Below you’ll find attached some notes I took while reading the articles listed i

Below you’ll find attached some notes I took while reading the articles listed in my bibliography. Please create a literature review that speaks on the topic of “Postpartum Maternal Depression influence on language and social development of children during early childhood” 
Here are some notes I took of the articles I read: 
Maternal Depressive symptoms and maternal child-directed speech: A systematic review
(Francesa et al., 2022)
Abstract
In this systematic review, we present maternal child-directed speech as a potential pathway through which maternal depressive symptoms influence children’s language skills.
Method: Following PRISMA guidelines, three database searches produced 546 articles related to maternal depressive symptoms, child-directed speech, and children’s language skills, ten of which examined the relation between maternal depressive symptoms and child-directed speech.
Results: Findings revealed that increases in maternal depressive symptoms may be associated with decreases in amount of child-directed speech but not necessarily with decreases in the complexity of child-directed speech.
Limitations: The studies in this review varied in sample size, the inclusion of important sociodemographic factors, and the operationalization of depression and child-directed speech, thereby limiting conclusions, especially about whether maternal depressive symptoms are associated with the complexity of child-directed speech.
Conclusions: This review has implications for prevention and intervention efforts aimed at optimizing children’s language skills; child-directed speech is modifiable, and mothers experiencing depressive symptoms may benefit from resources encouraging rich child-directed speech.
Discussion and future directions
The goal of this Here, we discuss one aspect of that interactional context—maternal mental health. We contribute to the growing literature examining parental factors that predict variability in child-directed speech by systematically reviewing ten studies related to the relation between maternal depres- sive symptoms and data-providing aspects of child-directed speech. Amount of child-directed speech, duration of utterances, and adjustment of child-directed speech across time may be plausible mechanisms through which maternal depressive symptoms exert their effects on children’s language skills. These potential mechanisms require further study, as part of important next steps in conceptualizing prevention and intervention efforts aimed at optimizing children’s language outcomes.
Limitations and future directions
This review identified several gaps in the literature. Future studies would benefit from several other opportunities. First, to better understand the mechanisms that link maternal depressive symptoms to children’s language skills, future studies should include maternal depressive symptoms, child-directed speech, and children’s language skills in the same model. Mediation models should be used to test the hypothesis that the features of maternal child-directed speech identified in this systematic review act as mechanisms through which maternal depressive symptoms affect chil- dren’s language skills. Analyzing maternal child-directed speech as a mediator is an important next step in identifying targets for in- terventions designed to improve children’s language skills in children at risk for falling behind their peers.
Future studies should examine several aspects of child- directed speech together, rather than examining each aspect individu- ally. 
Together, it appears that children best develop language skills through a dynamic system of processing input into meaningful information, interpreting social cues, and engaging with conceptually challenging material. Previous research has already established that mothers with depressive symptoms have difficulty with social-pragmatic aspects of dyadic interactions. Thus, an important next step is to move beyond the use of an isolated approach to examine these different as- pects of mother-child interactions by examining how data-providing aspects of child-directed speech fit into social-pragmatic difficulties and vice versa.
Third, future studies should incorporate a developmental approach that accounts for the dynamic ways in which mother-child interactions change across time. Not only should future studies examine the features of child-directed speech that are most developmentally relevant to the participating children but also examine the adjustment of child-directed speech across time. Relatedly, future studies should use a developmental approach to examine the timing and chronicity of maternal depressive symptoms, as maternal depressive symptoms may differentially affect children’s outcomes as a function of timing and chronicity.
