Background Infection is an important cause of neonatal/infant mortality. Antenatal care, neonatal intensive care and immunisation practices affect infectious mortality, but no good data show how these deaths have changed over time. Understanding this will help direct future medical priorities.
Objective To evaluate changes in neonatal/infant mortality from infection over 2 decades (1988–2008) in a geographical population.
Design and Methods We used a population database (Perinatal Mortality Survey, Northern region UK) and reviewed infant deaths coded as infection. Proportional contribution to deaths, pathogens identified and risk factors were analysed. To demonstrate changes over time, three 7-year epochs were created.
Results 625 deaths from infection were identified. Absolute numbers of deaths fell with time but the proportion from infection increased. Significantly preterm infants were increasingly represented in successive epochs.
Deaths from GBS fell, and a fall in meningoccal (MEN) infections follows universal immunisation (1999). Infections from staphylococcus aureus (SA) were unchanged.
Conclusions Despite better care and immunisations, the proportion of infant mortality from infections has increased. Term infants have benefited from changes in management but preterm infants have not, and deserve urgent prioritisation.