Why is a baby more likely to die according to the place where he is born? A study by Inserm (and its partners), published on September 16, 2025 in BMJ Medicinesheds unprecedented light: socio-economic inequalities play a decisive role.
Neonatal mortality increased since 2012
While in many European countries infantile mortality continues to retreat, France is experiencing a disturbing evolution. Between 2001 and 2019, the researchers observed a drop until 2012, then a significant rise in deaths for one year, mainly driven by neonatal mortality (death in the first 28 days of life).
This trend was confirmed by several works, including those carried out in Seine-Saint-Denis in 2012, a territory marked by infant and perinatal excess mortality. Audits then revealed that 33 % of deaths could be avoided by correcting differences in good follow -up and management practices for pregnant women.
Striking gaps between favored and disadvantaged territories
The study published in 2025 made it possible to measure the impact of the social context. By crossing an index of socio-economic disadvantage (unemployment rate, income level, proportion of single-parent families, etc.) with national health data, researchers have shown that:
- The neonatal death rate reached 3.34 per 1,000 living births in the 20 % of the most disadvantaged municipalities;
- Against 1.95 per 1,000 in the most favored 20 %.
Result: a risk 1.7 times higher for children born in the poorest municipalities. According to Victor Sartorius, the first author of the study, “About a quarter of neonatal deaths between 2015 and 2020, or 2,496 deaths, could have been avoided if the whole population had had the same risk that the territories favored“.
The role of birth care and conditions
The explanations are multiple. Individual factors (smoking, obesity, maternal age, exposure to pollution) combine with inequalities in access to care. The hospital organization is also involved: overload of maternity, sub -ffectives and coordination difficulties increase the risks.
A report by the High Authority for Health (HAS), published in April 2025, shows that 57 % of serious adverse events related to care in newborns could have been avoided. Among the immediate causes identified: errors in the monitoring of the fetal heart rate, delays in cesarean section, or even infections related to care.
A call to action to reduce inequalities
Experts converge on the urgency of acting. Inserm recommends carrying out audits of the perinatal care offer in each territory, while the HAS insists on the continuous training of teams, the reorganization of maternities and a better transmission of medical information.
As Jennifer Zeitlin sums it up, inserm epidemiologist: “Our study shows how much the disadvantaged populations are on the front line in the face of neonatal mortality and highlights the urgency of implementing targeted public health measures in high -risk areas. “