For the first time in 20 years, the U.S. infant mortality rate rose in 2022, with 5.6 deaths per 1,000 live births—a 3% increase likely influenced by Covid-19 and maternal health complications.

In 2022, the United States experienced its first statistically significant increase in infant mortality in two decades, with over 20,500 infant deaths recorded. Experts point to complications from Covid-19, rising rates of maternal health issues, and recent legislative changes affecting reproductive health as major contributing factors. This uptick highlights persistent racial and regional disparities, as the rate was highest among Black, American Indian, and Alaska Native infants, and in the South and Rust Belt regions. The increase in infant mortality underscores the urgent need for targeted interventions and comprehensive healthcare support for vulnerable populations.

The upward trend of infant mortality in the United States marks a significant shift from a consistently declining pattern observed since at least 1995. With 5.6 deaths per 1,000 live births in 2022, an increase of 3% from the previous year, the nation faces a renewed public health challenge. More than 20,500 infant deaths were reported in this period, underscoring the magnitude of the issue.

Several leading causes have been identified contributing to infant mortality in 2022. These include congenital malformations, disorders related to short gestation and low birth weight, sudden infant death syndrome, unintentional injuries, and maternal complications. Notably, the rate of infant deaths from maternal complications rose by 9% from 2021 to 2022, signaling a dire need for enhanced maternal health care services.

The relationship between infant health and maternal health is becoming increasingly evident. The U.S. continues to struggle with high rates of maternal mortality, which significantly impacts infant mortality rates. Research indicates that Covid-19 played a considerable role in this increase, exacerbating existing health issues and disproportionately affecting certain demographics.

Data reveals that American Indian and Alaska Native women were particularly hard-hit by Covid-19, experiencing a sharp rise in infant mortality between 2021 and 2022. Similarly, the highest rate of infant mortality was recorded among Black infants, with nearly 11 deaths per 1,000 live births. In contrast, White infants had relatively lower mortality rates, highlighting stark racial disparities in health outcomes.

Regional disparities also paint a concerning picture. Infant mortality rates were highest in the South and Rust Belt middle America, regions traditionally known for poorer health outcomes and access to care. Conversely, the Northeast, Northwest, and West regions of the country reported the lowest rates, suggesting that geographic location plays a critical role in infant health.

The legislative landscape surrounding reproductive health has undergone significant changes, particularly after the Supreme Court's Dobbs decision, which revoked the federal right to abortion in mid-2022. Anecdotal reports have emerged of women being forced to carry to term babies that were nonviable, further complicating the health landscape.

Covid-19 also altered the timing and severity of other health risks. For example, the RSV and flu seasons began earlier than usual post-pandemic, potentially contributing to the rise in infant mortality in 2022. These changes have posed additional challenges to an already strained healthcare system.

Despite these troubling trends, there are examples of successful interventions. In Hamilton County, Ohio, targeted efforts to reduce preterm births and improve Black infant mortality rates have shown promising results. These initiatives underscore the importance of localized, targeted efforts in addressing systemic health disparities.

While the infant mortality rate in the U.S. remains high compared to other developed nations, these findings emphasize the critical need for comprehensive healthcare policies and support systems to address this issue. Addressing racial and regional disparities, enhancing maternal healthcare, and adapting to evolving health challenges will be vital in reversing the upward trend in infant mortality.