Maternal perinatal depression and child executive function: A systematic review and meta-analysis

Background: Maternal depression during the perinatal period predicts adverse developmental outcomes for children, via poorly understood mechanisms. One plausible pathway may involve child executive function, a suite of cognitive capacities associated with social, emotional and educational outcomes. Systematic review and meta-analysis are applied to evaluate evidence of association between maternal perinatal depression and child executive function. Methods: Medline, Embase, PubMed, PsycInfo, and SCOPUS were searched for relevant articles to August 2020, with hand-search of relevant bibliographies. Original research published in English measuring maternal depressive symptoms during pregnancy and the first year postpartum, and child executive function outcomes at any age was included. 27 studies met criteria for review. 16 studies reporting raw data of the association between depressive symptoms and executive function were used for meta-analysis. Results: Our systematic review identified inadequate assessment of maternal depression, and unreliable measures of executive function in many studies. Assessment of confounders was also inconsistent. Our meta-analysis identified a small, statistically significant relationship between perinatal depression and child executive function (effect size r = 0.07; 95% CI 0.03-0.10); equivalent to Cohen's d = 0.14. Limitations: Variable quality of available studies leads to cautious interpretation of results. Conclusions: This meta-analysis is consistent with the hypothesis that maternal perinatal depression does have an impact on executive function in offspring. Future studies must use robust measurement of depression and executive function, and account for the chronicity of maternal depression, and developmental context to produce meaningful results.