Maternal Depression Impairs Parental Emotional Responsiveness, Daily Care for Infants, Children: Global Systematic Review

A global systematic review published in the Harvard Review of Psychiatry found that maternal depression is consistently associated with negative parenting behaviors that may have long-term consequences for child development. The study, led by Tiago N. Munhoz, PhD, of the Federal University of Pelotas in Brazil, found that 97% (27 out of 29) of observational studies published in the decade between 2013 and 2023, reported that maternal depression negatively affected parenting practices, particularly during a child’s early years, posing challenges across multiple domains.

Munhoz and colleagues found consistent links between depressive symptoms and lower involvement with a child in daily interactions; diminished maternal commitment to fulfilling childcare responsibilities; and low sensitivity and responsiveness to a child's needs. They reported that mothers with maternal depression, defined as major depressive disorder (MDD) that occurs during pregnancy or emerges within 4 to 30 weeks postpartum, were less likely to smile at their children, to touch them, or to enjoy interactions. They demonstrated more hostility and were inconsistent with discipline, the authors wrote. “Understanding this relationship is crucial for developing effective psychological methods and interventions.”

Before this study, the most recent systematic review of the literature exploring the link between maternal depression and parenting was limited to English language reports and data ended in 2013, according to the authors.

In their study, Munhoz et al included studies from diverse regions, including Europe, Latin America, East Asia, North America, and the Middle East; 8 studies were conducted in middle-income countries and one in a low-income setting. All eligible studies assessed maternal depression diagnosed as major depressive disorder or screened for depressive symptoms during the perinatal period or throughout the child’s youth. Parenting practices—specific behaviors directed toward children such as responsiveness, warmth, and interaction—were the primary focus of analysis; parenting styles, eg, authoritarian, permissive, neglectful, were excluded.

Across the included studies, maternal depression was associated with poor response to a child's cues and impaired bonding. Fourteen studies directly assessed the mother-infant bond, and all reported that depression was linked to poorer bonding outcomes. In studies using validated instruments such as the Edinburgh Postnatal Depression Scale and the Postpartum Bonding Questionnaire, higher depression scores corresponded with greater bonding impairment. Four studies found that mothers without depressive symptoms demonstrated stronger emotional connections with their infants than those with current or past depression.

One US based study involving 36 low-income mother-child dyads did not find a significant association between depression and maternal sensitivity or positive regard, but this was an outlier among the findings.

The majority of studies focused on children younger than 36 months of age and were conducted in high-income countries using cross-sectional designs. The review authors noted that future research should explore parenting in more diverse sociocultural contexts and use longitudinal designs to assess longer-term effects.

The "literature suggests that depression-alleviating interventions based on cognitive behavioral therapy and mindfulness improve parent–child relationships and reduce negative parenting behaviors,” the authors wrote. “Such tactics benefit maternal well-being and the overall family dynamic.”

Lages EM da Silva MAM, Soares FC, Munhoz TN. The impact of maternal depression on early parenting: a systematic review. Harv Rev Psychiatry. 2025;33(4):179-190. doi:10.1097/HRP.0000000000000434.