bACKgROuNd: We aimed to explore the leading causes and risk factors for infant mortality in a statewide study of infant deaths from 2005 to 2016. METhOdS: Rhode Island Vital Statistics was linked with KIDSNET, a statewide-integrated child health information system. Descriptive analyses examined infant mortality rates as well as risk factors of infant, neonatal, and postneonatal death. A multivariable logistic regression model of the risk of infant mortality adjusting for risk factors was computed. RESulTS: The majority (74%) of infant deaths occurred during the neonatal period. The top cause of infant mortality was prematurity (20.4%). After adjustment, infants born <28 weeks had 38.1 higher odds of mortality compared to term infants (p<0.01). Low 5-minute Apgar score, birth defects, less than 10 prenatal visits, and low maternal weight gain were associated with higher odds of infant mortality (p<0.01). dISCuSSION: Substantial reductions in the infant mortality rate will require improving strategies to prevent preterm births as well as using factors identifiable at birth to focus prevention efforts on those at higher risk. [ABSTRACT FROM AUTHOR]