About

Sara L Kornfield, Ph.D., is an Assistant Professor of Psychiatry at the Hospital of the University of Pennsylvania and holds the position of Senior Center Director at the Penn Center for Women's Behavioral Wellness within the Psychiatry Department at the Perelman School of Medicine, University of Pennsylvania. Her educational background includes a B.A. in Psychology from Barnard College, Columbia University, obtained in 2003, followed by an M.S. in Clinical Psychology from Drexel University in 2008, and a Ph.D. in Clinical Health Psychology from Drexel University in 2010. Her research focuses on maternal wellness, postpartum depression, and behavioral health in women, particularly in the context of pregnancy and postpartum periods. She has contributed to studies examining postpartum depression risk during COVID-19, traumatic birth experiences, and social communication difficulties in young children. Dr. Kornfield has also been involved in developing interventions for maternal opioid use disorder and infant neonatal abstinence syndrome, as well as exploring the impact of the pandemic on mothers and children, with a focus on Black families. Her work emphasizes addressing mental health disparities, maternal caregiving behaviors, and the development of educational and support tools for perinatal women.

Research topics

• Medicine
• Psychology
• Psychiatry
• Clinical psychology
• Developmental psychology

Selected publications

• Traumatic birth experiences and maternal caregiving behaviors and attitudes in black and white women

  Archives of Women s Mental Health · 2026-03-19

  articleOpen access1st authorCorresponding

  This longitudinal investigation examined the association between traumatic birth experiences (measured via self-report and clinician-report) and caregiving behaviors and attitudes and any race-related differences in these associations. Subjective childbirth trauma was measured via a three-item questionnaire at 12 weeks postpartum. Medical childbirth factors were extracted from the electronic health record. Maternal caregiving behaviors and attitudes were assessed via comprehensive questionnaires (i.e., mother-infant bonding and parenting stress) and observation ratings (i.e., positive parenting and mother-infant interactions) at 12 weeks, 12 months, and 24 months postpartum. Multiple linear regressions were run to analyze these relationships. A total of 255 mothers (106 Black and 149 White) who gave birth from April to December 2020 were examined. More traumatic childbirth experiences were significantly associated with higher-rated observed positive parenting scores (β = 0.21, pFDR<0.05) when controlling for demographic factors. There were no significant relationships at 12 weeks or 24 months postpartum. Additionally, there were no effects of race on the relationship between childbirth trauma and caregiving. Subjective reports of childbirth trauma were not significantly associated with poorer maternal caregiving behaviors and attitudes. This study adds to the literature by examining Black women, as they are underrepresented in this body of research and more at risk of experiencing traumatic childbirths. This study investigated the relationship between childbirth trauma and various maternal caregiving behaviors, measured at several timepoints during the postpartum period. The sample included Black and White women who gave birth early in the COVID-19 pandemic, a time of heightened stress for those delivering in a hospital setting. We found mostly nonsignificant relationships but one positive relationship between childbirth and caregiving behaviors when children were 12 months old: More traumatic birth experiences were related to better caregiving scores. This is the first study to focus on Black individuals’ childbirth experiences and its relation to caregiving behaviors. More research is needed on women of color, as they have a higher risk of experiencing a traumatic birth.

  PublisherOA PDFDOI

• An intervention mapping approach to closing the gap in maternal OUD and infant NOWS care: a study protocol

  BMC Pregnancy and Childbirth · 2026-02-24

  articleOpen access1st authorCorresponding

  The increasing prevalence of pregnant and postpartum individuals affected by opioid use disorder (OUD) in the US is highlighted by the growing number of babies referred to the NICU for neonatal opioid withdrawal syndrome after birth. Despite advances in integrating mental health and substance use treatment into adult healthcare settings, no treatment models exist to integrate maternal OUD treatment and referrals into the pediatric care setting. Integrating maternal OUD treatment into the NICU could help mothers access care and improve maternal functioning, while preserving the dyadic bond and maintaining stability for the infant. This study will use implementation mapping to develop and refine strategies to support NICU setting buprenorphine induction for mothers of babies hospitalized with NOWS to ensure treatment meets the needs of both providers and patients. Aim 1 will identify the primary barriers and facilitators to implementing bedside NICU OUD treatment and referrals to ongoing outpatient care for postpartum women through in-depth interviews with local NICU providers. Aim 2 will use the insights gained in Aim 1 to guide a process of implementation mapping to generate a suite of implementation strategies to support co-located buprenorphine induction and referrals for treating pregnant women with OUD in the NICU. Finally, in Aim 3 we will refine and examine the feasibility and acceptability of the implementation strategies by surveying stakeholders (n = 32); and conduct a pilot case series (n = 20 mothers). This will allow us to determine the best composition of the treatment team, where care should be delivered, and how providers, patients, and stakeholders respond. Results will establish the acceptability and feasibility of integrating OUD care into the NICU setting and identify the most promising implementation strategies for supporting this model in future confirmatory trials testing the effectiveness of NICU bedside buprenorphine induction and referrals to treatment on maternal and pediatric outcomes. This study was registered at clinicaltrials.gov on 08/28/2024 (NCT06576323) https://clinicaltrials.gov/study/NCT06576323?term=R21DA058815&rank=1.

