Instructions for classifying the underlying cause of death, 2021. NCHS Instruction Manual, part 2a. Hyattsville, MD. 13. National Center for Health Statistics.
NCHS Instruction. Manual, part 9. Hyattsville, MD. 2011. List of Detailed Tables. 1. Live births, infant, neonatal, and postneonatal deaths ...
National Vital Statistics Reports Volume 70, Number 14 December 8, 2021 Infant Mortality in the United States, 2019: Data From the Period Linked Birth/Infant Death File by Danielle M. Ely, Ph.D., and Anne K. Driscoll, Ph.D. Abstract Objectives--This report presents 2019 infant mortality statistics by age at death, maternal race and Hispanic origin, maternal age, gestational age, leading causes of death, and maternal state of residence. Trends in infant mortality are also examined. Methods--Descriptive tabulations of data are presented and interpreted for infant deaths and infant mortality rates using the 2019 period linked birth/infant death file. The linked birth/infant death file is based on birth and death certificates registered in all states and the District of Columbia. Results--A total of 20,927 infant deaths were reported in the United States in 2019, down 3% from 2018. The U.S. infant mortality rate was 5.58 infant deaths per 1,000 live Figure 1. Infant, neonatal, and postneonatal mortality rates: United States, 19952019 8 Infant 6 Neonatal 4 Deaths per 1,000 live births Postneonatal 2 0 1995 1997 1999 2001 2003 2005 2007 2009 SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. 2011 2013 2015 2017 2019 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm. 2 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 births, a historic low for the country, although not significantly different from the rate of 5.67 in 2018. The neonatal mortality rate declined to 3.69 in 2019 from 3.78 in 2018, while the postneonatal mortality rate was unchanged from 2018 at 1.89. The mortality rate declined for infants of non-Hispanic white women in 2019 compared with 2018; declines in rates for the other race and Hispanic-origin groups were not significant. The 2019 infant mortality rate for infants of non-Hispanic black women (10.62) was more than twice as high as that for infants of non-Hispanic white (4.49), non-Hispanic Asian (3.38), and Hispanic (5.03) women. Infants born very preterm (less than 28 weeks of gestation) had the highest mortality rate (374.46), 184 times as high as that for infants born at term (3741 weeks of gestation) (2.03). The five leading causes of infant death in 2019 were the same as in 2018. Infant mortality rates by state for 2019 ranged from a low of 3.21 in New Hampshire to a high of 8.71 in Mississippi. Keywords: infant death · maternal and infant characteristics · vital statistics · National Vital Statistics System Introduction This report presents infant mortality statistics based on data from the 2019 period linked birth/infant death file. Infant mortality and mortality rates are described by age at death, maternal race and Hispanic origin, maternal age, gestational age, leading causes of death, and maternal state of residence in the United States. Infant mortality trends are also presented by selected characteristics. In the linked file, information from the death certificate is linked to information from the birth certificate for each infant under age 1 year who died in the 50 states, District of Columbia (D.C.), Puerto Rico, or Guam during 2019 (1). The purpose of the linkage is to use variables available from the birth certificate to conduct more detailed analyses of infant mortality patterns (2,3). The linked birth/infant death data set also is the preferred source for examining infant mortality by race and Hispanic origin. Infant mortality rates by race and Hispanic origin are more accurately measured from the birth certificate compared with the death certificate. For 2019, linked birth/infant death data are not available for American Samoa, Commonwealth of the Northern Marianas, and U.S. Virgin Islands. Some rates calculated from the mortality file differ from those published using the linked file. More details can be found elsewhere (1). Methods Data shown in this report are based on birth and infant death certificates registered in all states, D.C., Puerto Rico, and Guam. As part of the Vital Statistics Cooperative Program, each state provides matching birth and death certificate numbers for each infant under age 1 year who died during 2019 to the National Center for Health Statistics. Further discussion of the process of linking births and deaths occurring in different states and file production can be found in the Methodology section of the "User Guide to the 2019 Period/2018 Cohort Linked Birth/Infant Death Public Use File" (1). The period linked file for 2017 marked the first data year for which the linked birth data for infant deaths for all 50 states and D.C. were based on the 2003 revision of the U.S. Standard Certificate of Live Birth (4) and, accordingly, the first year for which national data on race and Hispanic-origin categories based on 1997 Office of Management and Budget (OMB) standards became available (5). In 2019, 99.3% of all infant death records were successfully linked to their corresponding birth records. These records were weighted to adjust for the 0.7% of infant death records that were not linked to their corresponding birth certificates (1) (Technical Notes). Information on births for age and race of mother is imputed if it is not reported on the birth certificate. In 2019, race of mother was imputed for 6.8% of births; mother's age was imputed for 0.01% of births (2,3). The race and Hispanic-origin groups shown in this report follow the 1997 OMB standards and differ from the bridged-race categories shown in previous reports (5). The categories are: non-Hispanic single-race white, non-Hispanic single-race black or African American, non-Hispanic single-race American Indian or Alaska Native (AIAN), non-Hispanic single-race Asian, nonHispanic single-race Native Hawaiian or Other Pacific Islander (NHOPI), and Hispanic (for brevity, text references omit the term "single-race"). Race and Hispanic origin are reported separately on the birth certificate. Data are shown in most cases for four specified Hispanic groups: Mexican, Puerto Rican, Cuban, and Central and South American. Additional details on Hispanic origin are available (3). Comparisons between 2019 and 2018 by race and Hispanic origin are made in this report. The 2003 revision of the U.S. Standard Certificate of Live Birth allows the reporting of five race categories for each parent (6)--either alone, as in single race, or in combination, as in more than one race or multiple races--in accordance with the 1997 revised OMB standards (5). Further details on race reporting are available (3). Cause-of-death statistics are classified in accordance with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD10) (7) (Technical Notes). Data by maternal and infant characteristics This report presents descriptive tabulations of infant mortality data by a variety of maternal and infant characteristics. These tabulations are useful for understanding the basic relationships between risk factors and infant mortality, unadjusted for the possible effects of other variables. However, women with one risk factor may often have other risk factors as well. For example, teen mothers are more likely to be unmarried and of a low-income status, while mothers who do not receive prenatal care are more likely to be of a low-income status and uninsured. The preferred method for disentangling the multiple interrelationships among risk factors is multivariate analysis; however, an understanding of the basic relationships between risk factors and infant mortality is the first step before more sophisticated types of analyses and may help identify high-risk subgroups for prevention efforts. This report presents several key risk factors for infant