Objectives To analyze the mortality and impact factors of children under 5 years old in Baiyin, and to provide a theoretical basis for formulating effective measures and relevant policies to reduce child mortality in the local area.

Methods The data of death surveillance of children under 5 years old from 2014 to 2017 in Baiyin was used to analyze the related factors such as mortality, composition ratio, and cause of death of children under 5 years old.

Results In Baiyin there were 292 216 children under five years old from 2014 to 2017, and 417 deaths were reported, with a mortality of 1.43‰. Thereinto, the death of neonatal was the highest, which was 228 (54.68%) with the mortality of 3.12‰, and the male accounted for 57.79%, with the proportion higher than that of the females' (42.21%). The largest number of deaths occurred in medical institutions (55.53%), followed by deaths at home (31.90%) and deaths on the way to hospital (12.56%). The rank order of causes of death of children under 5 years old was:certain conditions in perinatal period, congenital malformations, deformation and chromosomal abnormalities, external cause of diseases and death, and respiratory diseases. There was no significant difference in the composition of causes of death between male and female (χ²=11.455, P>0.05); the composition difference of the cause of death in children of different age groups was statistically significant (χ²=270.363, P < 0.05). There was no statistically significant difference in the composition of the causea of death in different seasons (χ²=38.949, P>0.05).

Conclusions Certain conditions that originate in the perinatal period, congenital malformations, deformation and chromosomal abnormalities have become the leading diseases contributing to deaths of children in the city. It is necessary to further strengthen pre-pregnancy and pregnancy care, prenatal screening and other work, as well as the three-level prevention of birth defects, and strengthen children's health care and safety knowledge propaganda.