An investigation is to be carried out into the number of newborn baby deaths in Scotland.
The Scottish government has ordered the review of neonatal death rates after two spikes over a six-month period. Both increases were larger than what would normally be expected.
At least 18 babies under four weeks old died in March. That came after at least 21 babies died in September last year.
The review will be carried out by Healthcare Improvement Scotland.
It is expected to last six to nine months and cover all reported baby deaths between April 2021 and March 2022.
The average mortality rate among newborns is just over two per 1,000 births.
In September 2021 at least 21 babies under four weeks old died, a rate of 4.9 per 1,000 births. And in March at least 18 died, the equivalent of 4.6 per 1,000 births.
Public Health Minister Marie Todd said: “Every death is a tragedy for the families involved, that is why earlier this year I committed to this review to find out if there is a reason for the increase.
“I appreciate how difficult this time is for anyone affected and I would encourage them to access support if they wish to do so.”
She added information about organisations and help was available on the National Bereavement Care Pathways Scotland and Scottish government websites.
Ms Todd said anything identified would feed into recommendations and actions to improve the quality of care for mother and babies.
A preliminary investigation found the September spike was not linked to Covid.
The high rates were the first to be detected since this form of monitoring began in July 2017.
Meanwhile, in June it emerged there were 3.9 infant deaths for every thousand live births in 2021 – up from 3.1 the previous year.
The figures showed the death rate for babies under one year old in Scotland is at its highest level in 10 years.