Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis

Background Studies have reported conflicting findings on the association between maternal pre- and perinatal depression and autism spectrum disorder (ASD) in offspring. Aims To examine and consolidate the existing evidence on the association between maternal pre- and perinatal depression and the...

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Main Authors: Biruk Shalmeno Tusa, Rosa Alati, Getinet Ayano, Kim Betts, Adisu Birhanu Weldesenbet, Berihun Dachew
Format: Article
Language:English
Published: Cambridge University Press 2025-07-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472425000675/type/journal_article
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author Biruk Shalmeno Tusa
Rosa Alati
Getinet Ayano
Kim Betts
Adisu Birhanu Weldesenbet
Berihun Dachew
author_facet Biruk Shalmeno Tusa
Rosa Alati
Getinet Ayano
Kim Betts
Adisu Birhanu Weldesenbet
Berihun Dachew
author_sort Biruk Shalmeno Tusa
collection DOAJ
description Background Studies have reported conflicting findings on the association between maternal pre- and perinatal depression and autism spectrum disorder (ASD) in offspring. Aims To examine and consolidate the existing evidence on the association between maternal pre- and perinatal depression and the risk of ASD in children and adolescents. Method In this systematic review and meta-analysis, we searched PubMed, Medline, EMBASE, Scopus, CINAHL and PsycINFO from the database inception to 21 February 2024. A meta-analysis was performed using random-effect models, and summary effect estimates were presented as odds ratios with 95% confidence intervals. Heterogeneity was assessed with Cochran’s Q and the I 2-statistic test. Additionally, subgroup analysis was conducted to identify the source of potential heterogeneity within the included studies. A funnel plot and Egger’s regression test were employed to evaluate publication bias. Results Twelve studies involving over 1.6 million mother–offspring pairs were included in the final analysis. A random-effects meta-analysis of these studies revealed a 52% increased risk (odds ratio 1.52, 95% CI 1.13–1.90) of ASD in the offspring of mothers experiencing pre-pregnancy depression, a 48% increased risk (odds ratio 1.48, 95% CI 1.32–1.64) in those experiencing antenatal depression and a 70% increased risk (odds ratio 1.70, 95% CI 1.41–1.99) in those with postnatal depression. Conclusions This systematic review and meta-analysis found that offspring born to mothers with depression before, during and after birth have a higher risk of developing ASD. Our findings underscore the need for early screening and targeted intervention programmes for at-risk children.
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spelling doaj-art-11ed27957cb84abfa394dff085f336482025-08-20T02:32:04ZengCambridge University PressBJPsych Open2056-47242025-07-011110.1192/bjo.2025.67Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysisBiruk Shalmeno Tusa0https://orcid.org/0000-0003-4362-0851Rosa Alati1Getinet Ayano2Kim Betts3https://orcid.org/0000-0001-5855-1911Adisu Birhanu Weldesenbet4Berihun Dachew5https://orcid.org/0000-0002-4041-6129School of Population Health, Curtin University, Perth, Western Australia, Australia Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Haramaya, EthiopiaSchool of Population Health, Curtin University, Perth, Western Australia, Australia School of Public Health, The University of Queensland, Brisbane, Queensland, AustraliaSchool of Population Health, Curtin University, Perth, Western Australia, AustraliaSchool of Population Health, Curtin University, Perth, Western Australia, AustraliaDepartment of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Haramaya, EthiopiaSchool of Population Health, Curtin University, Perth, Western Australia, Australia enAble Institute, Curtin University, Perth, Western Australia, Australia Background Studies have reported conflicting findings on the association between maternal pre- and perinatal depression and autism spectrum disorder (ASD) in offspring. Aims To examine and consolidate the existing evidence on the association between maternal pre- and perinatal depression and the risk of ASD in children and adolescents. Method In this systematic review and meta-analysis, we searched PubMed, Medline, EMBASE, Scopus, CINAHL and PsycINFO from the database inception to 21 February 2024. A meta-analysis was performed using random-effect models, and summary effect estimates were presented as odds ratios with 95% confidence intervals. Heterogeneity was assessed with Cochran’s Q and the I 2-statistic test. Additionally, subgroup analysis was conducted to identify the source of potential heterogeneity within the included studies. A funnel plot and Egger’s regression test were employed to evaluate publication bias. Results Twelve studies involving over 1.6 million mother–offspring pairs were included in the final analysis. A random-effects meta-analysis of these studies revealed a 52% increased risk (odds ratio 1.52, 95% CI 1.13–1.90) of ASD in the offspring of mothers experiencing pre-pregnancy depression, a 48% increased risk (odds ratio 1.48, 95% CI 1.32–1.64) in those experiencing antenatal depression and a 70% increased risk (odds ratio 1.70, 95% CI 1.41–1.99) in those with postnatal depression. Conclusions This systematic review and meta-analysis found that offspring born to mothers with depression before, during and after birth have a higher risk of developing ASD. Our findings underscore the need for early screening and targeted intervention programmes for at-risk children. https://www.cambridge.org/core/product/identifier/S2056472425000675/type/journal_articleAntenatal depressionpostnatal depressionpre-pregnancy depressionautism spectrum disorder (ASD)
spellingShingle Biruk Shalmeno Tusa
Rosa Alati
Getinet Ayano
Kim Betts
Adisu Birhanu Weldesenbet
Berihun Dachew
Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis
BJPsych Open
Antenatal depression
postnatal depression
pre-pregnancy depression
autism spectrum disorder (ASD)
title Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis
title_full Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis
title_fullStr Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis
title_full_unstemmed Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis
title_short Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis
title_sort maternal pre and perinatal depression and the risk of autism spectrum disorders in offspring systematic review and meta analysis
topic Antenatal depression
postnatal depression
pre-pregnancy depression
autism spectrum disorder (ASD)
url https://www.cambridge.org/core/product/identifier/S2056472425000675/type/journal_article
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