Postpartum Depression Linked to Nearly 3 Times Infant Mortality

Maternal depressive symptoms identified immediately after delivery were associated with a nearly threefold higher adjusted risk of infant death within 364 days in a population-based New Jersey cohort published in JAMA Network Open.

The retrospective study linked 2016 to 2020 birth records with 2016 to 2021 death records and included 414,890 singleton infants with complete data. Mothers were screened after delivery and before discharge using the 10-item Edinburgh Postnatal Depression Scale (EPDS); scores of 10 or higher indicated depressive symptoms. The primary outcome was death within 364 days. Investigators used log-link generalized linear models and designated a model adjusted for maternal and infant demographic and socioeconomic characteristics as their preferred model.

Overall, 906 infants (0.2%) died, and 3.8% of mothers had depressive symptoms. Mortality was 7.2 per 1,000 births among infants of mothers with depressive symptoms and 2.0 per 1,000 among infants of mothers without symptoms. In the preferred model, the adjusted relative risk (ARR) was 2.89 (95% CI, 2.36-3.54). For deaths occurring 8 to 364 days after birth, the ARR was 2.10 (95% CI, 1.56-2.81).

Cause-specific analyses found higher adjusted risks related to prematurity (ARR, 4.07; 95% CI, 2.82-5.87), perinatal conditions (ARR, 5.12; 95% CI, 3.39-7.73), congenital malformations and chromosomal abnormalities (ARR, 3.56; 95% CI, 2.14-5.94), and sudden infant death syndrome (ARR, 2.08; 95% CI, 1.11-3.89). Associations were consistent across race and ethnicity, educational level, insurance status, and preterm birth subgroups.

The authors noted that findings may not generalize beyond New Jersey and that missing screening scores, unmatched death records, unmeasured confounding, and possible reverse causality limit interpretation. Sensitivity analyses using multiple imputation and weighting produced results similar to the main analysis. Investigators called for research to clarify mechanisms linking immediate postpartum depressive symptoms with infant mortality and identify opportunities to reduce risk.

Source: Woofter R, McGovern ME, Abe N, Rokicki S. Perinatal depression and infant mortality. JAMA Netw Open. 2026;9(9):e2631364. doi:10.1001/jamanetworkopen.2026.31364