We produce child and infant mortality statistics that are published under the National Statistics logo, the designation guaranteeing that those outputs have been produced to high professional standards set out in the Code of Practice for Statistics, and have been produced free from any political interference.
The main differences between these two sets of tables are that:
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 1 year of age) and child deaths (between 1 and 15 years of age), while the birth cohort tables are for infants only
in both cases, the death record 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; we also link the data to a third source, the birth notification records provided by the NHS; these records contain information about gestation length and ethnicity of the baby, which is not available on the birth registration
Figures from the death cohort tables are described and explained in a single Child and infant mortality publication, because they provide the most timely statistics.
The Child and infant mortality statistics Quality and Methodology Information 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 and notification 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.
From the 2019 data release of Child and infant mortality in England and Wales onwards:
- the death cohort is now additionally linked to birth notification data, to allow for timely analysis of infant mortality by gestational age
- the death cohort tables now include all infant deaths rather than just those infant deaths that linked to their corresponding birth registration
- there have been several updates made to the death cohort tables to improve clarity for users and increase consistency across tables and across other ONS publications; no existing data have been removed, unless they can be found in other ONS publications
From the 2020 data release of Child and infant mortality in England and Wales onwards:
- the death cohort tables now include analysis of infant mortality by ethnicity of the baby, using revised ethnic group categories
- there have also been updates to both the death cohort and birth cohort tables with both sets of tables now being presented in line with the GSS accessibility guidance
These changes are explained further in Section 7.Back to table of contents
The majority of the Office for National Statistics 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. Table 1 shows that between 10% and 12% of infant deaths that occurred in a reference year were registered the following year. This proportion is larger than what has been seen historically for all deaths. Figures for all deaths that occurred in a reference year by the year of registration are available in Table 6 of the Impact of registration delays to mortality statistics tables.
|Percentage of infant deaths|
Download this table Table 1: Percentage of infant deaths that were registered the year after they occurred, 2014 to 2021.xls .csv
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.
Coronavirus (COVID-19) pandemic and birth statistics
Birth registration services in England and Wales were temporarily suspended in March 2020 because of the coronavirus (COVID-19) pandemic. From June 2020, registration services restarted where it was safe to do so. Consequently, 2020 births registrations came in much later than in normal years with 42% arriving after 42 days (the usual legal limit). Delays in birth registrations continued in 2021, with 26% arriving after 42 days. We decided to strike a balance between timeliness and completeness, and we took the 2020 annual birth registrations dataset on 12 August 2021 and the 2021 annual birth registrations dataset on 15 May 2022.
Birth registration delays in 2020 have also had an impact on data linkage between infant deaths, birth registrations and birth notifications used for our death cohort tables in the data years 2020 and 2021. This is explained further in Section 7. We have also discussed births registration delays and how they affect our statistics in more detail in Births in England and Wales explained: 2020.Back to table of contents
In Child mortality (death cohort) tables, child 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 baby born after 24 or more weeks completed gestation and which did not, at any time, breathe or show 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 previously stated, 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:
- stillbirth rate
- perinatal mortality rate
- early neonatal mortality rate
- neonatal mortality rate
- postneonatal mortality rate
- infant mortality rate
- age-specific child mortality rate
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 2 provides the numbers of deaths by method of certification for those infants aged under one year.
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 2021, 88% of neonatal deaths were certified by a doctor, 12% by a coroner and only 6% 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||1,506||87.8||1,908||82.1|
|After referral to coroner||306||17.8||399||17.2|
|Certified by coroner||202||11.8||407||17.5|
Download this table Table 2: Neonatal and infant deaths: by method of certification, 2021.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 3 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.
|Infant deaths of|
England and Wales
|% of all|
Download this table Table 3: Infant deaths of non-residents, 2014 to 2021.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.
Considerations need to be made when drawing comparisons between infant mortality statistics for England and Wales and statistics for Scotland and Northern Ireland.
It is a legal requirement across the UK that all births and deaths are registered, which means that infant mortality can be expressed as the number of infant deaths per 1,000 live births. This is an internationally recognised measure of infant mortality and means that fair comparisons can be made over time and between countries.
In England and Wales, there can be long delays between when an infant dies and when the death is registered. Deaths should be registered within five days, unless they are referred to a coroner for investigation, where the delay between the date of occurrence and date of registration can be longer. The Office for National Statistics (ONS) produces figures based on when the death occurred and also when it was registered.
Statistics based on death registrations are timelier, however, deaths registered in any given year will include deaths that happened in that year as well as previous years. Statistics based on death occurrences cannot be produced until later as there must be time to account for late registrations. However, these statistics are the most accurate representation of deaths in a given year. Infant deaths in England and Wales based on death occurrences are the preferred figures and the ones used to monitor trends in infant mortality over time.
National Records of Scotland (NRS) publish infant death figures in Scotland based on date of registration. This is because registration delays are shorter in Scotland than in England and a Scottish series based on date of occurrence would be almost identical to the one based on date of registration.
Similarly, Northern Ireland Statistics and Research Agency (NISRA) present all of their data on infant deaths using the date of registration rather than the date of occurrence, acknowledging that infant deaths are likely to be referred to the coroner, which means that the death may be registered later.
