Infant Mortality

What is Infant Mortality?

The Centers for Disease Control and Prevention defines infant mortality as the death of an infant before his or her first birthday. The infant mortality rate (IMR) is the number of infant deaths for every 1,000 live births. The IMR provides key information about both maternal and infant health and is an important marker of the overall health of a society.

Alabama’s Infant Mortality Rate compared to the national infant mortality rate

In 2023, Alabama’s infant mortality rate was 7.8 deaths per 1,000 live births, with 449 infants dying before reaching their first birthday. The state’s infant mortality rate was above the U.S. 2023 provisional rate of 5.6 infant deaths per 1,000 live births[1]

Who is this disparity affecting?

Disparities in infant mortality by race continue to persist. Infant mortality increased in Alabama in 2023, however racial disparities continue to persist. The infant mortality rate of black infants remains well over twice that of white infants. In 2023, black infants died at a rate of 13.2 infant deaths per 1,000 live births, while deaths among other infants and white infants occurred at rates of 7.8 infant deaths per 1,000 births and 5.7 infant births per 1,000 live births, respectively. Incorporating evidence-based efforts will help address factors impacting health outcomes such as poverty, unemployment, education, urban/rural, access to health.

These factors, which contribute to health outcomes, are formed by the historical, social, political, and economic forces in the individual’s environment. Thus, addressing the factors that contribute to health outcomes and social determinants of health will improve individual and population health and will also advance health equity within the state. Resources that enhance quality of life can have a significant influence on population health.[2]

 Why is this important to know?

Social determinants of health, such as race, poverty, and education play a significant role in the infant mortality rate in our state. Healthy mothers, babies, and families are the foundation of a healthier Alabama. With the purpose of improving, promoting, and protecting health, it is essential that we address the factors that contribute to both maternal and infant poor health outcomes.

What are the three leading causes of infant mortality in Alabama?

Most often, there is no single factor that causes the death of an infant, and it is often the result of several contributing and associated factors. Leading causes of infant death that contribute to infant mortality in Alabama include birth defects, low birthweight & preterm births, and sudden infant death syndrome (SIDS). Associated factors include race, where one lives, environmental influences, and available resources known as social determinants of health or health inequities.

1. Birth Defects - were the leading cause of infant mortality in 2023.
   • Birth defects can occur at any stage of pregnancy. However, most occur within the first 3 months of pregnancy when major organs of the baby are forming. The cause is known for some birth defects, but for many the cause is unknown. Not all birth defects are preventable. In 2023, a total of 93 infant deaths resulted from births defects in Alabama.[3]
   • There are steps that can be taken to increase the chances of having a healthy baby. Women should:
     • Plan ahead, take folic acid daily, and see a healthcare provider regularly.
     • Avoid harmful substances: alcohol, smoking, marijuana, and other drugs.
     • Choose a healthy lifestyle.
     • Talk to their healthcare providers about any medications (prescription and over the counter), family history, and vaccinations.
2. Preterm and low birth weight (LBW) - was the second leading cause of infant mortality in 2023.
   • Preterm birth are infants that are born too early- before 37 weeks (about 8 and a half months) of pregnancy have been completed.[4] LBW births are defined as infants weighing less than 5 pounds and 8 ounces at delivery.[5] Preterm births comprised 12.9 percent and low birth weight 10.5 percent of the births in 2023, however they accounted for 14.3 percent of all infant deaths in Alabama in 2023.
3. Sudden Infant Death Syndrome (SIDS) - was the third leading cause of infant mortality in 2023.
   • SIDS is the sudden unexplained death of an infant less than 1 year of age that does not have a known cause after a complete investigation including a complete autopsy, examination of the death scene, and medical review of the clinical history.[6] SIDS is sometimes called “crib death” because of its association with the time when the infant was sleeping. SIDS deaths can occur anytime during the first year of life. Most SIDS death occur between 1 month and 4 months of age with 90 percent of SIDS deaths occurring before an infant reaches 6 months of age.

[1] Data for this report have been made available by the Center for Health Statistics and the Maternal and Child Health Epidemiology Branch 

[2] Centers for Disease Control and Prevention: Social Determinants of Health: Know What Affects Health. 

[3] Center for Health Statistics and the Maternal and Child Health Epidemiology Branch

[4] Percentages of Babies Born Low Birthweight by State. 

[5] Centers for Disease Control and Prevention: Preterm Birth. 

[6] National Institute of Child Health and Human Development: SIDS