To understand the epidemiological characteristics and trends of infant deaths due to perinatal diseases in China from 2012 to 2021, in order to provide a reference for the development of related prevention measures and policies.

An epidemiological analysis was conducted on the data of infant deaths due to perinatal diseases from 0-year-old group in the "Chinese Cause of Death Surveillance Dataset" for the years 2012-2021. The average annual percent change (AAPC) in mortality rates was analyzed using the Joinpoint regression model.

The overall mortality rate of infants due to perinatal diseases in China showed a downward trend from 2012 to 2021 (AAPC=-11.89, P<0.001). A declining trend was observed in both male and female infants, as well as urban and rural infants, with AAPCs of -11.73%, -11.98%, -18.70%, and -18.50%, respectively. There was a turning point in the trend for urban infants (APC=-5.20, P=0.124 for 2012-2016 and APC=-18.70, P<0.001 for 2016-2021). The annual average mortality rate due to perinatal diseases was higher in male infants (1.79 per thousand) than in female infants (1.36 per thousand) (χ²=776.474, P<0.001), and higher in rural infants (1.55 per thousand) than in urban infants (0.46 per thousand) (χ²=75.394, P<0.001). The overall mortality rates of "low birth weight, birth trauma and asphyxia, and others" showed a downward trend (AAPCs of -14.10%, -11.10%, and -9.60%, respectively, P<0.001), with differences between urban and rural areas observed in all three perinatal diseases (P<0.001 for each).

The mortality rate of infants due to perinatal diseases in China shows a general downward trend from 2012 to 2021, but the situation of deaths caused by perinatal diseases remains severe. The gap between urban and rural areas is significant, and priority should be given to the perinatal preventive health care of male infants and rural infants.