Objectives —This report describes drug-involved infant deaths in the United States for 2015–2017 by type of drug involved and selected maternal and infant characteristics. Deaths are grouped according to whether drugs were the underlying or a contributing cause of death. 

Methods —Descriptive tabulations are presented using information from the 2015–2017 National Vital Statistics System drug-involved mortality files and the 2015–2017 period linked birth/infant death files. Drug-involved infant deaths are classified according to whether the drug involvement was the underlying or a contributing cause of death. Specific drugs mentioned by type of involvement are presented. 

Results —From 2015 through 2017, 442 of the 68,609 total infant deaths (0.64%) in the United States had drug involvement. The drugs most frequently mentioned were methamphetamine, opioids, cocaine, opioid treatment drugs such as methadone or naloxone, and cannabis or cannabinoids. Mothers of infants who died of drug-involved causes were more likely to be non-Hispanic white, aged 35–39, have a high school degree or less, use Medicaid as the source of payment for delivery, and receive late or no prenatal care compared with mothers of infants who died of all other causes. Infants who died as a result of drug involvement were less likely than infants who died of all other causes to be born preterm (before 37 weeks gestation), born at very low birthweights (less than 1,500 grams), or die in the late neonatal period (7–27 days). Of the 442 drug-involved infant deaths, drugs were the underlying cause of death for 163 (37%) infants and a contributing cause of death for 279 (63%) infants. The most common cause of death among infants with drug involvement as the underlying cause of death was Newborn affected by maternal use of drugs of addiction (P04.4) (87 cases); Newborn affected by other forms of placental separation and hemorrhage (P02.1) (43 cases) was the most common cause for infants with drug involvement as a contributing cause of death.