Finally, the findings from this review highlight the importance of analyzing the relation between maternal depressive symptoms and maternal child-directed speech in a way that further parses the com- ponents of maternal depressive symptoms to illuminate why mothers who are depressed differ from mothers who are not depressed on certain aspects of child-directed speech. Future studies should utilize measures that enable not only the examination of different components of maternal depressive symptoms but also the examination of commonly comorbid symptoms (e.g., anxiety symptoms) 
Using more specific subscales would move us closer to un- derstanding the aspects of maternal depression that might drive variations in maternal behavior. Understanding the different compo- nents of depression is important for creating effective interventions as well. Several studies have demonstrated that treatment of maternal depression is not sufficient to improve certain aspects of mother-child interactions, including social-pragmatic ones, like responsivity. Under- standing the facets of depression that drive reductions in certain aspects of child-directed speech could help fine-tune the content of mother-child interventions.
Conclusion 
it is well-established that mothers vary in several aspects of child-directed speech, but less is known about the cause of the vari- ability itself. Several interventions aim to improve children’s language skills; however, mothers and their children do not interact in a vacuum. Understanding the broader interactional context in which mothers are embedded is crucial for developing effective interventions. 
Here, we discuss one aspect of that interactional context—maternal mental health. We contribute to the growing literature examining parental factors that predict variability in child-directed speech by systematically reviewing ten studies related to the relation between maternal depres- sive symptoms and data-providing aspects of child-directed speech. Amount of child-directed speech, duration of utterances, and adjustment of child-directed speech across time may be plausible mechanisms through which maternal depressive symptoms exert their effects on children’s language skills. These potential mechanisms require further study, as part of important next steps in conceptualizing prevention and intervention efforts aimed at optimizing children’s language outcomes.
Maternal postpartum depressive symptoms predict delay in non-verbal communication in 14-month-old infants
(Kawai, 2017)
Abstract
investigated the potential relationship between maternal depressive symptoms dur- ing the postpartum period and non-verbal communication skills of infants at 14 months of age in a birth cohort study of 951 infants and assessed what factors may influence this association.
Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, and non-verbal communication skills were measured using the MacArthur-Bates Communicative Development Inventories, which include Early Ges- tures and Later Gestures domains.
Infants whose mothers had a high level of depressive symptoms (13+ points) during both the first month postpartum and at 10 weeks were approximately 0.5 standard deviations below normal in Early Gestures scores and 0.5–0.7 standard deviations below normal in Later Gestures scores. These associations were inde- pendent of potential explanations, such as maternal depression/anxiety prior to birth, breastfeeding practices, and recent depressive symptoms among mothers. These findings indicate that infants whose mothers have postpartum depressive symptoms may be at increased risk of experiencing delay in non-verbal development.
Non-verbal communication skills
The CDI have two versions according to age of the subject: the “Words and Gestures form” and the “Words and Sentences form”. The “Words and Gestures form” is appropriate for use with 8- to 18-month-olds and generates scores for phrase and word comprehension, word production, and use of communicative and symbolic gestures.
We used these non-verbal communication skills domains (“Early Gestures” and “Late Gestures”.  In the present study, we do not use these verbal communication scores of the “Words and Gestures form” but use non-verbal communication skills domains along with the aim of this study.
Choice of factors potentially influencing associations of interest
After examining the literature, we decided to focus on the following three factors to determine what, if any, associa- tion they may have with maternal postpartum depression: maternal history of depression or anxiety prior to childbirth, breastfeeding practices, and recent maternal depressive symptoms, as follows.
First, we selected maternal history of depression or anxiety prior to childbirth given reports that maternal prenatal depression is an antecedent of perinatal and postnatal depressive symptoms and is associated with a range of developmental outcomes among infants. In addition, combined history of depressive and anxiety disorders is a best predictor for postpartum depression. 
Second, we selected breastfeeding practice because difficulties with breastfeeding have been associated with maternal depression after childbirth and are reportedly associated with poor cognitive outcome of infants. 
Third, we selected recent maternal depressive symptoms because maternal depressive symptoms during the first year after childbirth, not limited to postpartum period, have been repeatedly reported to be associated with reduced or slow general cognitive development of infants, likely due to negative effects of poor maternal responsiveness and limited frequency of play with infants. In the framework of HBC Study, recent maternal depressive symptoms were measured at 40 weeks (approximately 10 months) after childbirth.