mortality: age at death, maternal race and Hispanic origin, maternal age, gestational age, leading causes of infant death, and maternal National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 3 state of residence. For brevity, additional selected risk factors (sex, birthweight, plurality, and nativity [mother's place of birth]) are presented in tables but not discussed in this report. Race and Hispanic origin--Infant mortality rates are presented by race and Hispanic origin of the mother. The linked file is useful for computing accurate infant mortality rates by these characteristics because the race and Hispanic origin of the mother from the birth certificate are used in both the numerator and denominator of the infant mortality rate. In contrast, for rates based on the vital statistics mortality file, race information for the denominator is the race of the mother as reported on the birth certificate, while race information for the numerator is the race of the decedent as reported on the death certificate (2,3,8). More detail on the reliability of race and Hispanic-origin data from the linked file compared with the mortality file is available (8). Statistical significance--Statements in the text have been tested for statistical significance, and a statement that a given infant mortality rate is higher or lower than another rate indicates that the rates are significantly different using a two-tailed z test at the alpha level of 0.05. Information on the methods used to test for statistical significance, as well as information on differences between period and cohort data, the weighting of the linked file, maternal age, period of gestation, birthweight, and cause-ofdeath classification, also is available (1) (Technical Notes). Results Trends in infant mortality and infant age at death · In 2019, 20,927 infant deaths were reported in the United States, a decline of 3% from 2018 (21,498). The infant mortality rate was 5.58 deaths per 1,000 live births in 2019, a nonsignificant decline from the 2018 rate of 5.67 and the lowest rate reported in U.S. history (Figure 1, Table 1). · The U.S. infant mortality rate has generally trended downward since 1995 (the first year that the period linked birth/infant death file was available) and has declined 19% since 2005, the most recent high (6.86). · The 2019 neonatal mortality rate (infant deaths at less than 28 days) declined 2% to 3.69 from 3.78 in 2018. The neonatal mortality rate has generally declined since 1995 and is also down 19% since 2005 (4.54). · The 2019 postneonatal mortality rate (infant deaths at 28 days or more) was unchanged from 2018 (1.89). The postneonatal mortality rate has also generally declined since 1995 and is also down 19% since 2005 (2.32). Race and Hispanic origin · The mortality rate for infants of non-Hispanic white women declined 3% from 2018 to 2019 (from 4.63 to 4.49 infant deaths per 1,000 births). Declines in rates for infants born to non-Hispanic black (10.75 to 10.62), non-Hispanic AIAN (8.15 to 7.87), non-Hispanic Asian (3.63 to 3.38), and non-Hispanic NHOPI (9.39 to 8.19) women were not significant. A nonsignificant increase was found in the mortality rate for infants of Hispanic women from 2018 to 2019 (4.86 to 5.03) (Tables 1 and 2, Figure 2). · Among Hispanic-origin subgroups, the mortality rate for infants of Central and South American women increased 13% from 2018 to 2019 (4.02 to 4.53); declines in mortality rates for infants of Mexican and Cuban women were not significant between the 2 years. The increase in the mortality rate for infants of Puerto Rican women was not significant (5.61 to 6.17). · In 2019, infant mortality continued to vary by race: Infants of non-Hispanic black women had the highest mortality rate (10.62), followed by infants of non-Hispanic NHOPI (8.19), non-Hispanic AIAN (7.87), Hispanic (5.03), non-Hispanic white (4.49), and non-Hispanic Asian (3.38) women. · Infants of non-Hispanic black women also had the highest neonatal mortality rate in 2019 (6.85) compared with infants of the other race and Hispanic-origin groups; the lowest mortality rate was for infants of non-Hispanic Asian women (2.52). · In 2019, postneonatal mortality rates were higher for infants of non-Hispanic AIAN (3.87), non-Hispanic black (3.77), and non-Hispanic NHOPI (3.17) women than for infants of non-Hispanic white (1.57), Hispanic (1.55), and non-Hispanic Asian (0.85) women. · Among Hispanic-origin subgroups in 2019, infants of Puerto Rican women had the highest mortality rate (6.17), followed by infants of Mexican (4.96), Central and South American (4.53), and Cuban (4.14) women. Maternal age · No significant changes were found in mortality rates for infants of women in any maternal age group between 2018 and 2019. Rates declined for infants of women aged 2039 and increased for infants of women under age 20 and aged 40 and over, but these changes were not significant (Figure 3, Table 2). · Mortality rates were highest for infants of females under age 20 (8.68 infant deaths per 1,000 births), decreased to a low of 4.57 for infants of women aged 3034, and then increased to 7.01 for infants of women aged 40 and over (the second-highest rate). Gestational age · Infant mortality rates declined from 2018 to 2019 for infants born at less than 32 weeks (185.79 to 180.40 infant deaths per 1,000 births) and at 3233 weeks (21.95 to 19.21). Infant mortality rates for all other gestational age categories did not change significantly between 2018 and 2019 (Table, Table 2) (4). · In 2019, 66% of infant deaths occurred among infants born preterm (less than 37 weeks of gestation), unchanged from 2018. 4 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Figure 2. Infant mortality rate, by maternal race and Hispanic origin: United States, 20182019 12 10.75 10.62 10 8 8.15 7.87 2018 2019 9.39 8.19 Infant deaths per 1,000 live births 6 4.63 4.49 4 2 3.63 3.38 4.86 5.03 0 White Black American Indian or Alaska Native Asian Non-Hispanic SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. Native Hawaiian or Other Pacific Islander Hispanic Figure 3. Infant mortality rate, by maternal age: United States, 20182019 10 8.65 8.68 8 6 4 6.90 6.76 5.58 5.47 4.62 4.57 2018 2019 6.99 7.01 5.04 5.03 Infant deaths per 1,000 live births 2 0 Under 20 2024 2529 3034 Maternal age group SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. 3539 40 and over National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 5 Table. Infant mortality rate, by gestational age: United States, 20152019 Year Less than 32 weeks 3233 weeks 3436 weeks 2019. . . . . . . . . . . . . . . . . . . . . . . . . . 2018. . . . . . . . . . . . . . . . . . . . . . . . . . 2017. . . . . . . . . . . . . . . . . . . . . . . . . . 2016. . . . . . . . . . . . . . . . . . . . . . . . . . 2015. . . . . . . . . . . . . . . . . . . . . . . . . . 180.40 185.79 187.56 190.15 193.54 19.21 21.95 20.50 20.12 20.79 Deaths per 1,000 live births 8.21 8.21 8.50 8.65 8.76 SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. 