Objective To analyze the level and trend of infant mortality rate (IMR) in Tongzhou from 2017 to 2023, and to provide a scientific basis for policies aimed at further reducing IMR.

Methods A descriptive epidemiological analysis was conducted on the causes of death and their rankings for 106 infant deaths with locally registered household between 2017 and 2023 in Tongzhou District. Chi-square test was used to compare the differences between groups, and the chi-square trend test was applied to analyze the year-by-year trend of relevant indicators.

Results From 2017 to 2023, the IMR in Tongzhou District was 1.87‰, accounting for 72.11% of the deaths among children under 5 years old. A downward trend in IMR was observed from 2017 to 2023 (χ²_trend=6.734, P_trend=0.009). Early neonatal deaths accounted for 53.77% all neonatal deaths, with an early neonatal mortality rate of 1.01‰. The late neonatal mortality rate showed a declining trend (χ²_trend=6.194, P_trend=0.013). The IMR gender ratio of male to female was 1.25, and the IMR for females showed a declining trend (χ²_trend=8.628, P_trend=0.003). The top three causes of death were neonatal diseases, congenital anomalies, and pneumonia, accounting for 68.87% of all deaths. Among infants who died within the first three days, the primary causes of death were neonatal diseases and congenital anomalies, accounting for 92.31% of all deaths within this time frame. For infants aged 6 to 12 months, accidents and tumors were the leading causes of death, accounting for 50.00%.

Conclusion Early neonates, extremely premature infants, and very low birth weight infants are key groups for the prevention and reduction of infant mortality. It is crucial to standardize the management of high-risk pregnancies and explore the development of early warning assessments and graded management for high-risk fetuses.