Maternal and paternal depression and anxiety and offspring infant negative affectivity: A systematic review and meta-analysis

Maternal internalizing symptoms during pregnancy, specifically depression and/or anxiety, are commonly linked to negative affectivity (NA) in infant offspring. These links are commonly attributed to biological effects of the in utero environment on fetal development. However, research suggests that internalizing symptoms before and after pregnancy, as well as in fathers, may also be associated with NA in infant offspring. Such findings suggest greater complexity in transmission than can be explained by biological in utero programming alone. Further, infant NA is often treated as an homogenous construct, yet it covers a range of facets including fear, frus-tration, sadness, and slow recovery from distress that may each be differentially associated with parent internalizing distress. Here we aimed to (1) meta-analytically quantify associations between maternal and paternal internalizing symptoms and infant offspring NA, (2) examine how associations varied as a function of distinct phenotypic facets of NA, and (3) examine how associations varied by timing of parental symptoms (preconception, antenatal, postnatal) and infant age. Using random-effects meta-analysis, we found that maternal internalizing symptoms were positively associated with infant NA (r = 0.17 [95% CI 0.14, 0.21], 42 studies, 149 estimates). Preliminary evidence from studies of fathers likewise suggested a positive association with infant NA (r = 0.13 [95% CI 0.04, 0.22], 6 studies, 40 estimates). We observed associations with the global infant NA construct, as well as effect modification by infant NA facet (maternal r range 0.12-0.22; paternal r range 0.03-0.21). In mothers, there was no evidence of effect modification by timing of internalizing symptoms or infant age; in fathers, preliminary associations were larger for postnatal than antenatal symptoms. Further studies of preconception and paternal symptoms are now needed, and we suggest avenues for research to advance understanding of the relations between parent internalizing symptoms and infant NA.