NCHS Data Brief ■ No. 326 ■ November 2018

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Infant Mortality by Age at Death in the United States, 2016

Danielle M. Ely, Ph.D., Anne K. Driscoll, Ph.D., and T.J. Mathews, M.S.

Key findings

Data from the National 

Vital Statistics System

● The total infant mortality

rate declined from 6.75 infant

deaths per 1,000 births in 2007

to 6.07 in 2011, but did not

change significantly from 2011

through 2016 (5.87).

● In 2016, neonatal mortality

rates were highest among

infants of non-Hispanic black

women (7.41). Postneonatal

mortality rates were highest

among infants of non-Hispanic

black (3.81) and American

Indian or Alaska Native

(3.93) women.

● In 2016, neonatal mortality

rates were highest among 

infants of women under age 20 

and 40 and over compared with 

infants of other maternal age 

groups. Postneonatal mortality 

rates were highest among 

infants of women under age 20. 

● Low birthweight accounted

for the highest rate of neonatal

mortality, whereas congenital

malformations and sudden

infant death syndrome

accounted for the highest rates

of postneonatal deaths.

Infant mortality is an important public health measure in the United States 

and other countries (1–3). The United States’ infant mortality rate started to 

decline in 2007 (the most recent high), but has remained relatively unchanged 

in recent years (4,5). Previous research shows differences in infant mortality 

rates by age at death (i.e., neonatal, or deaths to infants aged 0–27 days, 

and postneonatal, or deaths to infants aged 28–364 days), age and race and 

Hispanic origin of the mother, and leading causes of death (4–6). This report 

examines infant mortality rates for the United States by age at death in 2016, 

by maternal age and race and Hispanic origin, and for the five leading causes 

of neonatal and postneonatal mortality.

Total infant, neonatal, and postneonatal mortality rates did 

not change significantly between 2015 and 2016.

1

Significant decreasing trend for 2007–2011 (p < 0.05); stable trend for 2011–2016. 2

Significant decreasing trend for 2007–2016 (p < 0.05). 3

Significant decreasing trend for 2007–2014 (p < 0.05); stable trend for 2014–2016. 

NOTE: Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db326_tables-508.pdf#1.

SOURCE: NCHS, National Vital Statistics System, Linked birth/infant death data set.

Figure 1. Total infant, neonatal, and postneonatal mortality rates: United States, 2007–2016 Infant deaths per 1,000 live births

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

6.75

4.42

2.33

5.87

3.88

1.99

8

6

4

2

0

Total1

Neonatal2

Postneonatal3
NCHS Data Brief ■ No. 326 ■ November 2018

■  2  ■

● The overall infant mortality rate did not change significantly from 2011 through 2016, after 

a 10% decline from 2007 through 2011. In 2016, the total infant mortality rate was 5.87 

deaths per 1,000 births (Figure 1). 

● The neonatal mortality rate declined from 4.42 in 2007 to 3.88 in 2016, but was essentially 

unchanged between 2015 and 2016 (3.94). 

● The postneonatal mortality rate declined from 2.33 in 2007 to 1.87 in 2014 and did not 

change significantly from 2014 (1.87) through 2016 (1.99). 

Infants of non-Hispanic black women had the highest total infant and 

neonatal mortality rates.

● The mortality rate among infants born to non-Hispanic black women was 11.21 deaths per 

1,000 births in 2016, compared with 8.61 among American Indian or Alaska Native, 4.96 

among Hispanic, 4.87 among non-Hispanic white, and 3.97 among Asian or Pacific Islander 

infants (Figure 2). 

● The neonatal mortality rate among infants of non-Hispanic black women was 7.41 compared 

with infants of non-Hispanic white (3.10), American Indian or Alaska Native (4.68), Asian 

or Pacific Islander (2.83), and Hispanic (3.45) women.

Figure 2. Total infant, neonatal, and postneonatal mortality rates, by race and Hispanic origin: United States, 2016

1

Significantly different rate compared with all groups except Hispanic (p < 0.05). 2

Significantly different rate compared with all groups (p < 0.05). 3

Significantly different rates across all groups (p < 0.05). 4

Significantly different rates across all groups except between non-Hispanic black and American Indian or Alaska Native (p < 0.05).