Association of maternal depressive symptoms during first month or 10 weeks postpartum with non-verbal communication skills of infants at age 14 months. 
The magnitude of the effect was −0.50 in the Full Model, indicating that Early Gestures scores in infants whose mothers had a high level of depressive symptoms during the first month after birth were approximately half an SD below normal. 
In the present study, we observed that maternal depressive symptoms, measured using the EPDS during the first month postpartum, were significantly associated with reduced Early and Later Gesture CDI scores in their infant at 14 months of age. These associations were not accounted for by any demographic or perinatal variables, nor by potential explanatory variables of maternal depression/anxiety prior to childbirth, breastfeeding practices by 14 months, or maternal depression at 40 weeks (recent depressive symptoms). In contrast, maternal depressive symptoms at 10 weeks postpartum were not associated with reduced Early Gesture scores, but were associated with reduced Later Gesture scores. Our present findings cannot be easily attributed to cultural factors, as frequency and morphology of communicative gestures are universal across human cultures. 
To our knowledge, this is the first large-scale study reporting that maternal postpartum depressive symptoms during the first month after childbirth can be a significant predictor of an infant’s non-verbal communication skills during the second year of life.
Interpretation of results
According to the authors of the CDI, Early Gesture is composed of two categories: “First Communicative Gestures” and “Games and Routines”. The “First Communicative Gestures” category is a potential predictor of emergence of speech and includes deictic gestures of giving, showing, pointing, reaching, and conventional communicative gestures. The “Games and Routines” category reflects early social interactive bases and includes playing peekaboo and patty cake and singing. Items listed in these two categories have been reported to emerge well before 1 year of age. Later Gestures is composed of three categories: “Actions with Objects”, “Imitating Other Adult Actions”, and “Pretending to Be a Parent”. Both the “Actions with Objects” and “Imitating Other Adults” categories are indicators of understanding objects around them and uses of these objects, which are connected with representational skills and accommodative acts. “Pretending to be a Parent” reflects prototypes of symbolic gestures. Some items listed in these three categories have been known to emerge during the first year of life, although others tend to appear during the second year of life. 
Given these previous findings regarding the developmental timeline of Early Gestures and Later Gestures, our findings suggest that post- partum depressive symptoms of mothers, particularly during the first month after childbirth, may adversely affect early social interactions as well as representation and accommodation.
of note, only high depressive symptoms scores were associated with hindered development of Early/Later Gestures, and relatively few participants in the present study (e.g. N = 47, 5% during the first month postpartum) had such high scores (13 points and over on EPDS). This can point towards two interpretations. One is that infants with mothers of mild depressive symptoms (i.e. 9–12 points) and infants with mothers of severe symptoms (i.e. 13 points and over) are clinically quite different. The other interpretation is that mothers with clinical need of intervention are those who scored 13 points and over with EPDS.
Postpartum depressive symptoms occurring at 10 weeks therefore may not adversely affect early patterns of social interaction. However, this conclusion remains arguable, as relatively few mothers had a high EPDS score at 10 weeks (N = 10, 1%), leading to wide CIs and lack of significance in findings. 
Conclusion
In conclusion, we found that maternal depressive symptoms over the first 10 weeks postpartum predict developmen- tal delay in non-verbal communication skills of infants at 14 months of age. Further, this association was not induced by known confounders or potential explanatory factors, including maternal depression/anxiety prior to childbirth, breastfeed- ing practices, or recent maternal depressive symptoms. Maternal postpartum mood, likely independent of later emergence of depression or a poor mother-child relationship, may influence development of early social skills.
Postpartum stress and infant outcome 
(Oyetunji & Chandra, 2020) 
Abstract 
Postpartum stress when persistent, recurring or chronic, it can negatively impact infant outcome, including the subscales of mental wellbeing such as growth, development, feeding, attachment and sleep. This study aims to define the physical and functional effect of postpartum stress on measures of infant mental wellbeing. 