  PublisherDOI

• The PMADS Project: A Longitudinal Multimodal Cohort Study to Understand Risk for Perinatal Mood and Anxiety Disorders

  bioRxiv (Cold Spring Harbor Laboratory) · 2026-04-14

  articleOpen access

  Abstract Background Perinatal mood and anxiety disorders (PMADs) are among the most common and consequential complications of pregnancy. The perinatal period is also characterized by profound hormonal fluctuations and large-scale brain plasticity. However, the mechanisms linking these neurobiological changes to psychiatric risk are poorly understood. Prospective, clinically informed studies are needed to identify quantitative biomarkers and clarify pathways linking perinatal neurobiology to PMADs risk. Methods This report describes the design of a prospective, longitudinal cohort study integrating multimodal neuroimaging, biofluid sampling, and deep clinical phenotyping to enable precision characterization of neurobiological trajectories of PMADs risk. Twenty-five individuals at elevated risk for PMADs will be recruited prior to conception and followed across six in-person timepoints spanning the menstrual cycle, pregnancy, and early postpartum, with additional remote follow-ups through the first postpartum year. Data collection includes high-resolution structural MRI, functional brain mapping using multi-echo resting-state fMRI, diffusion MRI, arterial spin labeling, ultra-high field MR-based techniques for measuring glutamate (GluCEST and 1 HMRS), biofluid sampling, and comprehensive clinical, behavioral, and cognitive assessments. Structured clinical interviews assess categorical diagnoses while dimensional symptom measures capture heterogeneity and transdiagnostic features of perinatal psychopathology. Longitudinal analyses will model nonlinear trajectories of brain and symptom change across the perinatal period as well as evaluate whether preconception network features and menstrual cycle-related brain changes are associated with subsequent perinatal symptom emergence. Discussion This cohort study establishes a longitudinal, multimodal framework for investigating neurobiological changes across the transition to pregnancy in individuals at elevated risk for PMADs. By anchoring pregnancy-related brain changes to preconception and menstrual cycle-related variability within the same individuals, this study is designed to evaluate associations between preconception hormone sensitivity, pregnancy-induced neuroplasticity, and PMADs risk. The resulting dataset will provide a deeply phenotyped longitudinal resource for investigating brain-behavior relationships across the perinatal period. Findings are expected to inform future larger-scale studies aimed at advancing mechanistic understanding of PMADs, improving individualized risk stratification, and supporting development of personalized preventive and neuromodulatory interventions.

  PublisherOA PDFDOI

• Characterizing Social Communication Difficulties in Young Children within a Longitudinal Ecological Systems Framework

  Research on Child and Adolescent Psychopathology · 2025-03-24

  articleOpen access

  Social communication difficulties are a transdiagnostic risk factor for psychopathology. However, few studies have examined prospective risk for social communication difficulties in young children within an ecological systems framework. Our sample was 251 parent-child dyads assessed during pregnancy, postpartum, and toddlerhood (child ages 1 and 2). We leveraged observer ratings of child behavior, parent-reported questionnaires, and geocoded data. We examined prospective risk factors for social communication difficulties at ages 1 and 2, including at the level of the child (gestational age), family (household income, maternal mental health, maternal-child bonding), and neighborhood (neighborhood resources). Fewer neighborhood resources were associated with more social communication difficulties at age 1, but only among dyads with impaired maternal bonding. Lower gestational age, lower household income, and impaired maternal bonding were associated with more child social communication difficulties at age 2. Fewer neighborhood resources were also related to more social communication difficulties at age 2, specifically among families with low household incomes. Findings provide insight into families who may benefit from early intervention to reduce transdiagnostic risk for child psychopathology across ecological systems, including efforts to target maternal bonding and poverty.

