Mortality Trends for Infant Intracranial Hemorrhage in the United States, 1999-2020: A 22-year Analysis.

BACKGROUND: Intracranial hemorrhage (ICH) is a major cause of infant mortality and neurodevelopmental complications, yet national mortality trends and demographic disparities remain poorly characterized. METHODS: A retrospective analysis using the CDC WONDER Multiple Cause of Death database (1999-2020) identified infant (<1 year) deaths with ICH (ICD-10 P52) as an underlying or contributing cause. Mortality rates per 100,000 live births were calculated by demographic and geographic factors, and Joinpoint regression estimated annual and average annual percent changes (APC, AAPC) with 95% confidence intervals. RESULTS: From 1999 to 2020, 20,544 infant ICH deaths were recorded in the United States, with a crude rate of 23.64 per 100,000 live births. Mortality peaked in 2003 at 31.57 and declined to 17.32 by 2020 (AAPC -2.51%). Among 20,544 ICH infant deaths recorded , mortality declined from 31.57 (2003) to 17.32 (2020) (AAPC -2.51%). Males exceeded females (28.18 vs. 18.88), Non-Hispanic Blacks had the highest racial rate (37.5), and Southern states showed the greatest regional burden. Urban areas declined faster than rural (AAPC -2.53% vs. -1.89%). CONCLUSIONS: Despite substantial overall decline in infant ICH rates, persistent disparities by sex, race, region, and urbanization underscore the need for equitable maternal and infant healthcare.