Northern Ireland has the highest infant mortality rate in the UK, children’s doctors and campaigners have said.
Smoking during pregnancy was a high risk factor but it was difficult to draw conclusive reasons due to the small number of cases, the Royal College of Paediatrics and Child Health said.
According to the report, 182 children and young people under the age of 19 died in Northern Ireland in 2012.
Almost half (49%) involved babies.
Dr Julie-Ann Maney, a consultant in paediatric emergency medicine representing the college, said: “Whilst there is a lot of good ongoing work on reducing child mortality in Northern Ireland, our current mortality rates not only identify us as one of the worst performing countries in Europe, but also the worst in the UK.”
The report said the country had the highest mortality rate for babies under the age of one in the UK.
In 2012, 16% of mothers in Northern Ireland smoked during pregnancy.
This figure was higher for mothers under 20 (37%) and for mothers who lived in areas of deprivation (29%).
Despite breastfeeding rates doubling in Northern Ireland over the past 20 years, Northern Ireland had the lowest rate in the UK.
Children’s doctors and child rights campaigners called on policymakers to address health inequalities and introduce a series of public health measures in a bid to reduce avoidable child deaths.
The college and the National Children’s Bureau NI published a series of recommendations on reducing mortality in its report Why Children Die - Part E.
It also noted 69 deaths of young people aged between 15 and 19 due to suicide from 2010 to 2013.
Of these, 78% were males and 22% female (2010 to 2013).
Suicide rates in Northern Ireland have been steadily increasing over the last 10 years, with rates in the most deprived areas of the country having more than tripled, the review said.
Ms Maney added: “Northern Ireland’s increasing teen suicide rate is a huge area of concern.
“We must ensure that all professionals who work with children have basic mental health awareness.
“This will allow them to identify ‘at risk’ children early and maximise the potential to intervene before the child’s mental health deteriorates further.”
Higher incidences of death and serious injury have also been found among young drivers (aged 16 to 24) and those within rural and deprived areas.
Teens aged between 15 and 19 were the second most at-risk group for child deaths in Northern Ireland (29%), with suicide, self-harm or assault leading causes, according to the report.
It said: “The number of deaths has been increasing steadily over the last 10 years with deprivation thought to be a considerable risk factor.”
The Why Children Die report reviewed existing evidence.
It called for renewed focus on road safety and the implementation of 20mph speed restrictions and graduated licensing schemes for inexperienced drivers.
Children have been highlighted as being particularly vulnerable to road traffic accidents, with injury mortality rate for boys in Northern Ireland being historically much higher than across the rest of the UK - 12 in England compared to 21 in Northern Ireland between 2006 and 2010.