We produce child and infant mortality statistics that are published under the National Statistics logo. This guarantees that those outputs have been produced to the high professional standards set out in the Code of Practice for Official Statistics, and have been produced free from any political interference.
The main differences between these two sets of tables are:
The death cohort tables are based on the year the death occurred, while the birth cohort are based on the year infant was born, whether they died in the same year or the following year
The death cohort tables cover both infant deaths (under one year of age) and childhood deaths (between 1 and 15 years of age), while the birth cohort tables are for infants only
In both cases, the death information has been linked to the relevant birth registration record so that tables broken down by information available on the birth registration (but not the death registration) can be produced. However, we currently only link the data that are used to produce the birth cohort tables to a third source – the birth notification records provided by the NHS. These records contain information about gestation length and ethnicity of the child, which is not available on the birth registration, therefore, some tables in the birth cohort release are broken down by these factors.
Both sets of tables are described and explained in a single Child and infant mortality publication.
The Child and infant mortality statistics QMI report contains important information on:
- the strengths and limitations of the data and how it compares with related data
- the quality of the output, including the accuracy of the data
- uses and users of the data
- how the output was created
The User guide to birth statistics provides more detailed information on the collection, production and quality of birth statistics based on birth registration data.
Following the results of an infant mortality user consultation carried out in spring and summer of 2017, we combined the Birth cohort tables for infant deaths and the Pregnancy and ethnic factors influencing births and infant mortality into one publication called Infant mortality (birth cohort) tables. In addition, there have been revisions to both these tables and the death cohort tables to improve presentation and to meet our user needs. More detail is available in the response to the consultation.Back to table of contents
The majority of Office for National Statistics (ONS) death statistics are based on when a death is registered rather than when it occurred. In most cases, this makes little difference in monitoring trends because the difference between when the death occurred and when it is registered is small.
However, in the case of infant deaths, this delay can be much longer and many deaths occurring in a year will be registered after that year has finished.
We recommend using occurrence-based statistics to monitor infant mortality patterns over time. The downside to this is that we take the data extract used to produce the statistics some months after the end of the reference year to ensure we capture as many of the deaths that actually occurred in that year as possible. We will still miss some later registrations but this is a balance we must strike between accuracy and timeliness.
The annual totals of live births and stillbirths included in these tables are derived from the standard annual extract of live births and stillbirths. This extract includes all births that occurred and were registered in England and Wales in a calendar year, but also include a small number of late registrations from the previous year.Back to table of contents
In Child mortality (death cohort) tables, childhood deaths are defined as between 1 and 15 years of age.
Infant deaths (under 1 year) can be broken down as follows:
The Stillbirth (Definition) Act 1992 defines a stillbirth as:
“a child which has issued forth from its mother after the twenty-fourth week of pregnancy, and which did not at any time after becoming completely expelled from its mother breathe or show other signs of life”.
This definition has been in use since 1 October 1992. Prior to this, the Births and Deaths Registration Act 1953 defined a stillbirth as above, but at 28 or more weeks completed gestation. Figures for stillbirths from 1993 are not comparable with those for previous years. The effect of this change on figures for 1992 is analysed in the annual volume of birth statistics for that year (Office of Population, Censuses and Surveys 1994).
Registration and certification of stillbirths, neonatal and infant deaths
General information about the registration and certification of stillbirths, neonatal and infant deaths in England and Wales can be found in the User guide to mortality statistics. It also provides information about the specific details collected when a death is certified and registered.
We calculate the following rates for England and Wales in the Child and infant mortality publication:
- perinatal mortality
- early neonatal mortality
- neonatal mortality
- postneonatal mortality
- infant mortality
- age-specific child mortality
More information on how we calculate these rates is available in Section 8 of this report.Back to table of contents
While the majority of infant deaths are certified by a doctor, some may be reported to the coroner by the certifying doctor or the registrar. The circumstances under which a death has to be referred are covered in the User guide to mortality statistics.
Table 1 provides the numbers of deaths by method of certification for those infants aged under one year, in 2018.
The conditions for certifying neonatal deaths are as for other deaths – that the doctor should have been in attendance during the deceased’s last illness, should have seen the patient prior to death or seen the body, and that the cause of death is known.
