Eugene Declercq, PhD, MBA, links maternal and infant mortality

A recent study led by Eugene Declercq, PhD, MBA, professor at the BU School of Public Health, explores the link between maternal deaths and infant outcomes, revealing a disparity in infant survival rates when mothers die during or after pregnancy. Using over 2 decades of longitudinally linked data from Massachusetts the research provides one of the few US-based analyses of how maternal mortality directly impacts infants’ chances of survival.

Between 1999 and 2020, Massachusetts recorded 474 pregnancy-associated maternal deaths and 6,566 infant deaths. By linking maternal and infant health records, the researchers found that the infant mortality rate among infants whose mothers survived was 4 deaths per 1000 live births—a figure consistent with Massachusetts’s reputation for having the lowest infant mortality in the nation.

However, when a maternal death occurred, the infant mortality rate surged to 55 per 1000, representing a 14-fold increase. In cases where maternal death was accompanied by severe maternal morbidity—including life-threatening complications documented in hospital records—the infant mortality rate rose even higher, to 87 per 1000, a 22-fold increase.

Declercq noted that sociodemographic factors, such as age or race, played a smaller role than expected in this association. Although detailed multivariable analyses were limited because of the relatively small number of maternal deaths with corresponding infant deaths, the data highlighted certain risk factors. Severe maternal morbidity and maternal opioid use were the strongest predictors of poor infant outcomes, while advanced maternal age also contributed.

The study underscores the broad health implications of maternal mortality, emphasizing that a mother’s health has a direct and lasting influence on her child’s survival and well-being. Declercq advocated for a lifespan approach to maternal care, ensuring that women receive comprehensive health support before, during, and especially after pregnancy. He pointed out that over half of maternal deaths occur in the postpartum period, a time when health systems often shift their focus exclusively to the newborn, neglecting maternal needs.

Ultimately, the findings highlight the urgent need for integrated maternal-infant care and renewed attention to maternal health policy. As Declercq emphasized, protecting mothers also protects infants—a message meant to re-engage policymakers and health care systems in improving women’s health throughout the reproductive life course.

No relevant disclosures.

Reference

Declercq E, Liu CL, Cabral HJ, Amutah-Onukagha N, Hwang S, Diop H. Relationship between maternal death and infant outcomes in a longitudinal, population-based dataset. Obstet Gynecol. 2025. doi:10.1097/AOG.0000000000006071