We produce 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 Official Statistics and have been produced free from any political interference.
This page provides information on the collection, production and quality of mortality data for:
- Child mortality statistics, which presents final statistics on stillbirths, infant deaths and childhood deaths that occurred in England and Wales in a calendar year
- Birth cohort tables for infant deaths (babies born in a reference year who died before their first birthday), which are published separately
The Child Mortality Statistics Quality and Methodology Information document contains important information on:
- the strengths and limitations of the data
- the quality of the output: including the accuracy of the data and how it compares with related data
- uses and users
- how the output was created
The User guide to birth statistics provides information on the collection, production and quality of birth statistics based on birth registration data.
Child mortality statistics and Birth cohort tables for infant deaths replaced the annual reference volume Mortality statistics: childhood, infant and perinatal (DH3) in 2010. The current releases contain selected tables from DH3, although some tables have been amended to improve presentation.
The ONS policy on protecting confidentiality in birth and death statistics (currently under revision) is available on our website.Back to table of contents
The annual total of deaths occurring in a calendar year is taken from the standard dataset for death occurrences created from the deaths database. To be acceptably complete, this annual extract must be taken some months after the end of the data year to allow for late death registrations. Although there will inevitably be a small number of deaths not registered when the annual extract of death occurrences is taken, delaying the timing of the extract any further will delay the publication of the data.
The Birth cohort tables for infant deaths represent those babies born in a calendar year who died before their first birthday.
The annual totals of live births and stillbirths are derived from the standard annual extract of live births and stillbirths. This extract includes all births occurring and registered in a calendar year plus late registrations from the previous year.Back to table of contents
In Child mortality statistics, childhood deaths are defined as between 1 and 15 years of age. Infant deaths (under 1 year) at various ages are defined as:
- early neonatal – deaths under 7 days
- perinatal – stillbirths and early neonatal deaths
- late neonatal – deaths between 7 and 27 days
- neonatal – deaths under 28 days
- postneonatal – deaths between 28 days and 1 year
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 thus 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 (OPCS 1994).
3.2 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.
3.3 Death rates
The rates presented in this publication are:
- stillbirth rate: number of stillbirths, per 1,000 live births and stillbirths
- infant mortality rate: number of deaths at ages under 1 year, per 1,000 live births
- perinatal mortality rate: number of stillbirths plus number of deaths at ages under 7 days, per 1,000 live births and stillbirths
- early neonatal mortality rate: number of deaths at ages under 7 days, per 1,000 live births
- neonatal mortality rate: number of deaths at ages under 28 days, per 1,000 live births
- postneonatal mortality rate: number of deaths at ages 28 days and over, but under 1 year, per 1,000 live births
- age-specific child mortality rate: number of deaths in a particular age group per 100,000 population in that group
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 1 year, in 2015. Stillbirths may be certified by the medical practitioner or the midwife who is present at or who conducts the delivery, or who examines the body after birth. In 2015, 68% were certified by midwives and 30% by doctors.
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 and is “natural”.
Inquests on stillbirths and neonatal deaths are rare. In 2015 86% of neonatal deaths were certified by a doctor and 12% by a coroner, with only 5% 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 due to sudden infant death syndrome (SIDS) without being subject to inquest.
Table 1: Stillbirths, neonatal and infant deaths: by method of certification, 2015
|England and Wales|
|Method of certification||Stillbirths||Neonatal deaths||Infant deaths|
|Certified by doctor||936||29.7||1,575||85.7||2,036||79.0|
|After referral to coroner||0||0.0||531||28.9||716||27.8|
|Certified by coroner||3||0.1||218||11.9||497||19.3|
|Certified by midwife||2,137||67.9||z||z||z||z|
|Source: Office for National Statistics|
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5.1 Area coverage
The births and deaths recorded in the annual publication Child mortality statistics and Birth cohort tables are those occurring in a given calendar year that have been registered in England and Wales.
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 sub-division 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 gives recent numbers of infant deaths that occurred in England and Wales in a given year for those infants not usually resident in England and Wales.
Table 2: Infant deaths of non-residents, 2011 to 2015
|England and Wales|
|Deaths at ages under 1 year||3,025||2,912||2,686||2,517||2,578|
|deaths of residents outside England and Wales||28||24||35||18||23|
|% of total||0.9||0.8||1.3||0.7||0.9|
|Source: Office for National Statistics|
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5.2 Base populations
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. Our 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 can be found on our website.Back to table of contents
For deaths at ages 28 days and over, the death certificate (Annex D) used in England and Wales accords with that recommended by the World Health Organisation (WHO) in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) (WHO 1992 to 1994). Further information regarding coding the underlying cause of death can be found in the User guide to mortality statistics.
