Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Department of Public Health, History of Science and Gynecology, Faculty of Medicine, Miguel Hernández University, Campus de San Juan, Alicante, Spain.
Department of Public Health, History of Science and Gynecology, Faculty of Medicine, Miguel Hernández University, Campus de San Juan, Alicante, Spain. Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain.
Braz J Psychiatry. 2024;46:e20233387. doi: 10.47626/1516-4446-2023-3387. Epub 2024 Mar 4.
To conduct a thorough examination of the current understanding of the effect of maternal depression exposure on the executive functions (EFs) of offspring.
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.
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.
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.
全面探讨母亲抑郁暴露对子代执行功能（EF）的影响。
根据系统评价和荟萃分析的首选报告项目（PRISMA）声明，在 MEDLINE（通过 PubMed）、ScienceDirect、LILACS、PsycINFO 和 SciELO 数据库中对同行评审的队列研究进行了全面检索。使用美国国立心肺血液研究所（NHLBI）的观察性队列和横断面研究质量评估工具评估研究质量。使用推荐分级评估、制定与评价（GRADE）框架评估证据。
分析了来自不同国家的 33 项队列研究，共纳入 38981 名参与者。24 项研究证实了母亲抑郁症状对后代 EF 有不良影响的假设。然而，研究之间存在高度异质性，无法进行荟萃分析。胎儿编程、遗传学和父母行为已被确定为可能影响经历抑郁症状的母亲所生孩子 EF 的潜在机制。
我们的研究结果表明，母亲抑郁症状与后代 EF 之间存在负相关。需要进一步研究母亲症状的慢性/严重程度以及不同敏感时期 EF 的变化对 EF 的影响。