A systematic review of English language articles published between 1995 and 2019 on PubMed, Medline and Psych base databases was carried out. Search terms used included postpartum, stress, infant, growth, development, nutrition, attachment and sleep. Both qualitative and quantitative studies were reviewed with eligibility criteria. Inclusion criteria of human studies, mothers diagnosed with depressive and anxiety symptoms postpartum with infant correlates were used. 
A total of 74 articles were reviewed and summarized into postpartum stress associations with infant growth, development, nutrition, sleep and maternal fetal attachment. Postpartum stress is negatively associated with poor developmental trajectories and linear growth deficits, causing stunting in growth; poor language and cognitive development; poor gross and fine motor movement, and infant sleep. An inverse relationship exists with breast feeding and postpartum depression. 
More importantly, breastfeeding ef- ficacy is important for sustaining positive infant feeding outcome. Increased maternal age during postpartum depression has been linked, as a contributing factor, to decreased maternal fetal attachment/bonding. A ripple effect exists from the association between postpartum stress and poor infant sleep. There is strong evidence that correlates PPS to infant outcome, mediated through many external factors. More research needs to be conducted to delineate and potentially mitigate the impact of modifiable factors. 
Conclusion
There is a strong negative association between, PPD/anxiety as well as PPPTSD and infant outcome when it comes to growth and develop- ment, neurodevelopment, nutrition and bonding. With more research being done to establish this association, more effort should delve into the accuracy of the role of contributing factors and their association in view of the degree of impact on infant outcome. This will drive and guide the provision for resources that would help control the factors that mitigate these subscales of infant outcome.
Speaking of State of mind: Maternal Mental Health Predicts Children’s Home language Environment and Expressive Language. 
(Clifford et al., 2022)
Introduction
Language development is a complex and multifaceted process that requires both person-centered and environmental factors (Hindman, Wasik & Snell, 2016). Researchers have consistently shown that language exposure and the quality of the language environment in which the child develops are important predictors to children’s later linguistic skills and cognitive development. 
Additionally, maternal mental health is a known risk factor to child development. Particularly, maternal depressive symptoms have been related to poorer child language scores in the first few years of life. 
Maternal depression 
Kawai, Takagai, Takei, Itoh, Kanayama and Tsuchiya (2017) also found postpartum depression at 1 month (but not 3 months) to be negatively related to children’s non-verbal communication skills at 14 months as measured by the Japanese version of the MacArthur-Bates Communicative Development Inventory (MCDI). Ahun, Geoffroy, Herba, Brendgen, Séguin, Sutter-Dallay and Côté (2017) found relations between postpartum maternal depression and children’s language.
Specifically, mothers who were chronically depressed over five years postpartum had children who scored lower on the Peabody Picture Vocabulary Test-Revised (PPVT-R). However, in another study, no relations were found between postpartum depression at six weeks or six months and children’s language composite scores on the Bayley-III at 18 months (Piteo, Yelland & Makrides, 2012).
The current study
Home language environment: To measure the home language environment, we used the Language Environment Analysis System designed to provide clinicians and researchers detailed information regarding the language environment of infants and toddlers. Parents placed a small digital recording device (language processor) in the pocket of a custom-made shirt, and this device recorded everything the infant uttered and heard during a 24-hour period. 
Infant’s expressive language was captured using both LENA and parental reports. LENA software produced three indices of children’s language production including: NUMBER OF CHILD VOCALIZATIONS, VOCAL PRODUCTIVITY SCORE (an automated canonical syllable count per conversational turn score), and AUTOMATIC VOCALIZATION ASSESSMENT (AVA; a categorized and quantified score of children’s protophones and phonemes). These LENA expressive language scores were standardized by age for analysis.
Discussion
The current study examined maternal mental health factors and their relations to a variety of home language environment and language indices. This study was unique in that it a) captured multiple aspects of maternal mental health, and b) utilized observational measures of the home language environment and expressive language in addition to parent-reported language comprehension and production. Each of these variables were then analyzed together in a single path model.