3741 weeks 2.03 2.05 2.10 2.19 2.17 42 weeks or more 5.72 5.39 3.98 4.31 4.20 Leading causes of infant death · In 2019, the five leading causes of all infant deaths were the same as those in 2018: congenital malformations (21% of infant deaths), disorders related to short gestation and low birth weight (17%), maternal complications (6%), sudden infant death syndrome (SIDS) (6%), and unintentional injuries (6%) (Table 3). · From 2018 through 2019, infant mortality rates for unintentional injuries increased from 30.8 infant deaths per 100,000 births to 33.7, while infant mortality rates declined for disorders related to short gestation and low birth weight (97.1 to 92.3) and maternal complications (36.2 to 33.4). Declines in rates for congenital malformations (118.7 to 115.1) and SIDS (35.1 to 33.4) were not significant. · Congenital malformations was the leading cause of death for infants born to non-Hispanic white (105.5), non-Hispanic AIAN (119.5), and Hispanic (127.5) women (Table 4). · Disorders related to short gestation and low birth weight was the leading cause of death for infants of non-Hispanic black (237.0) and non-Hispanic Asian (75.0) women. Infant mortality by state · By state, infant mortality ranged from a low of 3.21 infant deaths per 1,000 births in New Hampshire to a high of 8.71 in Mississippi (Figure 4, Table 5). · Twelve states had infant mortality rates significantly lower than the national infant mortality rate of 5.58: California, Colorado, Connecticut, Idaho, Kentucky, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Oregon, and Washington. Figure 4. Infant mortality rate, by state: United States, 2019 WA OR ID MT WY NV CA UT CO AZ NM AK ND SD NE KS MN WI IA IL MO OK TX AR MS LA HI NH ME VT NY MI IN OH KY TN PA WV VA NC SC AL GA MA RI CT NJ DE MD DC U.S. rate per 1,000 live births: 5.58 8.008.99 7.007.99 6.006.99 FL 5.005.99 4.00 4.99 Less than 4.00 Fewer than 20 infant deaths SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. 6 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 · Fourteen states had infant mortality rates significantly higher than the U.S. infant mortality rate: Alabama, Arkansas, Florida, Georgia, Indiana, Louisiana, Michigan, Mississippi, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, and Tennessee. and adopted by the Twenty-ninth World Health Assembly, 1975 revision. Geneva, Switzerland. 1977. 16. National Center for Health Statistics. ICD10 cause-of-death lists for tabulating mortality statistics (updated March 2011 to include WHO updates to ICD10 for data year 2011). NCHS Instruction Manual, part 9. Hyattsville, MD. 2011. References 1. National Center for Health Statistics. User guide to the 2019 period/2018 cohort linked birth/infant death public use file. Hyattsville, MD. 2021. Available from: https://ftp.cdc.gov/pub/ Health_Statistics/NCHS/Dataset_Documentation/DVS/periodcohort-linked/19PE18CO_linkedUG.pdf. 2. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final data for 2019. National Vital Statistics Reports; vol 70 no 2. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:100472. 3. National Center for Health Statistics. User guide to the 2019 natality public use file. Hyattsville, MD. 2020. Available from: https://ftp. cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/ DVS/natality/UserGuide2019-508.pdf. 4. Ely DM, Driscoll AK. Infant mortality in the United States, 2017: Data from the period linked birth/infant death file. National Vital Statistics Reports; vol 68 no 10. Hyattsville, MD: National Center for Health Statistics. 2019. 5. Office of Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Fed Regist 62(210):5878290. 1997. 6. National Center for Health Statistics. 2003 revisions of the U.S. Standard Certificates and Reports. Available from: https://www. cdc.gov/nchs/nvss/vital_certificate_revisions.htm. 7. World Health Organization. International statistical classification of diseases and related health problems, 10th revision (ICD10). 2nd ed. Geneva, Switzerland. 2004. 8. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf. 9. National Center for Health Statistics. U.S. Standard Certificate of Live Birth. 2003. Available from: https://www.cdc.gov/nchs/data/ dvs/birth11-03final-ACC.pdf. 10. Xu JQ, Murphy SL, Kochanek KD, Arias E. Deaths: Final data for 2019. National Vital Statistics Reports; vol 70 no 8. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:106058. 11. Martin JA, Osterman MJK, Kirmeyer SE, Gregory ECW. Measuring gestational age in vital statistics data: Transitioning to the obstetric estimate. National Vital Statistics Reports; vol 64 no 5. Hyattsville, MD: National Center for Health Statistics. 2015. 12. National Center for Health Statistics. Instructions for classifying the underlying cause of death, 2021. NCHS Instruction Manual, part 2a. Hyattsville, MD. 13. National Center for Health Statistics. Vital statistics ICD10 ACME decision tables for classifying underlying causes of death, 2016. NCHS Instruction Manual, part 2c. Hyattsville, MD. 14. National Center for Health Statistics. Mortality multiple cause-ofdeath public use data file documentation (published annually). Hyattsville, MD. 2016. 15. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the recommendations of the Ninth Revision Conference, 1975, List of Detailed Tables 1. Live births, infant, neonatal, and postneonatal deaths, and mortality rates: United States, 19952019, and by race and Hispanic origin, 20172019. . . . . . . . . . . . . . . . . . . . . . . . . 7 2. Infant mortality rates, live births, and infant deaths, by selected characteristics and by race and Hispanic origin of mother: United States, 2019 . . . . . . . . . . . . . . . . . . . . . . . . 9 3. Infant deaths, percentage of deaths, and infant mortality rates, by five leading causes of infant death: United States, 20102019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 4. Infant deaths and mortality rates for the five leading causes of infant death, by race and Hispanic origin of mother: United States, 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 5. Infant mortality rate: United States and each state, 2019. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 7 Table 1. Live births, infant, neonatal, and postneonatal deaths, and mortality rates: United States, 19952019, and by race and Hispanic origin, 20172019 Number Deaths per 1,000 live births Year and race and Hispanic origin Live births Postneonatal Infant deaths Neonatal deaths deaths Infant Neonatal Postneonatal All race and Hispanic-origin groups 2019. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,747,540 20,927 13,834 7,093 5.58 3.69 1.89 2018. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,791,712 21,498 14,329 7,169 5.67 3.78 1.89 2017. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,855,500 22,341 14,844 7,497 5.79 3.85 1.94 2016. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,945,875 23,157 15,303 7,854 5.87 3.88 1.99 2015. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,978,497 23,458 15,672 7,786 5.90 3.94 1.96 2014. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,988,076 23,211 15,737 7,474 5.82 3.95 1.87 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,932,181 23,446 15,893 7,553 5.96 4.04 1.92 2012. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,952,841 23,654 15,887 7,767 5.98 4.02 1.96 2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,953,590 24,001 16,065 7,936 6.07 4.06 2.01 2010. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,999,386 24,572 16,193 8,379 6.14 4.05 2.10 2009. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,130,665 26,408 17,261 9,148 6.39 4.18 2.21 2008. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,247,726 28,075 18,238 9,837 6.61 4.29 2.32 2007. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,316,233 29,153 19,094 10,059 6.75 4.42 2.33 2006. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,265,593 28,509 19,041 9,468 6.68 4.46 2.22 2005. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,138,573 28,384 18,782 9,602 6.86 4.54 2.32 2004. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,112,055 27,860 18,602 9,258 6.78 4.52 2.25 2003. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,090,007 27,995 18,935 9,060 6.84 4.63 2.22 2002. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,021,825 27,970 18,791 9,179 6.95 4.67 2.28 2001. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,026,036 27,523 18,275 9,248 6.84 4.54 2.30 2000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,058,882 27,961 18,733 9,227 6.89 4.62 2.27 1999. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,959,417 27,865 18,701 9,164 7.04 4.72 2.31 1998. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,941,553 28,325 18,915 9,410 7.19 4.80 2.39 1997. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,880,894 27,968 18,507 9,461 7.21 4.77 2.44 1996. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,891,494 28,419 18,556 9,863 7.30 4.77 2.53 1995. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,899,589 29,505 19,186 10,319 7.57 4.92 2.65 Non-Hispanic, single race White: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,915,912 8,603 5,589 3,014 4.49 2.92 1.57 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,956,413 9,059 5,873 3,186 4.63 3.00 1.63 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,992,461 9,306 6,061 3,246 4.67 3.04 1.63 Black: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548,075 5,821 3,754 2,067 10.62 6.85 3.77 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 552,029 5,933 3,897 2,037 10.75 7.06 3.69 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560,715 6,152 4,012 2,140 10.97 7.16 3.82 American Indian or Alaska Native: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,450 224 114 110 7.87 4.01 3.87 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,092 237 120 117 8.15 4.12 4.02 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,957 276 143 132 9.21 4.77 4.41 Asian: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238,769 806 602 204 3.38 2.52 0.85 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240,798 874 643 231 3.63 2.67 0.96 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249,250 943 675 268 3.78 2.71 1.08 Native Hawaiian or Pacific Islander: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,770 80 49 31 8.19 5.02 3.17 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,476 89 51 38 9.39 5.38 4.01 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,426 72 36 36 7.64 3.82 3.82 See footnotes at end of table. 8 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Table 1. Live births, infant, neonatal, and postneonatal deaths, and mortality rates: United States, 19952019, and by race and Hispanic origin, 20172019--Con. Number Deaths per 1,000 live births Year and race and Hispanic origin Live births Postneonatal Infant deaths Neonatal deaths deaths Infant Neonatal Postneonatal Hispanic Total: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 886,467 4,462 3,091 1,371 5.03 3.49 1.55 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 886,210 4,303 3,036 1,267 4.86 3.43 1.43 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 898,764 4,583 3,198 1,383 5.10 3.56 1.54 Mexican: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Puerto Rican: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cuban: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Central and South American: 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 496,716 495,831 512,126 70,950 71,614 70,813 23,668 23,471 23,362 165,229 147,430 145,614 2,462 2,426 2,588 438 402 459 98 90 93 749 592 653 1,693 1,690 1,795 294 290 307 65 64 69 535 438 465 769 4.96 3.41 1.55 736 4.89 3.41 1.48 792 5.05 3.50 1.55 144 6.17 4.14 2.03 112 5.61 4.05 1.56 151 6.48 4.34 2.13 33 4.14 2.75 1.39 26 3.83 2.73 1.11 24 3.98 2.95 1.03 214 4.53 3.24 1.30 154 4.02 2.97 1.04 188 4.48 3.19 1.29 NOTES: Infant deaths are weighted to adjust for the 0.7% of infant death records that were not linked to their corresponding birth certificates. The neonatal and postneonatal mortality rates combined may not add to totals due to rounding. SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. Table 2. Infant mortality rates, live births, and infant deaths, by selected characteristics and by race and Hispanic origin of mother: United States, 2019 Characteristic Non-Hispanic Hispanic Native American Hawaiian or Indian or Other Pacific Total White Black Alaska Native1 Asian Islander Total2 Mexican Puerto Rican Cuban Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age at death Total neonatal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Early neonatal (under 7 days) . . . . . . . . . . . . . . . . . Late neonatal (727 days) . . . . . . . . . . . . . . . . . . . Postneonatal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sex Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Period of gestation (weeks) Less than 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less than 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2831 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3233 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3436. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3741. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3738 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3940 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Birthweight (grams) Less than 2,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less than 1,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,5002,499 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,500 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,5004,499 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,500 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . Plurality Single births. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Twin births . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Triplet and higher-order births . . . . . . . . . . . . . . . . . . 5.58 3.69 2.97 0.72 1.89 6.08 5.06 111.65 374.46 42.13 19.21 8.21 2.03 3.09 1.58 1.47 5.72 44.90 203.52 12.75 1.97 1.97 2.45 5.00 21.77 62.69 4.49 2.92 2.31 0.61 1.57 4.95 4.01 98.20 380.58 45.20 18.66 7.87 1.84 3.00 1.40 1.22 5.23 40.27 195.14 13.12 1.81 1.81 2.01 3.99 17.61 52.01 10.62 6.85 5.55 1.30 3.77 11.41 9.80 134.61 368.22 39.21 22.95 10.49 3.37 4.44 2.81 2.43 * 55.06 209.89 13.70 3.19 3.19 * 9.42 36.48 96.77 Infant deaths per 1,000 live births in specified group 7.87 3.38 8.19 5.03 4.96 4.01 2.52 5.02 3.49 3.41 3.13 2.11 4.50 2.80 2.73 0.88 0.41 * 0.68 0.68 3.87 0.85 3.17 1.55 1.55 8.69 3.63 10.15 5.47 5.34 7.10 3.11 5.90 4.57 4.55 106.80 395.06 * * 11.35 4.23 5.09 3.96 * * 101.34 390.88 28.31 13.13 4.26 0.97 1.47 0.71 * * 148.41 402.44 * * * 3.24 * * * 107.20 355.52 39.10 18.27 7.82 1.80 2.63 1.39 1.59 * 108.42 359.70 40.12 20.37 7.37 1.84 2.67 1.45 1.57 * 47.56 210.24 16.14 4.40 4.37 * 28.59 184.13 5.97 0.93 0.93 * 57.95 283.58 * 3.99 4.07 45.18 202.19 13.04 1.71 1.70 2.84 45.83 206.04 13.69 1.74 1.72 * 7.64 3.03 7.97 4.59 4.54 * 15.23 * 21.04 21.33 * * 66.10 * 6.17 4.14 3.44 0.70 2.03 7.18 5.15 102.45 319.05 41.18 * 9.22 2.06 2.75 1.72 * * 43.37 185.45 11.43 2.02 2.02 * 5.31 30.09 * 4.14 2.75 1.99 * 1.39 4.43 3.84 105.77 312.50 * * * 1.08 * * 42.91 191.82 * 1.14 1.15 3.83 * * Central and South American 4.53 3.24 2.64 0.59 1.30 4.76 4.30 103.76 370.75 34.59 18.22 8.03 1.63 2.54 1.19 * * 43.88 203.10 13.26 1.54 1.53 * 4.21 16.60 * National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 9 See footnotes at end of table. 10 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Table 2. Infant mortality rates, live births, and infant deaths, by selected characteristics and by race and Hispanic origin of mother: United States, 2019--Con. Non-Hispanic Hispanic Characteristic Native American Hawaiian or Central and Indian or Other Pacific South Total White Black Alaska Native1 Asian Islander Total2 Mexican Puerto Rican Cuban American Age of mother Under 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.68 2024. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.76 2529. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.47 3034. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.57 3539. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.03 4054. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.01 Mother's place of birth Born in the 50 states or District of Columbia . . . . . . . 5.84 Born elsewhere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.51 8.30 12.03 5.94 10.92 4.49 10.28 3.56 10.34 4.02 10.06 5.03 12.71 4.58 11.06 3.03 8.02 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,747,540 Sex Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,917,446 Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,830,094 Period of gestation (weeks) Less than 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less than 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2831 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3233 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3436. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3741. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3738 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3940 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Not stated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103,759 24,758 34,748 44,253 279,302 3,352,638 1,022,874 2,135,518 194,246 9,435 2,406 Birthweight (grams) Less than 2,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less than 1,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,5002,499 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,500 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,5004,499 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,500 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . Not stated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312,153 52,610 259,543 3,432,666 3,396,318 36,348 2,721 Plurality Single births. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Twin births . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Triplet and higher-order births . . . . . . . . . . . . . . . . . . 3,623,963 120,291 3,286 See footnotes at end of table. 1,915,912 981,620 934,292 43,532 8,487 14,735 20,310 133,807 1,731,535 489,542 1,130,124 111,869 6,114 924 132,269 19,735 112,534 1,782,422 1,759,563 22,859 1,221 1,850,036 64,011 1,865 548,075 278,494 269,581 27,063 8,332 8,927 9,804 51,766 467,745 166,528 278,956 22,261 1,175 326 77,787 16,399 61,388 469,917 466,989 2,928 371 525,089 22,397 589 Infant deaths per 1,000 live births in specified group--Con. * * * 6.72 6.72 8.58 4.52 * 5.19 4.90 8.91 3.56 * 4.53 4.51 6.05 2.90 9.09 4.44 4.47 * 3.24 * 5.23 4.90 * 4.36 * 7.99 8.74 7.91 * 28,450 3.62 3.29 238,769 7.42 8.51 Live births 9,770 5.32 4.66 886,467 5.18 4.59 496,716 14,500 13,950 123,806 114,963 5,026 4,744 452,492 433,975 253,193 243,523 824 162 284 378 2,468 25,039 8,637 15,142 1,260 73 46 5,092 1,118 1,766 2,208 15,725 217,663 69,306 138,503 9,854 238 51 283 82 80 121 805 8,644 2,885 5,247 512 23 15 23,116 5,620 7,699 9,797 65,238 796,333 253,964 500,856 41,513 1,436 344 12,424 2,983 4,138 5,303 36,222 447,081 142,660 281,522 22,899 803 186 2,292 371 1,921 26,147 25,646 501 11 20,738 2,634 18,104 217,903 216,845 1,058 128 742 134 608 9,021 8,856 165 7 67,094 11,400 55,694 818,991 811,256 7,735 382 35,875 5,994 29,881 460,677 455,900 4,777 164 27,739 698 13 232,079 6,567 123 9,531 239 0 864,066 21,811 590 484,711 11,671 334 7.53 6.76 5.97 4.53 6.97 * 6.30 5.89 70,950 36,203 34,747 2,411 630 777 1,004 5,751 62,674 20,329 39,034 3,311 83 31 6,963 1,278 5,685 63,930 63,440 490 57 68,737 2,160 53 * 4.39 3.72 5.82 * 4.15 4.14 23,668 12,199 11,469 624 176 178 270 1,627 21,380 6,236 14,212 932 32 5 1,678 318 1,360 21,986 21,774 212 4 22,998 644 26 5.55 5.31 3.41 4.30 4.79 6.45 3.97 4.68 165,229 84,732 80,497 3,884 882 1,301 1,701 11,703 149,223 46,483 94,139 8,601 339 80 11,600 1,871 9,729 153,549 152,269 1,280 80 161,483 3,675 71 Table 2. Infant mortality rates, live births, and infant deaths, by selected characteristics and by race and Hispanic origin of mother: United States, 2019--Con. Non-Hispanic Hispanic Characteristic Native American Hawaiian or Central and Indian or Other Pacific South Total White Black Alaska Native1 Asian Islander Total2 Mexican Puerto Rican Cuban American Age of mother Under 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2024. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2529. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3034. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3539. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4054. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173,461 704,342 1,078,097 1,089,281 572,598 129,761 Mother's place of birth Born in the 50 states or District of Columbia . . . . . . . Born elsewhere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Not stated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,896,095 843,896 7,549 60,854 313,275 556,533 618,176 305,886 61,188 1,785,117 128,457 2,338 37,248 132,605 165,655 126,332 68,219 18,016 456,315 90,033 1,727 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age at death Total neonatal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Early neonatal (under 7 days) . . . . . . . . . . . . . . . . . Late neonatal (727 days) . . . . . . . . . . . . . . . . . . . Postneonatal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sex Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Period of gestation (weeks) Less than 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less than 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2831 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3233 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3436. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3741. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3738 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3940 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Not stated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,927 13,834 11,124 2,710 7,093 11,662 9,265 11,585 9,271 1,464 850 2,292 6,815 3,158 3,372 285 54 181 8,603 5,589 4,424 1,165 3,014 4,860 3,743 4,275 3,230 666 379 1,053 3,185 1,469 1,581 136 32 56 5,821 3,754 3,041 713 2,067 3,179 2,642 3,643 3,068 350 225 543 1,578 739 785 54 9 48 2,543 7,696 8,638 6,114 2,881 578 28,082 326 42 224 114 89 25 110 126 99 88 64 15 9 28 106 44 60 2 1 0 Live births--Con. 1,362 13,709 55,116 96,759 58,302 13,521 521 2,490 2,944 2,311 1,226 278 63,396 207,552 256,385 209,283 118,441 31,410 37,218 121,541 146,250 112,292 62,821 16,594 46,957 190,948 864 3,506 6,109 155 Infant deaths 806 80 474,821 410,361 1,285 4,462 298,178 197,996 542 2,462 602 49 3,092 1,693 504 44 2,486 1,354 98 5 606 339 204 31 1,371 769 449 51 2,477 1,353 357 28 1,985 1,108 516 42 2,478 1,347 437 33 1,998 1,073 50 4 301 166 29 5 179 108 67 9 510 267 211 28 1,431 824 102 15 668 381 99 12 697 407 10 1 66 36 1 0 10 5 12 0 35 17 5,315 18,948 21,433 15,660 7,743 1,851 49,999 20,704 247 438 294 244 50 144 260 179 247 201 32 14 53 129 56 67 6 1 8 674 3,770 7,063 7,799 3,608 754 10,121 13,535 12 98 65 47 18 33 54 44 66 55 7 4 8 23 10 13 0 0 1 10,628 32,228 43,135 43,439 27,740 8,059 32,758 132,304 167 749 535 437 98 214 403 346 403 327 45 31 94 243 118 112 13 4 5 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 11 See footnotes at end of table. 12 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Table 2. Infant mortality rates, live births, and infant deaths, by selected characteristics and by race and Hispanic origin of mother: United States, 2019--Con. Non-Hispanic Hispanic Characteristic Native American Hawaiian or Central and Indian or Other Pacific South Total White Black Alaska Native1 Asian Islander Total2 Mexican Puerto Rican Cuban American Birthweight (grams) Less than 2,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,017 5,327 4,283 109 Less than 1,500 . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,707 3,851 3,442 78 1,5002,499 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,310 1,476 841 31 2,500 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,767 3,231 1,500 115 2,5004,499 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,678 3,185 1,488 112 4,500 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 46 12 3 Not stated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 44 37 0 Plurality Single births. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,102 7,380 4,947 212 Twin births . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,619 1,127 817 11 Triplet and higher-order births . . . . . . . . . . . . . . . . . . 