Background This study aims to conduct a time series analysis to assess the effect of COVID-19 on infant and neonatal mortality in its first three years. Methods Linked infant birth and death certificate data from the United States between 2016 and 2022 were used. Long Short-Term Memory (LSTM) and Autoregressive Integrated Moving Average (ARIMA)/ARIMA with Exogenous Variables (ARIMAX) were employed to predict monthly infant and neonatal mortality trends in 2022 with and without incorporating COVID-19 as a feature. Interrupted Time Series Analysis was conducted to measure monthly rate changes before (pre-March 2020) and during the COVID-19 period (March 2020–December 2022). Results Infant and neonatal deaths declined from 2016 to 2020/2021, with increases observed starting in May 2022. Incorporating COVID-19 as a variable into prediction models reduced the predictive performance of both LSTM and ARIMA/ARIMAX models. Compared to the pre-COVID-19 period, ITS showed no significant changes in monthly infant and neonatal death rates. However, significant increases were noted in low birth weight, low Apgar scores, and infrequent prenatal visits during 2021-2022. Conclusion COVID-19 altered the previously continuous decline in infant and neonatal deaths in 2022. Despite this late increase, the overall impact of COVID-19 on infant and neonatal mortality remains minimal. Impact <UnorderedList Mark="Bullet"> <ItemContent> Infant and neonatal deaths showed a steady decline from 2016 through 2020/2021. </ItemContent> <ItemContent> However, an increase in infant and neonatal deaths emerged in the later stages of the COVID-19 pandemic (2022). </ItemContent> <ItemContent> Rates of risk factors associated with infant and neonatal deaths, such as low birth weight and inadequate prenatal care, increased during the COVID-19 period. </ItemContent> <ItemContent> Understanding the shifts in infant and neonatal mortality and related risk factors during the COVID-19 pandemic provides valuable insights into its impact and enhances preparedness for future pandemics. </ItemContent> </UnorderedList>

Time series analysis of impact of COVID-19 on infant and neonatal mortality in the United States

期刊论文
发表日期：

2025年6月2日

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Zhihong Zhang,
Jiebo Luo

摘要

Background

This study aims to conduct a time series analysis to assess the effect of COVID-19 on infant and neonatal mortality in its first three years.

Methods

Linked infant birth and death certificate data from the United States between 2016 and 2022 were used. Long Short-Term Memory (LSTM) and Autoregressive Integrated Moving Average (ARIMA)/ARIMA with Exogenous Variables (ARIMAX) were employed to predict monthly infant and neonatal mortality trends in 2022 with and without incorporating COVID-19 as a feature. Interrupted Time Series Analysis was conducted to measure monthly rate changes before (pre-March 2020) and during the COVID-19 period (March 2020–December 2022).

Results

Infant and neonatal deaths declined from 2016 to 2020/2021, with increases observed starting in May 2022. Incorporating COVID-19 as a variable into prediction models reduced the predictive performance of both LSTM and ARIMA/ARIMAX models. Compared to the pre-COVID-19 period, ITS showed no significant changes in monthly infant and neonatal death rates. However, significant increases were noted in low birth weight, low Apgar scores, and infrequent prenatal visits during 2021-2022.

Conclusion

COVID-19 altered the previously continuous decline in infant and neonatal deaths in 2022. Despite this late increase, the overall impact of COVID-19 on infant and neonatal mortality remains minimal.

Impact

Infant and neonatal deaths showed a steady decline from 2016 through 2020/2021.

However, an increase in infant and neonatal deaths emerged in the later stages of the COVID-19 pandemic (2022).

Rates of risk factors associated with infant and neonatal deaths, such as low birth weight and inadequate prenatal care, increased during the COVID-19 period.

Understanding the shifts in infant and neonatal mortality and related risk factors during the COVID-19 pandemic provides valuable insights into its impact and enhances preparedness for future pandemics.