Why infant mortality continues to increase in France?

2,700. This is the number of children who died before the age of one year in France in 2024. In other words, this means that a in 250 child does not reach their first anniversary, an infant mortality rate of 4.1 deaths for 1,000 children born living. However, this rate has “slightly increased” since 2011, going from 3.5 ‰ to 4.1 ‰ in 2024, according to new works by INSEE published Thursday, coming to corroborate previous studies of the National Institute of Demographic Studies (INED) which were already attesting to this disturbing phenomenon. Figures which prove to be greater than the European average, which was established in 2022 to 3.3 ‰.

In March, the INED was alarmed by this “worrying” development: “In 2022, France appeared as the 23ᵉ on the 27th in the European Union in matters of infantile mortality, a key indicator of the quality of perinatal care and public health policies, a marked fall compared to the 1990s, where it was among the best classified countries. »»

According to INSEE, “this increase is explained only by that of mortality of 1 to 27 days of life, which increased from 1.5 ‰ to 2.0 ‰”. It is during this period that half of infantile deaths occurred. A quarter of the other deaths takes place on the day of birth and a last quarter in the post-neonatal period, extending from 28 days to less than a year.

“The French situation has deteriorated”

Between 1985 and 1995, the mortality rate fell considerably, going from 8.3 ‰ to 4.9 ‰. Since the late 1990s, this downward trend has persisted, but at a much lower pace. In 2011, the infant mortality rate was 3.5 ‰. However, since 2020, this rate has experienced a worrying increase. “In the space of thirty years, the French situation has degraded significantly,” observes the INED.

This situation raises many questions. Why does France go against its European neighbors? Although a recent study indicates that the redefinition of living births could partially explain this negative trend, other factors also seem involved. “Medical factors and state of health of mothers, territorial and social inequalities of access to care, quality of management: several hypotheses must be explored to understand and stop this evolution”, lists the INED.Read too Maltractance in maternity: “Let’s redesign the world of birth”

In addition, in May 2024, the health results of perinatal policy were deemed “mediocre” by the Court of Auditors, despite the increase in the means allocated.

Also, according to INED, recent progress in care for great prematurers now allow certain babies to live briefly-a few hours, a few days-before died, when they were allegedly classified before. This phenomenon thus mechanically increases the number of deaths recorded “without reflecting a degradation of care”. As Magali Barbieri, research director at INED, points out, “this stagnation of infant mortality in France contrasts with the progress observed elsewhere in Europe and poses a real challenge for our health system”.

A higher rate among young and old mothers

In addition, according to INSEE work, boys present an increased risk of infant deaths of 21 % compared to girls, since, over the period 2004-2022, the rate amounts to 4.1 ‰ for boys who died before this age, against 3.4 ‰ for girls.

This risk of death is also five times higher for children from multiple delivery. Thus, this rate amounts to 16.7 ‰. “The mortality of twins or triplets is more marked the first days of life: it is five times higher on the day of birth, six times higher from 1 to 27 days, and ‘” only “three times more than 28 days to a year,” observes INSEE.

Regarding risk factors, the profile of mothers also plays a decisive role. First, age. The infant mortality rate is greater than 5 ‰ for very young (21 or less) or “very old” (44 years or more) mothers.

To discover

The kangaroo of the day

Answer

Then, mortality varies according to the socio -professional category, being higher for children of employees (3.6 ‰), workers (3.5 ‰) and inactive women (5.1 ‰), against an average of 2.2 ‰ for executive children. According to INSEE, this difference could be explained by the health of inactive mothers, used or workers, on average less good than that of executives. Added to this other factors: unfavorable working conditions, greater smoking consumption, lower recourse to preventive care …

Read too Maternity, the taboo of mistreatmentInfant mortality is also higher in the overseas departments and territories, reaching on average 8 ‰, with a peak in Guyana (9.7 ‰). On March 27, arrested in the National Assembly on this subject, the Minister of Health Catherine Vautrin had announced that he was “putting in place the registers of births and deaths and deployment at the local level of Morbi-Mortality review, so as to watch and study each of the deaths because this is how we can provide concrete answers”.