Figure 1 shows infant mortality rates per 1,000 live births for England, Wales, Scotland and Northern Ireland. The England and Wales rates are based on death occurrences, the figures presented in our death cohort tables. The figures for both Scotland and Northern Ireland are based on death registrations.
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.
The Office for National Statistics (ONS) 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 International Classification of Diseases: 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; Annexes A.3, B.3 and C.3 refer to 2014 to 2020; and Annexes A.4, B.4 and C.4 refer to 2021 onwards).
However, for the data years 2001 to 2013, postneonatal deaths were assigned to the ONS cause groups based on mentions rather than underlying cause.
From the 2021 data year, the hierarchical classification used to classify ONS cause of death groups for stillbirth and neonatal deaths has been updated to align with changes to the cause of death coding software. As such, ONS cause groups from 2021 onwards are not directly comparable with 2014 to 2020 data.
Stillbirths by cause of death
Dual coding of the 2,371 stillbirths registered in 2020 in England and Wales enabled identification of the differences because of the reclassification. For stillbirths, 311 records (13.1%) changed cause group when reclassifying them into ONS cause groups. Of the eight ONS cause groups, three groups saw statistically significant changes in the number of records. These three cause groups were:
- asphyxia, anoxia or trauma (antepartum/unknown)
- congenital anomalies
- other conditions
The asphyxia, anoxia or trauma (antepartum/unknown) cause group saw a net loss of 75 records because of the reclassification, a 16.8% decrease in the number of records. These records were reclassified mainly into the other specific conditions (86) and other conditions antepartum/unknown (25) cause groups. The largest number of new records entering the cause group came from the other conditions antepartum/unknown cause group (31).
The congenital anomalies cause group saw a 16.8% increase in the number of records, a net increase of 79 records. This increase was primarily because of reclassification from the other specific conditions (65) cause group, with a further 14 records being reclassified from several other cause groups.
In the other conditions cause group, the update resulted in a 4.3% decrease, a net loss of 51 records. A total of 89 records were reclassified into new cause groups, the largest being to the other specific conditions (45) and asphyxia, anoxia or trauma antepartum/unknown (31) cause groups.
Neonatal deaths by cause of death
For neonatal deaths, 79 records (3.3%) changed cause groups when reclassifying them into ONS cause groups. Of the nine ONS cause groups for neonatal deaths, two saw statistically significant changes (congenital anomalies and antepartum infections).
Congenital anomalies saw a 3.2% increase in the number of records in this cause group, a net increase of 23. The increase was mostly the result of the reclassification of ICD-10 codes, which were previously attributed to the immaturity related conditions cause group (17).
Antepartum infections saw a 6.8% decrease in the number of records, a net decrease of 11 records. Deaths were reclassified into the immaturity related conditions (six), congenital anomalies (three) and other conditions (three) cause groups.Back to table of contents
The rates presented in these publications are described in this section.
Perinatal mortality rate:
Early neonatal mortality rate:
Neonatal mortality rate:
Postneonatal mortality rate:
Infant mortality rate:
Age-specific child mortality rate:
Within this bulletin, a change that is described as statistically significant has primarily been assessed using a chi-square test; for infant mortality data where we have all the death records, they help tell the difference between a change caused by random fluctuations between years and a real change in the infant mortality rate – if the result is said to be statistically significant it is not likely caused by chance, therefore, we can say with more confidence that the difference is likely to be a real change.Back to table of contents
Our website (www.ons.gov.uk) provides a comprehensive source of freely available vital statistics and Office for National Statistics (ONS) products. More information on our website can be obtained from the contact numbers and addresses found in this section.
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). Such enquiries should be made to the Child Health team at Health.Data@ons.gov.uk or +44 1329 444110). All user requested data will be published on the website.
Other sources of information on births and deaths
Additional information on the background and quality of mortality data can be found in 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 calendar year in England and Wales.
- Infant mortality (birth cohort) tables - statistics on stillbirths, live births and deaths of infants born in a calendar year in England and Wales.
- 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.
We welcome feedback from users on the content, format and relevance of child/infant mortality outputs.Back to table of contents
Occurring just before birth.
The ONS cause groups is another term used for “Hierarchical classification”; see the relevant subheading in this section.
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 ONS’s method for classifying the causes of neonatal deaths and stillbirths, made up of groups of International Classification of Diseases and Related Health Problems (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 or birth notification 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 baby born after 24 or more weeks completed gestation and which did not, at any time, breathe or show 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 Organization.Back to table of contents
Office for National Statistics (ONS), published 1 March 2023, ONS website, methodology, User guide to child and infant mortality statistics
Contact details for this Methodology
Telephone: +44 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 to 2020 (19.6 kB xlsx)
- Annex A.4 – ONS classification of stillbirths and associated ICD-10 codes, 2021 onwards (21.4 kB xlsx)
- 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 to 2020 (20.8 kB xlsx)
- Annex B.4 – ONS classification of neonatal deaths and associated ICD-10 codes, 2021 onwards (20.1 kB xlsx)
- 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 to 2020 (18.4 kB xlsx)
- Annex C.4 – ONS classification of postneonatal deaths and associated ICD-10 codes, 2021 onwards (20.7 kB xlsx)
- Annex D - Death certificate (1.4 MB pdf)