After more than five years of steadily trending downward, child fatalities in Arizona increased slightly - by 2 percent -  in 2012.

About one-third of those deaths were preventable, a new report says.

In Pima County the trend was much better. Child deaths here dropped 16 percent, from 109 in 2011 to 91 last year.

The information was in the 20th annual Child Fatality Review Report, released this week by the Arizona Department of Health Services. The chair of the Arizona Child Fatality Review Program is Dr. Mary Ellen Rimsza of the University of Arizona College of Medicine.

Eight hundred and fifty-four children from ages birth to 17 in Arizona died last year, the majority deemed natural deaths from medical causes, often prematurity, congenital anomalies or a disease like cancer.

Thirty-four percent of the deaths were categorized as preventable, while 57 percent were probably not preventable, and the child fatality review team could not determine whether 9 percent of the deaths were preventable or not.

Deaths due to drowning and homicide increased in 2012 compared to 2011, but deaths due to suicide decreased from 39 in 2011 to 22 last year. Child maltreatment deaths declined slightly, from 71 in 2011 to 70 in 2012.

Child deaths related to firearms jumped 39 percent last year. Thirty-two children died in firearms-related incidents in 2012, the majority of those suicides. Fourteen of the incidents were homicides.

Authors of the report say a lack of supervision, substance use and unsafe sleep environments were among factors contributing to the preventable deaths.

Lack of supervision and access to water were the leading preventable factors identified in the 36 child drownings that occurred in Arizona last year.

One of the report's recommendations is that the Arizona Legislature strengthen current legislation regarding pool fencing to require four-sided fencing with self-closing and self-latching gates for all backyard pools where children live or play.