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Background and Objectives: Although mortality rates are highest for infants of teens aged 15 to 19, no studies have examined the long-term trends by race and ethnicity, urbanicity, or maternal age. The objectives of this study were to examine trends and differences in mortality for infants of teens by race and ethnicity and urbanicity from 1996 to 2019 and estimate the contribution of changes in the maternal age distribution and maternal age-specific (infant) mortality rates (ASMRs) to differences in infant deaths in 1996 and 2019., Methods: We used 1996 to 2019 period-linked birth and infant death data from the United States to assess biennial mortality rates per 1000 live births. Pairwise comparisons of rates were conducted using z test statistics and Joinpoint Regression was used to examine trends. Kitagawa decomposition analysis was used to estimate the proportion of change in infant deaths because of changes in the maternal age distribution and ASMRs., Results: From 1996 to 2019, the mortality rate for infants of teens declined 16.7%, from 10.30 deaths per 1000 live births to 8.58. The decline was significant across racial and ethnic and urbanization subgroups; however, within rural counties, mortality rates did not change significantly for infants of Black or Hispanic teens. Changes in ASMRs accounted for 93.3% of the difference between 1996 and 2019 infant mortality rates, whereas changes in the maternal age distribution accounted for 6.7%., Conclusions: Additional research into the contextual factors in rural counties that are driving the lack of progress for infants of Black and Hispanic teens may help inform efforts to advance health equity., (Copyright © 2023 by the American Academy of Pediatrics.)

When compared with births among women aged 20 and over, teen pregnancies result in higher rates of neonatal and infant mortality, preterm birth, low birthweight, and maternal complications (1,2). Despite the declining birth rate for teenagers aged 15-19 since 1991, differences continue to occur in the mortality of infants born to teenagers by race and ethnicity and cause of death (1,3). This report examines 2017-2018 linked birth/infant death data from the National Vital Statistics System to describe the recent pattern in racial and ethnic differences in mortality and the leading causes of death for infants born to teen mothers aged 15-19., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)