A recent study published in the Journal of Perinatal Medicine investigates drug-related infant death patterns in the United States between 2018 and 2022.

Study: Increases in drug-related infant mortality in the United States. Image Credit: PeopleImages.com – Yuri A / Shutterstock.com

Infant mortality in the U.S.

Infant deaths are defined as deaths that occur between the time the child is born and one year of age. As compared to the previous year, there was a 3% increase in the overall infant mortality rate in the U.S. in 2022, with an estimated infant mortality rate of 5.6 deaths for every 1,000 live births that year. Infant mortality rates due to maternal complications and bacterial sepsis, both of which are leading causes of infant death, also increased during this period.

In many cases, drugs are directly involved with or contributing to factors related to infant mortality. Infants can be introduced to various drugs through maternal use, illicit or non-medical use of drugs, and accidental intake of specific prescriptions.

Recently, there has been a significant increase in drug overdose deaths in the general population, including among pregnant and postpartum women. Since drug-related deaths are potentially avoidable causes, these events must be seriously investigated to reduce the rate of infant deaths.

Drug-related infant mortality in the U.S.

The current study explored the temporal trend in drug-related infant deaths between 2018 and 2022 in the U.S. To this end, all relevant data were obtained from the U.S. Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER).

A total of 295 drug-involved infant deaths were recorded between 2018 and 2022, which reflects 0.29 % of the 102,110 total infant deaths that occurred during this period. Between 2018 and 2022, there was an increase in drug-related infant deaths from 10.8% to 24.4%. Comparatively, one previous study reported a significantly lower drug-related infant mortality rate of 0.64 % between 2015 and 2017.

Although most drug-related infant deaths were recorded in 2021, the highest number of fatalities was recorded in 2019, followed by 2022. Importantly, this period was also associated with a significant rise in drug overdose mortality among both pregnant and postpartum women.

At the end of 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged, with its subsequent widespread transmission ultimately leading to the declaration of the coronavirus disease 2019 (COVID-19) pandemic in March 2020. To date, many studies have investigated the severe impact of pandemic-related lockdowns on psychiatric health and related behaviors. The potential relationship between these effects of the COVID-19 pandemic on drug overdoses among pregnant and postpartum women, combined with the increased rate of drug-related mortality among infants, necessitates further research.  

Several studies have shown that substance use, including opioids and cocaine, can lead to adverse birth outcomes such as low birth weight and premature birth, which increases the risk of infant mortality. Reduced prenatal care during the pandemic and hospital closures, particularly in rural areas, may have also contributed to the increase in drug-related infant fatalities.

Infant mortality has also been associated with maternal health, living conditions, and economic development. As compared to different race and ethnic groups, non-Hispanic White and Black infants were associated with a higher number of drug-related infant deaths.

Conclusions

The current study estimates an alarming 2.2-fold increase in the U.S. infant mortality rate associated with drugs between 2018 and 2022. Some notable limitations of the current study include the descriptive study design and methodology, which may have omitted crucial drug-related information.

In the future, more research is needed to identify the specific drugs that increase the risk of infant mortality and patterns of perinatal substance use. It is also crucial to develop effective strategies to reduce death rates by preventing maternal substance use and enhancing prenatal care access. New strategies could be created by collaborating with different stakeholders, including public health agencies, health providers, and community partners.