Only a small proportion of neonatal deaths require inquests. In 2018, 84% of neonatal deaths were certified by a doctor, 14% by a coroner and only 7% were subject to a coroner’s inquest. This reflects the fact that nearly all neonatal deaths occur in hospitals, and that infant deaths can be certified as to the result of sudden infant death syndrome (SIDS) without being subject to inquest.
|Numbers and percentages|
|Method of certification||Neonatal deaths||Infant deaths|
|Certified by doctor||1,528||84.2||1,931||77.6|
|After referral to coroner||452||24.7||604||24.3|
|Certified by coroner||254||13.9||522||21.0|
|Certified by midwife||z||z||z||z|
Download this table Table 1: Neonatal and infant deaths: by method of certification, 2018.xls .csv
Births and deaths to residents of England and Wales that occur and are registered outside of England and Wales are excluded.
Births and deaths registered in England and Wales to persons whose usual residence is outside England and Wales are included in any total figures for England and Wales, but are excluded from any subdivision of England and Wales.
Figures for live births and stillbirths to women whose usual residence is outside of England and Wales can be found in Tables 5 and 6 in the publication Birth characteristics.
Table 2 provides the number of infant deaths that occurred in England and Wales by calendar year, for those infants who were not usually resident in England and Wales.
|Numbers and percentages|
|All infant deaths (aged under one year)||2,517||2,578||2,651||2,636||2,488|
|Infant deaths of residents outside England and Wales||18||23||25||23||13|
|% of all infant deaths||0.7||0.9||0.9||0.9||0.5|
Download this table Table 2: Infant deaths of non-residents, 2014 to 2018.xls .csv
The population figures used to calculate child mortality rates are mid-year estimates of the resident population of England and Wales based on the census of population. The Office for National Statistics mid-year population estimates are based on updates from the most recent census allowing for births, deaths, net migration and ageing of the population.
The population estimates used for the calculation of mortality rates are the latest consistent estimates available at the time of production. Further information on population estimates and their methodology is also available.Back to table of contents
In England and Wales, stillbirths and neonatal deaths are registered using a special death certificate introduced in 1986 (Annex D), which enables reporting of relevant diseases or conditions in both the infant and the mother (see section 11.3 of the User Guide to Mortality Statistics for more detail). Equal weighting is given to main conditions recorded in the infant and in the mother, so it is no longer possible to identify a single underlying cause of death for neonatal deaths and stillbirths. For postneonatal deaths (between 28 days and one year), a single underlying cause of death can be reported using the standard death certificate.
We developed a hierarchical classification system (PDF, 72KB) producing broad cause groups to enable direct comparison between neonatal and postneonatal deaths. This classification is referred to as the ONS cause groups, and allows the death to be assigned to a specific category, based on the likely timing of the damage leading to the death.
A computer algorithm assigns any mention, in the case of neonatal deaths, and underlying cause in the case of postneonatal deaths, to the first appropriate class of the following mutually exclusive categories:
Before the onset of labour
1. congenital anomalies
2. antepartum infections
3. immaturity related conditions
In, or shortly after labour
4. asphyxia, anoxia, or trauma
5. external conditions
7. other specific conditions
9. sudden infant deaths
0. other conditions
A similar algorithm is used for stillbirths.
The grouping of ICD-10 codes into these nine categories for neonatal and postneonatal deaths is shown in Annexes B and C respectively. Corresponding groupings for stillbirths are shown in Annex A. (Annexes A.1, B.1 and C.1 refer to 2001 to 2010, Annexes A.2, B.2 and C.2 refer to 2011 to 2013 and Annexes A.3, B.3 and C.3 refer to 2014 onwards).
However, for the data years 2001 to 2012, postneonatal deaths were assigned to the ONS cause groups based on mentions rather than underlying cause.Back to table of contents
The rates presented in these publications are described below.
Perinatal mortality rate:
Early neonatal mortality rate:
Neonatal mortality rate:
Postneonatal mortality rate:
Infant mortality rate:
Age-specific child mortality rate:
Within our statistical bulletin, a change which is described as statistically significant has primarily been assessed using confidence intervals. For infant mortality data where we have all the death records, confidence intervals help tell the difference between a change caused by random fluctuations between years, and a real change in the infant mortality rate. If the confidence interval around a figure does not overlap with the interval around another, we can say with more confidence that the difference is likely to be a real change rather than simply down to chance.Back to table of contents
Special extracts and tabulations of child mortality data for England and Wales are available to order (subject to legal frameworks, disclosure control, resources and our charging policy, where appropriate). Enquiries should be made to the Office for National Statistics (ONS) Vital Statistics Outputs Branch to Health.Data@ons.gov.uk or +44 (0)1329 444 110). All user requested data will be published on the website.