206 97 57 1 Age of mother Under 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,505 505 448 16 2024. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,761 1,861 1,448 66 2529. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,895 2,498 1,703 77 3034. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,978 2,200 1,306 37 3539. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,879 1,231 686 19 4054. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 909 308 229 8 Mother's place of birth Born in the 50 states or District of Columbia . . . . . . . 16,922 8,172 5,048 222 Born elsewhere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,810 389 722 2 Not stated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 42 50 0 Infant deaths--Con. 593 43 3,031 1,644 302 485 38 2,305 1,235 237 108 5 726 409 65 203 36 1,403 803 129 202 36 1,381 786 128 1 0 22 17 1 10 0 28 15 7 704 76 3,963 2,199 365 100 4 459 249 65 3 0 39 14 8 19 6 426 250 40 62 17 1,077 596 128 196 17 1,161 660 128 281 21 929 502 71 189 17 619 308 54 59 1 251 145 16 170 26 2,528 1,544 315 629 52 1,914 908 122 8 1 20 10 1 72 509 61 380 11 129 25 236 25 233 0 3 1 4 88 680 7 61 3 7 0 59 16 171 31 147 29 187 21 133 1 52 42 130 56 619 0 0 * Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator. Quantity zero. 1Includes Aleut and Eskimo infants. 2Includes other and unknown Hispanic origin not stated, not shown separately. NOTES: Infant deaths are weighted, so numbers may not add to totals due to rounding. Not stated responses are included in totals but not distributed among groups for rate computations. Race and Hispanic origin are reported separately on the birth certificate. Race categories are consistent with 1997 Office of Management and Budget standards. Persons of Hispanic origin may be of any race. SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. Table 3. Infant deaths, percentage of deaths, and infant mortality rates, by five leading causes of infant death: United States, 20102019 Congenital malformations (Q00Q99) Short gestation and low birth weight, not elsewhere classified (P07) Maternal complications of pregnancy (P01) Sudden infant death syndrome (R95) Accidents (unintentional injures) (V01X59) Rate (deaths Rate (deaths Rate (deaths Rate (deaths Rate (deaths per 100,000 per 100,000 per 100,000 per 100,000 per 100,000 Year Number Percent live births) Number Percent live births) Number Percent live births) Number Percent live births) Number Percent live births) 2019. . . . . . . . . . . . . . . . . 4,313 20.6 115.1 3,460 16.5 92.3 1,250 6.0 33.4 1,251 6.0 33.4 1,264 6.0 33.7 2018. . . . . . . . . . . . . . . . . 4,501 20.9 118.7 3,683 17.1 97.1 1,371 6.4 36.2 1,331 6.2 35.1 1,169 5.4 30.8 2017. . . . . . . . . . . . . . . . . 4,596 20.6 119.2 3,757 16.8 97.4 1,436 6.4 37.2 1,360 6.1 35.3 1,313 5.9 34.1 2016. . . . . . . . . . . . . . . . . 4,823 20.8 122.2 3,926 17.0 99.5 1,407 6.1 35.7 1,498 6.5 38.0 1,217 5.3 30.8 2015. . . . . . . . . . . . . . . . . 4,847 20.7 121.8 4,087 17.4 102.7 1,527 6.5 38.4 1,567 6.7 39.4 1,289 5.5 32.4 2014. . . . . . . . . . . . . . . . . 4,754 20.5 119.2 4,172 18.0 104.6 1,580 6.8 39.6 1,541 6.6 38.6 1,163 5.0 29.2 2013. . . . . . . . . . . . . . . . . 4,778 20.4 121.5 4,213 18.0 107.1 1,597 6.8 40.6 1,561 6.7 39.7 1,150 4.9 29.2 2012. . . . . . . . . . . . . . . . . 4,967 21.0 125.7 4,214 17.8 106.6 1,518 6.4 38.4 1,676 7.1 42.4 1,163 4.9 29.4 2011. . . . . . . . . . . . . . . . . 5,016 20.9 126.9 4,115 17.1 104.1 1,598 6.7 40.4 1,905 7.9 48.2 1,167 4.9 29.5 2010. . . . . . . . . . . . . . . . . 5,115 20.8 127.9 4,151 16.9 103.8 1,563 6.4 39.1 2,058 8.4 51.5 1,107 4.5 27.7 NOTE: The five leading causes of death were the same during 20102019. SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 13 14 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Table 4. Infant deaths and mortality rates for the five leading causes of infant death, by race and Hispanic origin of mother: United States, 2019 [Rates per 100,000 live births in specified group] Non-Hispanic Cause of death (based on International Classification of Diseases, 10th Revision, 1992) All races Rank Number Rate White Rank Number Rate Black Rank Number Rate American Indian or Alaska Native Rank Number Rate Asian1 Rank Number Rate All causes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 20,927 558.4 ... 8,603 449.0 ... 5,821 1,062.1 ... Congenital malformations, deformations and chromosomal abnormalities . . . . . . . . (Q00Q99) 1 Disorders related to short gestation and low birth weight, not elsewhere classified . . . . . .(P07) 2 Accidents (unintentional injuries). . . . . . .(V01X59) 3 Sudden infant death syndrome . . . . . . . . . . . .(R95) 4 Newborn affected by maternal complications of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . .(P01) 5 4,313 3,460 1,264 1,251 1,250 115.1 92.3 33.7 33.4 33.4 1 2,021 105.5 2 1,091 56.9 3 650 33.9 4 553 28.9 5 422 22.0 2 779 142.1 1 1 1,299 237.0 3 5 332 60.6 3 3 404 73.7 2 4 366 66.8 5 224 787.3 ... 34 119.5 2 21 73.8 1 21 73.8 6 24 84.4 8 14 * 3 806 337.6 163 68.3 179 75.0 23 9.6 14 * 63 26.4 Cause of death (based on International Classification of Diseases, 10th Revision, 1992) Total Hispanic Rank Number Rate Mexican Rank Number Rate Puerto Rican Rank Number Rate Central and South American2 Rank Number Rate All causes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... Congenital malformations, deformations and chromosomal abnormalities . . . . . . . . (Q00Q99) 1 Disorders related to short gestation and low birth weight, not elsewhere classified . . . . . .(P07) 2 Accidents (unintentional injuries). . . . . . .(V01X59) 5 Sudden infant death syndrome . . . . . . . . . . . .(R95) 4 Newborn affected by maternal complications of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . .(P01) 3 4,462 503.3 ... 2,462 495.7 ... 1,130 127.5 1 698 78.7 2 176 19.9 5 193 21.8 4 306 34.5 3 634 127.6 2 372 74.9 1 102 20.5 5 110 22.1 4 179 36.0 3 438 617.3 ... 78 109.9 1 79 111.3 2 19 * 5 26 36.6 9 27 38.1 3 749 453.3 229 138.6 116 70.2 23 13.9 13 * 44 26.6 ... Category not applicable. * Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator. 1For non-Hispanic Asian infants, Newborn affected by complications of placenta, cord and membranes (P02) was the fourth leading cause of death, with 37 deaths and a rate of 15.5. Bacterial sepsis of newborn (P36) was the fifth leading cause of death, with 30 deaths and a rate of 12.6. 2For Central and South American infants, Newborn affected by complications of placenta, cord and membranes (P02) was the fourth leading cause of death, with 27 deaths and a rate of 16.3. NOTES: Reliable cause-specific infant mortality rates cannot be computed for Cuban or non-Hispanic Native Hawaiian or Other Pacific Islander infants because of the small number of deaths. Race and Hispanic origin are reported separately on the birth certificate. Race categories are consistent with 1997 Office of Management and Budget standards. Persons of Hispanic origin may be of any race. SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 15 Table 5. Infant mortality rate: United States and each state, 2019 [By place of residence] Area Rate Infant deaths United States1 . . . . . . . . . . . . . . . . . . . . . . . . . 5.58 Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.71 Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.99 Arizona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.43 Arkansas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.00 California . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.23 Colorado. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.85 Connecticut . . . . . . . . . . . . . . . . . . . . . . . . . 4.38 Delaware. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.44 District of Columbia . . . . . . . . . . . . . . . . . . . 4.96 Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.10 Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.02 Hawaii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.12 Idaho . