In France, for the first time in peacetime, the infant mortality rate has risen significantly over the past ten years. ©Adobe Stock
The infant mortality rate is a key indicator of the health of a population. In the absence of updated data on the statistical trends of this indicator in France, researchers from Inserm, University of Paris, AP-HP and Nantes University Hospital, in collaboration with teams from University of California, analyzed vital statistics data from the National Institute of Statistics and Economic Studies (INSEE) between 2001 and 2019. They were able to identify a significant increase in the infant mortality rate since the year 2012, France moving away from the situation of other countries with developed economies. The results are published in the journal The Lancet Regional Health Europe and bear witness to the importance of deepening the search for the precise causes of these 1,200 excess deaths observed each year in France before the age of one year.
The United Nations has set as one of its priority goals the elimination of preventable child deaths by 2030. The vast majority of pediatric deaths occurring during the first year of life, the mortality rate is used infantile[1] to track progress towards this goal. This rate is a key indicator of the health of the population, given its strong relationship with socio-economic development and the quality of existing preventive and curative care in the country. In some countries with advanced economies such as Finland and Sweden, the reduction in the infant mortality rate has been continuous since World War II. In other countries like France, this decline seems to be slowing down.
Scientists from Inserm, the University of Paris, the Assistance Publique-Hôpitaux de Paris, the University Hospital of Nantes and the University of California wanted to go further in the statistical analyzes of the evolution of the rate of infant mortality in France and focused more specifically on the period from 2001 to 2019.
During this study period, 53,077 infant deaths were recorded among the 14,622,096 live births, giving an average infant mortality rate of 3.63/1,000 (4.00 in boys, 3.25 in girls). Nearly a quarter of deaths (24.4%) occurred during the first day of life and half (47.8%) during the early neonatal period, ie during the first week after birth.
Extensive statistical analysis identified two inflection points in 2005 and 2012 (figure above). The infant mortality rate decreased sharply from 2001 to 2005, then more slowly from 2005 to 2012. From 2012, a significant increase in the infant mortality rate was observed. This 7% increase took infant mortality from 3.32 in 2012 to 3.56 deaths per 1000 live births in 2019. Sensitivity analyzes[2] showed that this trend was not linked to the modification of civil status practices, nor to the modification of medical practices for the care of newborns with serious conditions. Subgroup analyzes indicate that this increase is mainly due to an increase in the infant mortality rate in the early neonatal period.
« Thanks to advanced statistical analyses, we have identified a significant worsening of the infant mortality rate in France since 2012. By comparing the data with other European countries with similar economies such as Sweden and Finland, each year in France we observe an excess of approximately 1200 death of children under one year old “, explains Professor Martin Chalumeau, the last author of the study. “It is essential to be able to explore in detail the causes of this increase by having, for example, systematic information on the precise medical and social circumstances of these deaths and by making this population, which is the most vulnerable, a real research priority. and public health, which is not currently the case”concludes the researcher.
[1] The infant mortality rate (IMR) was defined as the number of deaths of children under one year old (D0-D364) per 1,000 live births in a given period
[2] Additional analyzes that support the robustness of the main analyzes