Our first hypothesis was partially supported – in that maternal depression (but not anxiety) was negatively related to indices of the home language environment (i.e., observed number of adult words spoken and observed number of conversational turns). Our second hypothesis was also partially supported – in that maternal depression was negatively related with indices of children’s expressive language (i.e., number of child vocalizations, AVA scores) but not child vocal productivity scores or parent-reported language production or comprehension scores. 
Previous researchers have shown that maternal depression is a risk factor to child development (Goodman, Rouse, Connell, Broth, Hall & Heyward, 2011; Goodman & Gotlib, 1999), and the current study lends support to this previous work. These results are in line with previous studies finding negative associations between maternal depression and assessments of children’s language development (Ahun, et al., 2017; Kawai et al., 2017; Quevedo et al., 2012; Stein et al., 2008). 
Maternal depression
The current study lends support to these previous studies and extends previous work by examining the effect of maternal depression on the quality of the home language environment. In line with past work, the results of the current study suggest maternal depression to modulate the quality of the home language environment and place children at increased risk for experiencing language delays 
Importantly, maternal depression was not related to concurrent parental reports of their child’s language production or comprehension. There are three possible explanations for this finding. The first is that parents’ reports of language differ from observed measures of children’s expressive language – in that the former is a parent’s assessment of the words that children understand and/or have produced whereas the latter captures various measures of children’s expressive language during one 24-hour period. The second explanation is that depressed mothers may not be accurate reporters of their own children’s language development. Maternal depression is known to influence maternal reports of children’s temperament. 
However, less is known regarding the effects of maternal depression on mothers’ ability to accurately report on their child’s language development. The fact that we found relations between maternal depression and observational measures of children’s expressive language and not parental reports of children’s language production provides some indication that mothers with depression may struggle to accurately report on their child’s language development.
Limitations and future directions
First, the cross-sectional nature of the data prevents us from inferring causation. Future research should examine observational measures of the child’s home language environment, language, and parental reports of children’s language comprehension and production across time and development. By examining these relations longitudinally, a better understanding of sensitive periods for child susceptibility to maternal mental health issues can be captured. Further, longitudinal data is needed to examine mediating mechanisms in the relations between contextual (e.g., SES) and relational factors (e.g., parent-child interactions), maternal mental health (e.g., depression, anxiety, stress), the home language environment, and children’s language development. By identifying mechanisms in these relations and the timing of these effects, scholars, interventionists, and practitioners will be better enabled to gain further knowledge on these topics and provide improved treatment to children and families. Additionally, we examined these relations using depressive and anxiety symptoms rather than clinical diagnoses of these mental disorders. 
Although elevated scores on our measures of depressive and anxiety symptoms are indicative of mental disorders, future work is needed using clinical and non-clinical samples when examining these relations. 
Lastly, a proportion (22%) of the parents in our sample reported their child being spoken to in two or more languages. Though in this study we only included families who could complete the in-home assessments and surveys in English, future research should examine the role of multiple languages being present in children’s environments as this may relate to their home language environments and expressive language.
Conclusion 
Parents are a vital source of language exposure, repetition, contextual support, and scaffolding; thus, when parents are less able to be involved in this process, children may struggle in their language development. The current study provided evidence that maternal mental health may modulate the quality of the home language environment and the expressive language of children. Lastly, the current study provided some indications that maternal depression and anxiety may have an impact on mother’s ability to accurately report on their children’s language development. These findings highlight the need to better understand how caregivers’ mental health shapes children’s environments and language development over time.
Timing and Chronicity of Maternal Dpression Symptoms and Children’s Verbal Abilities
(Ahun et al., 2017)
Objective: To test the associations between the timing and chronicity of maternal depression symptoms (MDS) and children’s long-term verbal abilities.