Other sources of information on births and deaths
Additional information on background to mortality data that we publish, together with the quality of mortality data can be found in Sections 16 and 12 of the User guide to mortality statistics. Further information and background on birth statistics can be found in the User guide to birth statistics.
Other sources of data on births and deaths
Deaths occurring in a given year
- Child mortality (death cohort) tables - statistics on stillbirths, infant deaths and childhood deaths occurring in a given year in England and Wales
- Infant mortality (birth cohort) tables - statistics on stillbirths, live births and deaths of infants born in a calendar year using additional data from the birth record such as gestational age
- Unexplained deaths in infancy - both sudden infant deaths and deaths for which the cause remained unknown or unascertained
Deaths registered in a given year
Summary data for infant mortality in England and Wales are available in the Deaths registrations summary tables. A geographical breakdown of infant death numbers and rates by local authority and county level is available in Deaths registered in England and Wales by area of usual residence.
The Vital statistics in the UK: births, deaths and marriages provide annual infant mortality data for the United Kingdom and its constituent countries.
Other UK countries
For infant mortality data for other UK countries please see the latest infant death statistics for Northern Ireland and the latest infant death statistics for Scotland.
The Births summary tables, England and Wales provide the main summary statistics for live births in England and Wales.
Other useful information
The ONS response to the review of infant mortality statistics that took place between 20 April and 20 July 2017 is available.Back to table of contents
Occurring just before birth.
The ONS cause groups is another term used for “Hierarchical classification”.
Children aged between 1 and 15 years.
A structural or functional abnormality of the human body that develops before birth.
Public official responsible for the investigation of violent, sudden or suspicious deaths.
Relating to infants aged under seven days.
The Office for National Statistics (ONS) method for classifying the causes of neonatal deaths and stillbirths, made up of groups of ICD codes referred to as “ONS cause groups”.
International Classification of Diseases and Related Health Problems.
Child aged under one year.
Inquiry into the cause of an unexplained, sudden or violent death, held by a coroner.
The matching of infant death records to their corresponding birth registration record.
Relating to infants aged under 28 days.
National Statistics Socio-economic Classification categorises the socio-economic classification of people, and has replaced the Registrar General’s Social Class and the Socio-economic Group (SEG).
Number of deaths according to the date on which the death occurred.
Stillbirths and early neonatal.
Relating to infants aged between 28 days and 1 year.
Local authority employee responsible for the registration of births, deaths, marriages and civil partnerships.
Number of deaths according to the date on which the deaths were registered.
Standard Occupational Classification 2010 is the current occupational classification. SOC2010 codes, details of employment status and size of organisation are required for the derivation of NS-SEC. See NS-SEC.
A child that has issued forth from its mother after the 24th week of pregnancy, and that did not at any time after being completely expelled from its mother breathe or show any signs of life.
Underlying cause of death
“The disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury” in accordance with the rules of the International Classification of Diseases (excludes deaths at age under 28 days).
World Health Organisation.Back to table of contents
Contact details for this Methodology
Telephone: +44 (0)1329 444110
You might also be interested in:
- Annex A.1 - ONS classification of stillbirths and associated ICD-10 codes, 2001 to 2010 (42.0 kB xls)
- Annex A.2 - ONS classification of stillbirths and associated ICD-10 codes, 2011 to 2013 (42.0 kB xls)
- Annex A.3 - ONS classification of stillbirths and associated ICD-10 codes, 2014 onwards (42.0 kB xls)
- Annex B.1 – ONS classification of neonatal deaths and associated ICD-10 codes, 2001 to 2010 (43.0 kB xls)
- Annex B.2 – ONS classification of neonatal deaths and associated ICD-10 codes, 2011 to 2013 (45.1 kB xls)
- Annex B.3 – ONS classification of neonatal deaths and associated ICD-10 codes, 2014 onwards (43.0 kB xls)
- Annex C.1 – ONS classification of postneonatal deaths and associated ICD-10 codes, 2001 to 2010 (38.9 kB xls)
- Annex C.2 – ONS classification of postneonatal deaths and associated ICD-10 codes, 2011 to 2013 (39.4 kB xls)
- Annex C.3 – ONS classification of postneonatal deaths and associated ICD-10 codes, 2014 onwards (39.4 kB xls)
- Annex D - Death certificate (1.4 MB pdf)