Infant mortality in Missouri went up 16% between 2021 and 2022, according to federal data released this month.
Missouri babies died before their first birthday at a rate of 6.8 per 1,000 live births, according to the Centers for Disease Control and Prevention.
The numbers were painful to see for Melinda Monroe, CEO of Nurses for Newborns, a nonprofit that provides screening services and care for infants and families.
“We have seen infant mortality rates trending down, overall,” Monroe said. “And this was the first time in over 20 years that we have seen an uptick as a nation, and a significant uptick in Missouri's rate.”
The state saw 61 more infant deaths in 2022 than in 2021, despite fewer overall births that year. The data lacked state-specific data beyond the raw numbers and infant mortality rate
Monroe said that the state will need to examine Missouri-specific data on why the babies died once it becomes available:
“But when we're talking about a baby dying, one more is too many,” she said “It’s not OK. And so that's where we have to pay attention to the most granular data we can get our hands on.”
Public health experts say infant mortality is one of the major measures of a population’s overall health and ability to access health care.
The recent data signals an end to a steady decline in infant mortality, which has been decreasing nationally and statewide for years. While Missouri, Iowa, Georgia and Texas were the only states with what the CDC described as significant increases in infant deaths, other states saw small increases or rates that stayed relatively flat, leading to a 3% increase nationally.
The agency reported deaths due to maternal health complications and bacterial sepsis, or a body’s reaction to infection, increased.
The higher infant mortality rate in Missouri could be in part due to advances in care for premature babies, said Dr. Nick Holekamp, chief medical officer of Ranken Jordan Pediatric Bridge Hospital in west St. Louis County. More babies are able to live when they’re born premature than in years before. Because of advances in medical care, babies that would have been miscarriages or stillbirths are now living, but with extreme health problems, he said.
“We decreased [the] age of survivability from about 25 weeks gestation, when I started, to less than 22 weeks,” Holekamp said. “And so the converse of that is that every next child that survives delivery [at that gestation], weighs less than one pound.”
Infants born premature are likely to be born with undeveloped lungs, brains and gastrointestinal systems, which puts them at risk of death within the first year of life, he said.
When families don’t have access to a social safety net that includes easy access to doctors and other support, it’s likely they will experience both premature birth and infant mortality, Holekamp said.
“It works both before and after delivery … against the child and against the family,” he said.
The CDC’s data release comes about four months after the state released a report showing Missouri women were more likely to die during pregnancy and after they gave birth between 2018 and 2020 than in the previous three-year period that ended in 2019.
Maternal and infant health go hand-in-hand, said Kendra Copanas, Executive Director of Generate Health STL, a St. Louis-based group that advocates for policies that help the region’s Black people.
“I think that we’re still seeing maternal mental health concerns, we’re still seeing opioid use and overdose and we’re still seeing factors that are probably connected, but it’s harder to know how much to attribute,” she said. “With infant mortality, it’s not one thing ever, it’s multiple factors. This isn’t simple, easy answers.”