  PublisherOA PDFDOI

• Evidence for missed cases of postpartum depression based on paediatric clinical care screenings

  The British Journal of Psychiatry · 2025-06-01 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

• Examining the Impact of the Syndemic on Black Birthing Individuals in the USA: a Systematic Review

  Journal of Racial and Ethnic Health Disparities · 2025-02-24

  reviewOpen access
  PublisherOA PDFDOI

• Traumatic birth experiences and maternal caregiving behaviors and attitudes in Black and White women

  Research Square · 2025-11-03

  preprintOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Correction to: Clinician-reported childbirth outcomes, patient-reported childbirth trauma, and risk for postpartum depression

  Archives of Women s Mental Health · 2025-05-19

  erratumOpen access
  PublisherOA PDFDOI

• Reproducible sex differences in personalised functional network topography in youth

  The British Journal of Psychiatry · 2025-06-01 · 1 citations

  articleOpen access

  BACKGROUND: A key step toward understanding psychiatric disorders that disproportionately impact female mental health is delineating the emergence of sex-specific patterns of brain organisation at the critical transition from childhood to adolescence. Prior work suggests that individual differences in the spatial organisation of functional brain networks across the cortex are associated with psychopathology and differ systematically by sex. AIMS: We aimed to evaluate the impact of sex on the spatial organisation of person-specific functional brain networks. METHOD: = 6437 youths from the Adolescent Brain Cognitive Development Study. Across independent discovery and replication samples, we used generalised additive models to uncover associations between sex and the spatial layout (topography) of personalised functional networks (PFNs). We also trained support vector machines to classify participants' sex from multivariate patterns of PFN topography. RESULTS: Sex differences in PFN topography were greatest in association networks including the frontoparietal, ventral attention and default mode networks. Machine learning models trained on participants' PFNs were able to classify participant sex with high accuracy. CONCLUSIONS: Sex differences in PFN topography are robust, and replicate across large-scale samples of youth. These results suggest a potential contributor to the female-biased risk in depressive and anxiety disorders that emerge at the transition from childhood to adolescence.

  PublisherOA PDFDOI

• Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study

  Health Equity · 2024-01-01 · 5 citations

  articleOpen access

  Introduction: Elevating Voices, Addressing Depression, Toxic Stress and Equity (EleVATE) is a group prenatal care (GC) model designed to improve pregnancy outcomes and promote health equity for Black birthing people. This article outlines the foundational community-engaged process to develop EleVATE GC and pilot study results. Methods: We used community-based participatory research principles and the Ferguson Commission Report to guide creation of EleVATE GC. The intervention, designed by and for Black birthing people, centers trauma-informed care, antiracism, and integrates behavioral health strategies into group prenatal care to address unmet mental health needs. Using a convenience sample of patients seeking care at one of three safety-net health care sites, we compared preterm birth, small for gestational age, depression scores, and other pregnancy outcomes between patients in individual care (IC), CenteringPregnancy™ (CP), and EleVATE GC. Results: =23 EleVATE GC) and 86% self-identified as Black. Patients participating in group prenatal care (EleVATE GC or CP) were significantly less likely to experience a preterm birth <34 weeks. Rates of small for gestational age, preterm birth <37 weeks, depression scores, and other pregnancy outcomes were similar across groups. Participants in CP and EleVATE GC were more likely to attend their postpartum visit and breastfeed at hospital discharge than those in IC. Discussion: Our findings model a systematic approach to design a feasible, patient-centered, community-based, trauma-informed, antiracist intervention. Further study is needed to determine whether EleVATE GC improves perinatal outcomes and promotes health equity.

  PublisherDOI

Recent grants

• PTSD and Pregnancy: Psychophysiology, Response to Treatment & Pregnancy Outcome

  NIH · $532k · 2017–2020

• PTSD and Pregnancy: Psychophysiology, Response to Treatment & Pregnancy Outcome

  NIH · $143k · 2017–2019

Frequent coauthors

• Raquel E. Gur

  Children's Hospital of Philadelphia

  37 shared

• Megan M. Himes

  Children's Hospital of Philadelphia

  35 shared

• Wanjikũ Njoroge

  University of Pennsylvania

  33 shared

• Rebecca Waller

  28 shared

• Barbara H. Chaiyachati

  24 shared

• Lauren K. White

  University of Pennsylvania Health System

  24 shared

• Ran Barzilay

  University of Pennsylvania

  24 shared

• C. Neill Epperson

  University of Colorado Anschutz Medical Campus

  21 shared