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Original Investigation
September 14, 2020

Association Between Maternal Perinatal Depression and Anxiety and Child and Adolescent Development: A Meta-analysis

Author Affiliations
  • 1Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
  • 2National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
  • 3Counselling Psychology Department, Trinity Western University, Langley, British Columbia, Canada
  • 4British Columbia Children’s Hospital Research Institute, University of British Columbia, Vancouver, Canada
  • 5Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
  • 6Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
  • 7Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
JAMA Pediatr. Published online September 14, 2020. doi:10.1001/jamapediatrics.2020.2910
Key Points

Question  Are maternal perinatal depression and anxiety adversely associated with social-emotional, cognitive, language, motor, and adaptive behavior development in offspring during the first 18 years of life?

Findings  In this systematic review and meta-analysis, maternal perinatal depression and anxiety were associated with poorer social-emotional, cognitive, language, motor, and adaptive behavior development in offspring. Developmental outcomes extended beyond infancy, into childhood and adolescence.

Meaning  Evidence suggests that perinatal depression and anxiety in mothers are adversely associated with offspring development and, therefore, are important targets for prevention and early intervention to support mothers transitioning into parenthood and the health and well-being of next-generation offspring.

Abstract

Importance  There is widespread interest in associations between maternal perinatal depression and anxiety and offspring development; however, to date, there has been no systematic, meta-analytic review on the long-term developmental outcomes spanning infancy through adolescence.

Objective  To provide a comprehensive systematic review and meta-analysis of the extant literature on associations between maternal perinatal depression and anxiety and social-emotional, cognitive, language, motor, and adaptability outcomes in offspring during the first 18 years of life.

Data Sources  Six databases were searched (CINAHL Complete, Cochrane Library, Embase, Informit, MEDLINE Complete, and PsycInfo) for all extant studies reporting associations between perinatal maternal mental health problems and offspring development to March 1, 2020.

Study Selection  Studies were included if they were published in English; had a human sample, quantitative data, a longitudinal design, and measures of perinatal depression and/or anxiety and social-emotional, cognitive, language, motor, and/or adaptability development in offspring; and investigated an association between perinatal depression or anxiety and childhood development.

Data Extraction and Synthesis  Of 27 212 articles identified, 191 were eligible for meta-analysis. Data were extracted by multiple independent observers and pooled using a fixed- or a random-effects model. A series of meta-regressions were also conducted. Data were analyzed from January 1, 2019, to March 15, 2020.

Main Outcomes and Measures  Primary outcomes included social-emotional, cognitive, language, motor, and adaptability development in offspring during the first 18 years of life.

Results  After screening, 191 unique studies were eligible for meta-analysis, with a combined sample of 195 751 unique mother-child dyads. Maternal perinatal depression and anxiety were associated with poorer offspring social-emotional (antenatal period, r = 0.21 [95% CI, 0.16-0.27]; postnatal period, r = 0.24 [95% CI, 0.19-0.28]), cognitive (antenatal period, r = −0.12 [95% CI, –0.19 to –0.05]; postnatal period, r = −0.25 [95% CI, –0.39 to –0.09]), language (antenatal period, r = −0.11 [95% CI, −0.20 to 0.02]; postnatal period, r = −0.22 [95% CI, −0.40 to 0.03]), motor (antenatal period, r = −0.07 [95% CI, −0.18 to 0.03]; postnatal period, r = −0.07 [95% CI, −0.16 to 0.03]), and adaptive behavior (antenatal period, r = −0.26 [95% CI, −0.39 to −0.12]) development. Findings extended beyond infancy, into childhood and adolescence. Meta-regressions confirmed the robustness of the results.

Conclusions and Relevance  Evidence suggests that perinatal depression and anxiety in mothers are adversely associated with offspring development and therefore are important targets for prevention and early intervention to support mothers transitioning into parenthood and the health and well-being of next-generation offspring.

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