State of South Dakota's Child: 2020.

Between 2015 and 2019, the total number of births in South Dakota declined by 7 percent. As infant mortality rates are calculated per 1,000 live births, slight increases or decreases in total deaths and deaths due to specific causes manifest in notable shifts in yearly infant mortality rates (IMR). In 2019, 10 more infants died than in 2018 (80 vs. 70). With the decline in the state's births, the IMR increased from 5.9 to 6.7, which is significantly higher than the U.S. rate of 5.7 for 2018. South Dakota's 2019 increase in births of very low birth weight infants and deaths due to congenital anomalies contributed to this increase in mortality. In South Dakota, between 2015-19, 62 percent of all infant deaths occurred during the first 27 days of life. Though the rate of death for the state's minority infants remains significantly higher than that of its white infants, a decline in the ratio of the minority to white IMR is noted. Further, the rate of death due to sudden unexpected infant death (SUID) remained stable between 2018-19 but there is evidence that increasingly these deaths are caused by accidental suffocation or strangulation in bed which is typically preventable with safe sleeping environments for infants. The interactions between birth weight, incidence, cause, and timing of death are explored in this annual review of infant mortality.