Perinatal depression carries increased risk of infant death

Infants born to mothers with depressive symptoms have a higher risk of death within the first year of life compared with those born to mothers without depressive symptoms, according to a retrospective study from the US.

Researchers used birth records linked to death records in New Jersey, which mandates screening for depressive symptoms in the immediate postpartum period. The cohort included 414,890 singleton infants (51.3 percent male, mean age of mothers 30.5 years).

Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale, with a score of ≥10 indicating the presence of maternal depressive symptoms. The primary outcome was infant death within 364 days after birth.

There were 906 infant deaths (0.2 percent) documented in the cohort. The infant mortality rate was 7.2 per 1,000 births among infants born to mothers with depressive symptoms vs 2 per 1,000 births among infants born to mothers without depressive symptoms.

Maternal perinatal depressive symptoms were associated with an increased risk of infant death within 364 days of birth (adjusted relative risk [ARR], 2.89, 95 percent confidence interval [CI], 2.36–3.54). This association persisted across maternal race and ethnicity, educational level, insurance status, and infant preterm birth.

Causes of infant deaths associated with maternal depressive symptoms included prematurity-related conditions (ARR, 4.07, 95 percent CI, 2.82-5.87), perinatal conditions (ARR, 5.12, 95 percent CI, 3.39–7.73), congenital malformations and chromosomal abnormalities (ARR, 3.56, 95 percent CI, 2.14–5.94), and sudden infant death syndrome (ARR, 2.08, 95 percent CI, 1.11–3.89).

The findings underscore the need for expanding maternal depression screening and interventions for individuals with depressive symptoms in order to improve maternal and infant health.