On 1 January 2014, ONS changed the software used to code cause of death from MMDS to IRIS. The new IRIS software version 2013 incorporates official updates to ICD-10 that are approved by WHO. The use of the IRIS software will help to improve the international comparability of mortality statistics. For stillbirths and neonatal deaths, any maternal condition mentioned on the death certificate will be coded to the P chapter (certain conditions originating in the perinatal period) rather than elsewhere in the ICD classification. Previously these deaths may have been coded to the O chapter (pregnancy, childbirth and the puerperium). The 2014 registrations of stillbirths and neonates that occurred in 2013 were recoded to ensure comparability within the 2013 occurrences dataset. Although this change was implemented on 1 January 2014 there were a very small number of infant deaths that occurred in 2013 and were registered in 2014, that were affected by the change.
Further information on IRIS can be found on our website. There is also a study that looks into the impact of the coding changes on stillbirths and neonatal deaths.
6.1 Neonatal and stillbirth cause of death certificates
The neonatal and stillbirth certificates (Annex D), introduced in January 1986 follow recommendations of WHO in the ICD, whereby causes of death are given separately in the following categories:
- main diseases or conditions in infant or fetus
- other diseases or conditions in infant or fetus
- main maternal diseases or conditions affecting infant or fetus
- other maternal diseases or conditions affecting infant or fetus
- other relevant causes
While conditions arising in the mother that affected the infant could be mentioned on certificates prior to 1986, no provision was made for those cases in which the certifier considered that both maternal and infant conditions contributed to the death. The current certificates overcome this problem. However, since equal weighting is given to main conditions in the infant and in the mother, it is no longer possible to identify a single underlying cause of death for neonatal deaths and stillbirths.
6.2 ONS cause of death groups
In England and Wales, stillbirths and neonatal deaths are registered using a special death certificate (Annex D), which enables reporting of relevant diseases or conditions in both the infant and the mother. For postneonatal deaths, a single underlying cause of death can be reported using the standard death certificate. ONS has developed a hierarchical classification system producing broad cause groups to enable direct comparison of neonatal and postneonatal deaths. The hierarchical classification, which is referred to as the ONS cause groups, 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 directs 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 Annex B and Annex 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. Some analysis of the impact of this change in methods is available on request.Back to table of contents
Our website provides a comprehensive source of freely available vital statistics and ONS products. More information on our website can be obtained from the contact addresses found in the next paragraph.
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 Vital Statistics Outputs Branch (email@example.com or telephone: +44 (0)1329 444 110). All user requested data will be published onto the website.
8.1 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 3 and 4 of the User guide to mortality statistics. Further information and background on birth statistics can be found in the User guide to birth statistics.
8.2 Other sources of data on births and deaths
Deaths occurring in a given year
- Child mortality statistics – statistics on stillbirths, infant deaths and childhood deaths occurring in a given year in England and Wales
- Birth cohort tables for infant deaths – deaths of infants born in a given calendar year using additional data from the birth record
- Pregnancy and ethnic factors influencing births and infant mortality (previously called Gestation-specific infant mortality) – live births and infant deaths by 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: population and health reference tables provide annual infant mortality data for the UK and its constituent countries.
Other UK countries
For 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 main summary statistics for live births in England and Wales.
8.3 Other useful information
Response to the ONS review of infant mortality statistics
Results from the ICD-10 bridge coding study for stillbirths and neonatal deaths
Disclosure Control Policy for Birth and Death Statistics (currently under revision)
We welcome feedback from users on the content, format and relevance of mortality outputs.Back to table of contents
Occurring just before birth.
The ONS cause groups is another term used for “Hierarchical classification”; see this definition.
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 7 days.
ONS' method for classifying the causes of neonatal deaths and stillbirths, made up of groups of ICD codes referred to as “ONS cause groups”.
Under 1 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.
Office for National Statistics.
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 cause of death selected for primary tabulation (excludes deaths at age under 28 days).
Vital Statistics Outputs Branch (at ONS).
World Health Organisation.Back to table of contents
Contact details for this Methodology
Telephone: +44 (0)1329 444110