked to their birth registration and birth notification.

In 2020 the linkage rate was lower than normal at 90.5%, which is likely to have been affected by birth registration delays during the coronavirus pandemic. More information can be found in our User guide to child and infant mortality statistics.

Differences between the ONS and MBRRACE-UK figures

The Office for National Statistics’ (ONS) figures on perinatal mortality are based on all births and deaths registered via the General Register Office regardless of gestational age, and all stillbirths registered at 24 weeks or more gestation in line with the Stillbirth (Definition) Act 1992.

Births below 24 weeks gestational age and births that resulted in a death following termination of pregnancy are excluded from the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) figures on stillbirth and neonatal mortality rates. Reasons for these exclusions can be found in the Child and infant mortality statistics Quality and Methodology Information (QMI) report.

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8. Strengths and limitations

More information on the strengths, limitations and accuracy of the data are available in the Child and infant mortality statistics Quality and Methodology Information (QMI) report.

Our User guide to child and infant mortality statistics provides further information on data quality, legislation and procedures relating to mortality and cause of death coding, and includes a full glossary of terms.

National Statistics status for child and infant mortality

National Statistics status means that our statistics meet the highest standards of trustworthiness, quality and public value, and it is our responsibility to maintain compliance with these standards.

The most recent assessment and compliance check (PDF, 152MB), confirms National Statistics status in May 2012. The improvements since the last review are that we:

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Manylion cyswllt ar gyfer y Bwletin ystadegol

Gemma Quayle
health.data@ons.gov.uk
Ffôn: +44 1329 444110