The study, which used data from the NCMD cohort — a first-of-its-kind initiative to collect comprehensive and timely information on every child death in England, sought to identify any risks or patterns from 9,872 child deaths over three 12-month periods spanning 1 April 2019 until 31 March 2022. Of these deaths, 6,257 (63%) occurred under one year of age, the majority (56%) 5,534 were male, and 8,766 (89%) lived in an urban area.

Within the three periods, the team show that prior to the pandemic (1 April 2019 to 31 March 2020) there were 3,409 child deaths recorded in England but during the same period of the first year of the pandemic (2020 to 2021) the number reduced significantly to 3,035, due to a decreased number of infections in younger children. However, since the pandemic (2021-2022), this number has increased to 3,428.

Despite this increase in 2021 to 2022, the team show there were 4% fewer deaths over the whole three-year period than would have been expected from extrapolating the risks seen in 2019 to 2020. The reductions were largest in rural areas and in children under 10 years old.

In line with this, a 22.8% reduction in the number of deaths caused by infection and 13.3% reduction in underlying disease was seen. But in contrast to most deaths, those from trauma have increased 14.8% across the three years and this association does not appear to be restricted to one particular age group. There has also been an increase in sudden unexpected death in infancy or childhood (SUDIC), this may be the first mortality signal we are seeing from families struggling with increasing poverty as we move out of the pandemic.

Karen Luyt, Programme Lead for the National Child Mortality Database and Professor of Neonatal Medicine at the University of Bristol, said: "Our research shows the number of deaths of children in England dropped substantially during the first year of the pandemic but returned to baseline levels in the following year.

"However, there was little to suggest an excess of deaths in 2021-22 overall, or for most sub-groups investigated. Disruption to healthcare services, and potentially later diagnoses or underdiagnosed conditions, appear not to have had a measurable impact on mortality.

"It is important that we learn from the effects highlighted in this study to improve the outcome for the most vulnerable children in our society and identify interventions which can help prevent deaths in future."

Paper

'Child mortality in England during the first two years of the COVID-19 pandemic' by David Odd, Sylvia Stoianova, Tom Williams, Peter Fleming, Karen Luyt in JAMA Network Open [open access]