NOTES: Total neonatal and postneonatal mortality rates may not sum to totals due to rounding. Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db326_tables-508.pdf#2.

SOURCE: NCHS, National Vital Statistics System, Linked birth/infant death data set. Infant deaths per 1,000 live births

10

12

8

6

4

2

0

Postneonatal 

mortality rate4

Neonatal 

mortality rate3

Non-Hispanic 

white

Non-Hispanic 

black

American Indian 

or Alaska Native

Asian or 

Pacific Islander

Hispanic

1

4.87

2

11.21

2

8.61

2

3.97

4.96

1.78

3.81 3.93

1.14 1.51

3.10

7.41

4.68

2.83

3.45
NCHS Data Brief ■ No. 326 ■ November 2018

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● Postneonatal mortality rates were highest among infants of non-Hispanic black women 

(3.81) and infants of American Indian or Alaska Native women (3.93) compared with infants 

of non-Hispanic white (1.78), Asian or Pacific Islander (1.14), and Hispanic (1.51) women.

Total infant and postneonatal mortality rates were highest for infants of 

women under age 20. 

● The total mortality rate for infants of women under age 20 was 8.69 deaths per 1,000 births 

in 2016; infants of women aged 30–34 had the lowest total mortality rate (4.86) (Figure 3). 

● Neonatal mortality rates were highest for infants of women under age 20 and aged 40 and 

over (5.32 each); infants of women aged 30–34 had the lowest neonatal mortality rates 

(3.44). 

● Postneonatal mortality rates were highest for infants of women under age 20 (3.36); infants 

of women in their thirties had the lowest postneonatal mortality rates (1.42 for infants of 

women aged 30–34 and 1.46 for infants of women aged 35–39).

5.32

4.24

3.66

3.44 3.80

5.32

1

8.69

2

7.13

1

5.57

1

4.86

1

5.26

7.27

3.36 2.89

1.91 1.42 1.46 1.95

Figure 3. Total infant, neonatal, and postneonatal mortality rates, by maternal age: United States, 2016

1

Significantly different from all other maternal age groups (p < 0.05). 2

Significantly different from all other maternal age groups except aged 40 and over (p < 0.05). 3

Significant difference between all age groups except between those under age 20 and aged 40 and over, and between those aged 25–29 and 35–39 (p < 0.05). 4

Significant difference between all age groups except between those aged 25–29 and 40 and over, and between those aged 30–34 and 35–39 (p < 0.05).

NOTES: Total neonatal and postneonatal mortality rates may not sum to totals due to rounding. Access data table for Figure 3 at: 

https://www.cdc.gov/nchs/data/databriefs/db326_tables-508.pdf#3.

SOURCE: NCHS, National Vital Statistics System, Linked birth/infant death data set. Infant deaths per 1,000 live births

10

8

6

4

2

0

Postneonatal 

mortality rate4

Neonatal 

mortality rate3

Under 20 20–24 25–29 30–34 35–39 40 and over
NCHS Data Brief ■ No. 326 ■ November 2018

■  4  ■

In 2016, for the five leading causes of death, the rate of mortality from 

congenital malformations was second highest for neonatal infant deaths 

and highest for postneonatal infant deaths.

● Mortality rates for the five leading causes of neonatal death were 97.7 neonatal deaths per 

100,000 births for low birthweight; 86.4 for congenital malformations; 35.3 for maternal 

complications; 21.0 for placenta, cord, and membrane complications; and 14.0 for bacterial 

sepsis (Figure 4). 

● Mortality rates for the five leading causes of postneonatal death were 35.8 for congenital 

malformations, 34.9 for sudden infant death syndrome (SIDS), 27.4 for unintentional 

injuries, 9.1 for diseases of the circulatory system, and 6.4 for homicide.

● Neonatal mortality rates for low birthweight and congenital malformations were two to 

seven times higher than rates for maternal complications; placenta, cord, and membrane 

complications; and bacterial sepsis. 

