Abstract
Aims and objectives: The aim of this systematic review was to summarize the key findings of empirical studies assessing the influence of maternal depression on child attachment security measured before 24 months after birth. Method: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A literature search was conducted on the EBSCO (Academic Search Complete; Health Source: Nursing/Academic Edition; MEDLINE; PsycARTICLES) and PubMed databases, with infant attachment AND depression as search terms with Boolean operators. Study design or sample size did not affect inclusion. After screening, 29 of the 1510 unique publications originally identified were included in the review. Results: The studies reveal an equivocal association between maternal depression and child attachment security. Our findings indicate that depression had a significant influence on the attachment style almost only when diagnosed by structured interview: Depression measured by self-descriptive questionnaires was unrelated to attachment style. Furthermore, postpartum depression was found to be significant only when measured up to six months after childbirth. Conclusion: The relationship between maternal depression and infant attachment is both complex and dynamic, and the possible negative effects of depression might be compensated by maternal involvement in childcare. Therefore, further studies in this area should employ a reliable methodology for diagnosing depression and a suitable time point for measuring it; they should also adopt a multifactorial and prospective approach. It is important to note that breastfeeding/formula feeding was omitted as a factor in the majority of studies.
Highlights
Depression is one of the main causes of disability worldwide, and its lifetime prevalence ranges from 20% to 25% in women [1,2]
Depression that occurs during pregnancy is referred to as antenatal or prenatal depression, and depression occurring after childbirth is described as postpartum depression (PPD)
The term depression was applied to either major depression, prenatal depression occurring during pregnancy, or postpartum depression occurring during the first year after delivery
Summary
Depression is one of the main causes of disability worldwide, and its lifetime prevalence ranges from 20% to 25% in women [1,2]. PPD is a common and serious mental health problem, and one that is a source of suffering for both the mother and her offspring. It is often defined as an episode of a major or sometimes minor depressive disorder that occurs anytime within the first year postpartum [6]; most episodes begin within two to three months after giving birth [5,7]. The prevalence of PPD has been estimated to range from 9%
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