Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
The neonatal period (first 6 days of life) is at most risk of infant mortality1. Babies born to mothers under 20 years old have the highest infant mortality rates2.
Gender
In general population, male infants are at greater risk of infant mortality3, 4 and experience higher admissions to PICUs5. In PICUs, female infants have higher mortality rates5.
Socioeconomic status
Lower occupational status and unemployment are significantly associated with infant mortality6. Preterm birth rates are significantly higher in the most deprived areas in England7.
Qualifications
Mothers were no formal or low levels of education are significantly more likely to experience adverse birth outcomes8.
Mental health
Untreated maternal mental health conditions during the perinatal period are linked to complications including infant mortality9 and linked to deprivation10.
Ethnicity
Black ethnic groups had the highest infant mortality and stillbirth rates in England and Wales, Asian ethnic groups (especially Bangladeshi and Pakastani) had the second highest11.
Prisoners
Pregnant women in prison are at significantly increased risk of infant mortality, pregnant women in prison are 7 times more likely to experience a stillbirth than a woman who is not incarcerated12.
Sexual Orientation
Sexual minority women (particularly lesbian and bisexual women) are at increased risk of adverse infant outcomes13.
Vulnerable Children
Vulnerable children face higher risks due to missed antenatal care, poor nutrition and lack of support14. Extreme prematurity is most common among vulnerable populations14. There is a direct link between rising child poverty and the increase of infant mortality in England15.
Substance & Alcohol Use
Smoking and alcohol use are linked to stillbirth, low birth weight, preterm birth and sudden infant death syndrome (SIDS)16.