The effects of pre- and post-partum depression on child behavior and psychological development from birth to pre-school age: a protocol for a systematic review and meta-analysis.

Background: Pre- and post-partum depression is a common mood disorder with detrimental effects on both mother and child. The aim of the proposed review is to summarize evidence related to the effects of both pre- and post-partum depression on child behavior and development from birth to preschool age. In particular, our review will address mutual relations between pre- and post-partum depression in order to determine whether pre- and post-partum depression predict child psychological outcomes independently, whether there is an effect of timing of depression on child outcomes, whether pre- and post-partum depression interact to affect child outcomes, and whether the effect of pre-partum depression is mediated by depression after child's birth.

Methods: We will include prospective longitudinal studies that report data about the effects of both pre- and post-partum depression on child psychological outcomes as published in peer-reviewed academic journals since January 1998. We will search EMBASE, MEDLINE, PsycARTICLES, PsycINFO, ISI Web of Science, Scopus, and Wiley Online databases to identify original research articles written in English. Two independent reviewers will screen search results in two stages: (i) titles and abstracts and (ii) full text. The first one will extract data into tables, while the latter will verify whether the data extracted are correct. We will assess the risk of bias in the selected studies using the Critical Appraisal Skills Programme (CASP), Cohort Study Checklist. The results of the review will be reported in a narrative form. If there are sufficient data available, a meta-analysis will be conducted using metaSEM package in R.

Discussion: The proposed review will be the first systematic review summarizing the effects of both pre- and post-partum depression on child psychological development and behavior from birth to preschool age. The results of such a review may contribute to a better understanding of mutual relations between pre- and post-partum depression in their effects on child outcomes. They may also shed light on what periods in early human development are most vulnerable to the effects of maternal depression.

Trial Registration: PROSPERO CRD42018106269.