Impact of maternal depressive symptoms on offspring executive functions: a systematic review

Objective: To conduct a thorough examination of the current understanding of the effect of maternal depression exposure on the executive functions (EFs) of offspring. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement, a comprehensive search for peer-reviewed cohort studies was performed on the MEDLINE (via PubMed), ScienceDirect, LILACS, PsycINFO, and SciELO databases. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The evidence was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation framework. Results: Thirty-three cohort studies from different countries, enrolling a total of 38,981 participants, were analyzed. Twenty-four studies confirmed the hypothesis of a harmful effect of maternal depressive symptoms on offspring EF. However, high heterogeneity among studies was found, and meta-analysis was not feasible. Fetal programming, genetics, and parental practices have been identified as potential mechanisms that can affect the EFs of children born to mothers who have experienced depressive symptoms. Conclusion: Our findings suggest a negative association between maternal depressive symptoms and offspring EF. Further studies on the effects of chronicity/severity of maternal symptoms and changes in EFs in different sensitive periods are needed. Registration number: PROSPERO CRD42020221193.