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.31 Illinois. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.67 Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.54 Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.02 Kansas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.42 Kentucky. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.90 Louisiana . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.97 Maine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.43 Maryland . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.84 Massachusetts . . . . . . . . . . . . . . . . . . . . . . . 3.73 Michigan. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.38 Minnesota. . . . . . . . . . . . . . . . . . . . . . . . . . . 4.53 Mississippi . . . . . . . . . . . . . . . . . . . . . . . . . . 8.71 Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.14 Montana . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.78 Nebraska . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.93 Nevada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.67 New Hampshire . . . . . . . . . . . . . . . . . . . . . . 3.21 New Jersey . . . . . . . . . . . . . . . . . . . . . . . . . . 4.22 New Mexico . . . . . . . . . . . . . . . . . . . . . . . . . 5.66 New York . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.33 North Carolina . . . . . . . . . . . . . . . . . . . . . . . 6.78 North Dakota . . . . . . . . . . . . . . . . . . . . . . . . 7.46 Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.89 Oklahoma . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.00 Oregon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.85 Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . 5.93 Rhode Island . . . . . . . . . . . . . . . . . . . . . . . . 5.90 South Carolina . . . . . . . . . . . . . . . . . . . . . . . 6.89 South Dakota . . . . . . . . . . . . . . . . . . . . . . . . 6.99 Tennessee. . . . . . . . . . . . . . . . . . . . . . . . . . . 6.96 Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.48 Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.27 Vermont . . . . . . . . . . . . . . . . . . . . . . . . . . . . * Virginia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.81 Washington . . . . . . . . . . . . . . . . . . . . . . . . . 4.26 West Virginia . . . . . . . . . . . . . . . . . . . . . . . . 6.12 Wisconsin. . . . . . . . . . . . . . . . . . . . . . . . . . . 5.86 Wyoming . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.16 Puerto Rico . . . . . . . . . . . . . . . . . . . . . . . . . 6.63 Guam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.87 Deaths per 1,000 births 20,927 452 49 431 256 1,889 305 150 68 45 1,342 887 86 95 794 529 189 192 260 470 64 410 258 688 299 319 443 53 122 199 38 420 130 959 805 78 927 344 203 796 60 393 80 560 2,069 247 15 566 362 111 371 47 135 30 * Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator. 1Does not include Puerto Rico or Guam. SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. Live births 3,747,540 58,615 9,822 79,375 36,564 446,479 62,869 34,258 10,562 9,079 220,002 126,371 16,797 22,063 140,128 80,859 37,649 35,395 53,069 58,941 11,779 70,178 69,117 107,886 66,027 36,636 72,127 11,079 24,755 35,072 11,839 99,585 22,960 221,539 118,725 10,454 134,461 49,143 41,858 134,230 10,175 57,038 11,449 80,450 377,599 46,826 5,361 97,429 84,895 18,136 63,270 6,565 20,353 3,041 16 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Technical Notes Data source and 2003 revision Information on the data source for the linked birth/infant death file is available elsewhere (1). Additionally, further information on the 2003 revision of the birth certificate is available (3); see also the U.S. Standard Certificate of Live Birth (9). Weighting In 2019, a record weight was added to the U.S. linked file to compensate for the 0.7% of infant death records that could not be linked to their corresponding birth certificates. The percentage of records linked varied by registration area, ranging from 96.0% through 100.0% (Table). The number of infant deaths in the linked file for the 50 states and District of Columbia (D.C.) was weighted to equal the sum of the linked plus unlinked infant deaths by state of occurrence of birth and age at death (under 7 days, 727 days, and 28 days to under 1 year). The addition of the weight reduced the potential for bias in comparing infant mortality rates by maternal and infant characteristics. The 2019 linked file started with 20,968 infant death records. Of these records, 20,814 were linked; 154 were unlinked because corresponding birth certificates could not be identified. The 20,968 linked and unlinked records contained records of infants whose mothers' usual place of residence was outside of the United States; 41 records were excluded from linked file analyses for a weighted total of 20,927 infant deaths by place of residence for 2019. Comparison of infant mortality data between linked file and vital statistics mortality file The overall infant mortality rate of 5.58 from the 2019 period linked file is the same as that from the 2019 vital statistics mortality file (5.58) (10). The number of infant deaths in the linked file (20,814) differs slightly from the number in the mortality file (20,921) (10). Differences in numbers of infant deaths between the two data sources are primarily due to geographic coverage differences. For the vital statistics mortality file, all deaths occurring in the 50 states and D.C. are included regardless of the place of birth of the infant. In contrast, to be included in the U.S. linked file, both the birth and death must occur in the 50 states and D.C. (the territory linked file is a separate file). Weighting of the linked file also may contribute to small differences in numbers and rates by specific variables between these two data sets. Period of gestation Beginning with the 2014 data year, the National Center for Health Statistics (NCHS) transitioned to a new standard for estimating the gestational age of the newborn. The new measure--the obstetric estimate of gestation at delivery (OE)-- replaces the measure based on the date of the last normal menses (11). Accordingly, gestational age data shown in this report are based on OE. National data based on OE data are available only Table. Percentage of infant deaths linked to corresponding birth records, by state of occurrence of death: United States and each state, 2019 Percent linked by state of Area occurrence of death United States1 . . . . . . . . . . . . . . . . . . . . Alabama . . . . . . . . . . . . . . . . . . . . . . . Alaska . . . . . . . . . . . . . . . . . . . . . . . . . Arizona . . . . . . . . . . . . . . . . . . . . . . . . Arkansas. . . . . . . . . . . . . . . . . . . . . . . California . . . . . . . . . . . . . . . . . . . . . . Colorado . . . . . . . . . . . . . . . . . . . . . . . Connecticut . . . . . . . . . . . . . . . . . . . . Delaware. . . . . . . . . . . . . . . . . . . . . . . District of Columbia . . . . . . . . . . . . . . Florida . . . . . . . . . . . . . . . . . . . . . . . . Georgia . . . . . . . . . . . . . . . . . . . . . . . . Hawaii. . . . . . . . . . . . . . . . . . . . . . . . . Idaho . . . . . . . . . . . . . . . . . . . . . . . . . Illinois. . . . . . . . . . . . . . . . . . . . . . . . . Indiana . . . . . . . . . . . . . . . . . . . . . . . . Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . Kansas . . . . . . . . . . . . . . . . . . . . . . . . Kentucky. . . . . . . . . . . . . . . . . . . . . . . Louisiana . . . . . . . . . . . . . . . . . . . . . . Maine . . . . . . . . . . . . . . . . . . . . . . . . . Maryland . . . . . . . . . . . . . . . . . . . . . . Massachusetts . . . . . . . . . . . . . . . . . . Michigan. . . . . . . . . . . . . . . . . . . . . . . Minnesota. . . . . . . . . . . . . . . . . . . . . . Mississippi . . . . . . . . . . . . . . . . . . . . . Missouri . . . . . . . . . . . . . . . . . . . . . . . Montana . . . . . . . . . . . . . . . . . . . . . . . Nebraska . . . . . . . . . . . . . . . . . . . . . . Nevada . . . . . . . . . . . . . . . . . . . . . . . . New Hampshire . . . . . . . . . . . . . . . . . New Jersey . . . . . . . . . . . . . . . . . . . . . New Mexico . . . . . . . . . . . . . . . . . . . . New York . . . . . . . . . . . . . . . . . . . . . . New York City . . . . . . . . . . . . . . . . . . . North Carolina . . . . . . . . . . . . . . . . . . North Dakota . . . . . . . . . . . . . . . . . . . Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . Oklahoma . . . . . . . . . . . . . . . . . . . . . . Oregon . . . . . . . . . . . . . . . . . . . . . . . . Pennsylvania . . . . . . . . . . . . . . . . . . . Rhode Island . . . . . . . . . . . . . . . . . . . South Carolina . . . . . . . . . . . . . . . . . . South Dakota . . . . . . . . . . . . . . . . . . . Tennessee. . . . . . . . . . . . . . . . . . . . . . Texas . . . . . . . . . . . . . . . . . . . . . . . . . Utah . . . . . . . . . . . . . . . . . . . . . . . . . . Vermont . . . . . . . . . . . . . . . . . . . . . . . Virginia . . . . . . . . . . . . . . . . . . . . . . . . Washington . . . . . . . . . . . . . . . . . . . . West Virginia . . . . . . . . . . . . . . . . . . . Wisconsin. . . . . . . . . . . . . . . . . . . . . . Wyoming . . . . . . . . . . . . . . . . . . . . . . 99.3 100.0 100.0 97.4 99.6 99.1 100.0 100.0 98.6 100.0 100.0 99.9 100.0 100.0 99.9 99.6 100.0 100.0 99.2 100.0 100.0 100.0 100.0 99.6 99.7 100.0 99.2 100.0 99.3 100.0 100.0 100.0 98.3 99.2 99.8 100.0 100.0 100.0 98.8 99.5 100.0 100.0 100.0 100.0 99.7 96.0 100.0 100.0 99.6 100.0 100.0 100.0 100.0 1Excludes data for Puerto Rico, U.S. Virgin Islands, and Guam. SOURCE: National Center for Health Statistics, National Vital Statistics System, Linked birth/infant death file. National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 17 from data year 2007 forward. Information on and discussion of the reasons for the change, as well as a detailed comparison of the two measures, are presented elsewhere (11). Sex, birthweight, plurality, and nativity Detailed definitions and more information on sex, birthweight, plurality, and nativity are available elsewhere (1,3). Beginning with 2005, the public-use file no longer includes geographic detail; such files are available upon special request (see the NCHS Division of Vital Statistics data release policy at: https://www.cdc.gov/nchs/nvss/nvss-restricted-data.htm). Data are also available in issues of Vital and Health Statistics, Series 20; National Vital Statistics Reports; and Data Briefs, from the NCHS website: https://www.cdc.gov/nchs/products/index.htm. Cause-of-death classification The mortality statistics presented in this report were compiled in accordance with World Health Organization (WHO) regulations, which specify that member nations classify and code causes of death according to the current revision of the International Statistical Classification of Diseases (ICD). ICD provides the basic guidance to code and classify causes of death, details disease classification, and supplies definitions, tabulation lists, the format of the death certificate, and the rules for coding cause of death. Cause-of-death data presented in this report were coded by procedures outlined in annual issues of the NCHS Instruction Manual (12,13). In this report, tabulations of cause-of-death statistics are based solely on the underlying cause of death. Generally, more medical information is reported on death certificates than is directly reflected in the underlying cause of death. This is captured in NCHS multiple cause-of-death statistics (14,15). Tabulation lists and cause-of-death ranking The cause-of-death rankings for ICD10 are based on the "List of 130 Selected Causes of Infant Death." The tabulation lists and rules for ranking leading causes of death are published in the NCHS Instruction Manual, Part 9, ICD10 Cause-of-death Lists for Tabulating Mortality Statistics (16). Computation of rates Information on and discussion of computation of rates (1) is also available from the "User Guide to the 2010 Natality Public Use File" at: https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_ Documentation/DVS/natality/UserGuide2010.pdf. Random variation in infant mortality rates For information and discussion on random variation and significance testing for linked data (1), see also the "User Guide to the 2010 Natality Public Use File" at: https://ftp.cdc.gov/pub/ Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/ UserGuide2010.pdf. Availability of linked file Linked file data are available for download from the Vital Statistics Online Data Portal: https://www.cdc.gov/nchs/data_ access/vitalstatsonline.htm. Linked period file data may also be accessed via the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER), available from: https://wonder.cdc.gov/lbd.html. U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Room 4551 Hyattsville, MD 207822064 OFFICIAL BUSINESS PENALTY FOR PRIVATE USE, $300 For more NCHS NVSRs, visit: https://www.cdc.gov/nchs/products/nvsr.htm. FIRST CLASS MAIL POSTAGE & FEES PAID CDC/NCHS PERMIT NO. G-284 National Vital Statistics Reports, Vol. 70, No. 14, December 8, 2021 Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Data by maternal and infant characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Trends in infant mortality and infant age at death. . . . . . . . . . . . . . . . . . . . . . 3 Race and Hispanic origin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Maternal age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Gestational age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Leading causes of infant death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Infant mortality by state . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 List of Detailed Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Technical Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Acknowledgments This report was prepared by the Division of Vital Statistics (DVS) under the general direction of DVS Director Steven Schwartz; Isabelle Horon, Branch Chief, Reproductive Statistics Branch (RSB); and Joyce Martin, Team Leader, RSB Birth Team. Rajesh Virkar, Chief of the Information Technology Branch (ITB), and Steve J. Steimel, Annie S. Liu, and Jasmine N. Mickens of ITB provided computer programming support and statistical tables. Steve J. Steimel and Annie S. Liu prepared the natality file; Jasmine N. Mickens prepared the linked birth/infant death data file. The Data Acquisition, Classification, and Evaluation Branch staff of DVS evaluated the quality of and acceptance procedures for the state data files on which this report is based. The National Center for Health Statistics Office of Information Services, Information Design and Publishing Staff, edited and produced this report: editor Jane Sudol, and typesetter and graphic designer Odell D. Eldridge (contractor). Suggested citation Ely DM, Driscoll AK. Infant mortality in the United States, 2019: Data from the period linked birth/infant death file. National Vital Statistics Reports; vol 70 no 14. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:111053. Copyright information All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. National Center for Health Statistics Brian C. Moyer, Ph.D., Director Amy M. Branum, Ph.D., Associate Director for Science Division of Vital Statistics Steven Schwartz, Ph.D., Director Isabelle Horon, Dr.P.H., Acting Associate Director for Science For e-mail updates on NCHS publication releases, subscribe online at: https://www.cdc.gov/nchs/email-updates.htm. For questions or general information about NCHS: Tel: 1800CDCINFO (18002324636) · TTY: 18882326348 Internet: https://www.cdc.gov/nchs · Online request form: https://www.cdc.gov/info · CS327547Adobe PDF Library 16.0.3