● Postneonatal mortality rates for congenital malformations and SIDS were three to six times 

higher than rates for diseases of the circulatory system and homicide.

Figure 4. Neonatal and postneonatal mortality rates for five leading causes of neonatal and postneonatal death: 

United States, 2016

1

Significantly different rates across all leading causes of death (p < 0.05). 2

Significantly different rates across all leading causes of death except between congenital malformations and sudden infant death syndrome (p < 0.05).

NOTE: Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db326_tables-508.pdf#4.

SOURCE: NCHS, National Vital Statistics System, Linked birth/infant death data set.

Infant deaths per 100,000 live births

Postneonatal2

Neonatal1

Low birthweight

Congenital malformations

Congenital malformations

Unintentional injuries

Diseases of the circulatory system

Maternal complications

Bacterial sepsis

Sudden infant death syndrome

Homicide

Placenta, cord, and membrane

complications

0 20 40 60 80 100

97.7

86.4

35.3

21.0

14.0

35.8

34.9

27.4

9.1

6.4
NCHS Data Brief ■ No. 326 ■ November 2018

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Summary

Total infant, neonatal, and postneonatal mortality rates in 2016 were generally unchanged from 

2015. After the decline from 2007 through 2011, the total infant mortality rate in the United States 

has been relatively stable through 2016. Neonatal mortality rates decreased over the 2007–2016 

period, while postneonatal mortality rates declined from 2007 through 2014 but remained stable 

from 2014 through 2016. A recent report also found a recent lack of change in perinatal mortality 

overall, and in late fetal and early neonatal mortality (7). Concurrently, rates of preterm and low 

birthweight, newborn outcomes associated with infant death, have been on the rise (8,9).

In 2016, total infant, neonatal, and postneonatal mortality rates in the United States continue to 

vary by maternal characteristics such as mother’s race and Hispanic origin and age. Infants of 

non-Hispanic black and American Indian or Alaska Native women continue to have higher overall 

mortality rates, as well as higher neonatal and postneonatal mortality rates, than infants of women 

of other race and Hispanic-origin groups; this pattern has remained stable over time (4,10). Both 

neonatal and postneonatal mortality rates were generally higher for infants of the youngest and 

oldest mothers. This pattern reflects risk factors for infant death among women under age 20 and 

aged 40 and over, such as higher rates of low birthweight and preterm births and lower rates of 

timely prenatal care (9). Although rates have decreased since 2007 among all groups, significant 

variations across groups remain (4,5).

Neonatal and postneonatal infant deaths are largely due to different causes. With the exception of 

congenital malformations, the leading causes differed by age at death, and the highest neonatal 

mortality rate from low birthweight was more than 2.5 times the highest postneonatal mortality 

rates for congenital malformations or SIDS.
NCHS Data Brief ■ No. 326 ■ November 2018

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Definitions

Cause-of-death classification: Medical information—including injury diagnoses and external 

causes of injury—is entered on death certificates filed in the United States and classified and 

coded in accordance with the International Statistical Classification of Diseases and Related 

Health Problems, 10th Revision (ICD–10) (6). Corresponding abbreviations of infant cause-ofdeath categories and ICD–10 codes presented in this report are:

● Diseases of the circulatory system (I00–I99)

● Maternal complications: Newborn affected by maternal complications of pregnancy (P01)

● Placenta, cord and membrane complications: Newborn affected by complications of 

placenta, cord and membrane (P02)

● Low birthweight: Disorders related to short gestation and low birthweight, not elsewhere 

classified (P07)

● Bacterial sepsis (P36)

● Congenital malformations: Congenital malformations, deformations, and chromosomal 

abnormalities (Q00–Q99)

● Sudden infant death syndrome (R95)

● Unintentional injuries: Accidents [unintentional injuries (V01–X59)]

● Homicide: Assault [homicide (*U01.0, X85–Y09)]

Infant mortality rate: Number of infant (under 1 year) deaths per 1,000 live births.

Leading causes of death: Ranked according to the number of deaths assigned to rankable 

causes (6).

Neonatal mortality rate: Number of deaths to infants aged 0–27 days per 1,000 live births.

