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Scientist comments on study on perinatal depression and infant mortality, as published in JAMA Network Open.
Prof Stella Chan, Charlie Waller Chair in Evidence-Based Psychological Treatment, University of Reading, said:
“This study performed advanced statistical analyses on retrospective data routinely collected in New Jersey and while associations were shown between perinatal depression and infant mortality rates, it is crucially important to understand that these deaths were underpinned by genuine biological causes (e.g. prematurity-related conditions, perinatal conditions, congenital malformations, and chromosomal abnormalities) largely beyond the control of mothers. Serious infant health conditions like these would inevitably have contributed to postnatal distress, stress and poorer mental health. While findings are novel, the study has hardly captured the full complexity of the associations. Urgent caution is needed in the interpretation of these results as they do not show that prenatal depression causes higher infant mortality.”
Prof Asma Khalil, Professor of Obstetrics and Maternal Medicine and Consultant Obstetrician, City St George’s, University of London (CSGUL), said:
“This is a large population-based study using linked records from more than 400,000 births, and its strengths include systematic depression screening, adjustment for several important social and demographic factors, and extensive sensitivity analyses addressing missing data and unmatched deaths. The association is therefore unlikely to be simply a statistical chance finding within this dataset.
“In absolute terms, infant mortality was 7.2 per 1,000 births among mothers who screened positive for depressive symptoms, compared with 2.0 per 1,000 among those who did not. However, the estimated association became appreciably smaller after accounting for clinical factors including smoking, substance use, preterm birth and low birth weight: the relative risk fell from 3.36 before adjustment to 1.97 in the most comprehensively adjusted model.
“The study cannot establish that maternal depression caused the infant deaths. Depressive symptoms were assessed shortly after delivery, by which time a mother may already have known that her baby was premature, had a congenital abnormality or was seriously unwell; these circumstances could themselves cause depressive symptoms as well as increasing the baby’s risk of death. The analysis excluding deaths during the first seven days reduces this concern but does not remove it, because serious conditions present at birth may lead to death weeks or months later.
“It is also important that the Edinburgh scale identifies depressive symptoms rather than providing a clinical diagnosis of depression, and screening immediately after birth will miss many women who develop postnatal depression later. The analyses of individual causes of death were based on relatively small numbers and should therefore be interpreted cautiously.
“These findings identify maternal depressive symptoms as a potentially valuable marker of families and infants who may need additional support, but they do not demonstrate that treating maternal depression would reduce infant mortality. Screening and treatment for perinatal mental health problems are important in their own right, but preventing infant deaths would require prospective research that measures depression during pregnancy and more fully separates maternal mental health from the effects of an infant’s underlying illness.”
* ‘Perinatal Depression and Infant Mortality’ by Rebecca Woofteret al. will be published in JAMA Network Open at on Wednesday 2 September 2026
DOI: 10.1001/jamanetworkopen.2026.31364 (Re
Declared interests
Prof Stella Chan: “No COI”
Prof Asma Khalil: “No relevant DOIs”