Postneonatal mortality rate: Number of deaths to infants aged 28 to 364 days per 1,000 live births.
NCHS Data Brief ■ No. 326 ■ November 2018

■  7  ■

Data sources and methods

This report contains data from the period linked birth/infant death data set, which is part of the 

National Vital Statistics System (5). The period linked birth/infant death data set includes all 

infant deaths under 1 year of age reported on death certificates and all births reported from birth 

certificates. The period linked birth/infant death data set is the primary data set for analyzing 

infant mortality trends and patterns in the United States, and it is the only source for examining 

race and Hispanic-origin infant mortality and for examining factors related to birth (5,11). Race 

and Hispanic origin are self-reported by the mother on the birth certificate.

Linked birth/infant death data sets are available from: 

https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.

References to increases or decreases in rates indicate that differences are statistically significant 

at the 0.05 level (5). References to trends in rates for Figure 1 were evaluated using the Joinpoint 

Regression Program. A maximum of one joinpoint was allowed during the 2007–2016 period, 

which is the default setting. The default settings were also selected for the other parameters of the 

analysis (12).

About the authors

Danielle M. Ely, Anne K. Driscoll, and T.J. Mathews are with the National Center for Health 

Statistics, Division of Vital Statistics.

References

1. Chen A, Oster E, Williams H. Why is infant mortality higher in the United States than in 

Europe? Am Econ J Econ Policy 8(2):89–124. 2016.

2. Jacob JA. US infant mortality rate declines but still exceeds other developed countries. JAMA 

315(5):451–2. 2016.

3. MacDorman MF, Mathews TJ, Mohangoo AD, Zeitlin J. International comparisons of infant 

mortality and related factors: United States and Europe, 2010. National Vital Statistics Reports; 

vol 63 no 5. Hyattsville, MD: National Center for Health Statistics. 2014.

4. Mathews TJ, Driscoll AK. Trends in infant mortality in the United States, 2005–2014. NCHS 

Data Brief, no 279. Hyattsville, MD: National Center for Health Statistics. 2017.

5. Mathews TJ, MacDorman MF, Thoma ME. Infant mortality statistics from the 2013 period 

linked birth/infant death data set. National Vital Statistics Reports; vol 64 no 9. Hyattsville, MD: 

National Center for Health Statistics. 2015.

6. Heron M. Deaths: Leading causes for 2015. National Vital Statistics Reports; vol 66 no 5. 

Hyattsville, MD: National Center for Health Statistics. 2017.

7. Gregory ECW, Drake P, Martin JA. Lack of change in perinatal mortality in the United States, 

2014–2016. NCHS Data Brief, no 316. Hyattsville, MD: National Center for Health Statistics. 

2018. 
NCHS Data Brief ■ No. 326 ■ November 2018

8. Martin JA, Osterman MJK. Describing the increase in preterm births in 

the United States, 2014–2016. NCHS Data Brief, no 312. Hyattsville, MD: 

National Center for Health Statistics. 2018.

9. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. 

Births: Final data for 2016. National Vital Statistics Reports; vol 67 no 1. 

Hyattsville, MD: National Center for Health Statistics. 2018.

10. MacDorman MF, Mathews TJ. Recent trends in infant mortality in the 

United States. NCHS Data Brief, no 9. Hyattsville, MD: National Center for 

Health Statistics. 2008.

11. Kochanek KD, Murphy SL, Xu JQ, Tejada-Vera B. Deaths: Final data 

for 2014. National Vital Statistics Reports; vol 65 no 4. Hyattsville, MD: 

National Center for Health Statistics. 2016.

12. National Cancer Institute. Joinpoint Regression Program (Version 

4.6.0.0) [computer software]. 2018.

Keywords: infant death • births • infant health • National Vital Statistics 

System

Suggested citation

Ely DM, Driscoll AK, Mathews TJ. Infant 

mortality by age at death in the United 

States, 2016. NCHS Data Brief, no 326. 

Hyattsville, MD: National Center for Health 

Statistics. 2018.

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

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Vital Statistics

Steven Schwartz, Ph.D., Director

Hanyu Ni, Ph.D., M.P.H., Associate Director 

for Science

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