Results: Children exposed to chronic MDS had lower PPVT-R scores than children never exposed (mean differ- ence = 9.04 [95% CI = 2.28-15.80]), exposed early (10.08 [3.33-16.86]) and exposed late (8.69 [1.85-15.53]). There were no significant differences between scores of children in the early compared with the late exposure group. We adjusted for mother-child interactions, family functioning, socioeconomic status, PPVT-R administration language, child’s birth order, and maternal IQ, psychopathology, education, native language, age at birth of child, and par- enting practices. Maternal IQ, (h2 = 0.028), native language (h2 = 0.009), and MDS (h2 = 0.007) were the main pre- dictors of children’s verbal abilities.
Conclusions: Exposure to chronic MDS in early childhood is associated with lower levels of verbal abilities in middle childhood. Further research is needed in larger community samples to test the association between MDS and children’s long-term language skills. (J Pediatr 2017;190:251-7). 
Discussion
The objective of this study was to model the association between the timing and chronicity of MDS in early childhood (first 5 years of life) and children’s long-term verbal abilities (5-10 years). In our population-based birth cohort (n = 1073), 37.8% of mothers reported elevated MDS (eg, experiencing few symp- toms a lot of the time or many symptoms at least some of the time over the past week) at least once during the first 5 years of the target child’s life. 
However, only children exposed to chronic MDS had significantly lower verbal abilities during middle childhood (ages 5-10 years). Specifically, children exposed chronically had lower scores than those never exposed and those exposed early or late. This association remained after adjusting for a wide range of potential confounders of the MDS and receptive language skills association. Maternal verbal IQ and native language, as well as family SES, were the main predictors of children’s verbal abilities. These results illustrate that multiple family factors are in- volved in the long-term development of verbal abilities and points to the importance of addressing the wider psychoso- cial environments of families affected by MDS in interventions.
It has not been well explored whether the timing and chro- nicity of MDS are associated with receptive verbal skills with effects lasting into middle childhood (age 10 years).
A number of psychosocial factors, including lack of social support, in-home violence, and use of childcare services32-36 could explain or modify the associations between MDS and child development. 
Questions about the timing of effects of depressive symp- toms on child development have often been framed within the context of the debate concerning “sensitive periods”; that is, whether there are specific periods when the occurrence of ex- periences has heightened importance even if the exposure is transient. However, support for sensitive periods in correla- tional and longitudinal studies is weak. 
The present results, together with previous ones showing nega- tive impact of chronic MDS, suggest that children may be able to cope with such stressful situations for a limited period, bu their self-regulation cpacities may become overwhelmed if the stressor is chronic. 
Clinical assessment of depression was not available in this sample because this was a population-based study, which limits our capacity to make inference to populations with clinically significant levels of depression. However, we relied on a widely used and validated instrument for assessing maternal depres- sion in population samples such as ours, where prevalence of clinically severe mental health problems is relatively low but prevalence of symptoms is high.
Overall, this study shows that exposure to chronic mater- nal depression during the first 5 years of life is a potential risk factor for lower levels of receptive language skills, and this risk may extend up to middle childhood. Further research is needed to replicate these findings in samples with larger numbers of chronically depressed mothers to understand the underlying mechanisms of this association and to test the impact of pre- vention programs to support mothers who experience lasting depression after the birth of a child. 
Antenatal depression and the impact on infant cognitive, language and motor development at six and twelve months postpartum 
(O’Leary et al., 2019)
Abstract
Antenatal depression is associated with adverse social-emotional and behavioural outcomes during childhood but there has been little investigation of the impact on infant neurodevelopment during the first postnatal year.
Aims: The aim of this study was to assess the impact of depression during pregnancy on infant cognitive, language and motor development at six and twelve months using a prospective longitudinal study design.
Outcome measures: MDD was measured during pregnancy and both maternal depression and infant cognitive, language and motor development were measured at six and twelve months postpartum.
Results: At six months, infants in the MDD group had lower motor development scores (M = 95.48, SD = 11.87) compared with controls (M = 99.97, SD = 10.64, p=.026) after controlling for maternal concurrent depression scores. At twelve months, infants in the MDD group had lower language scores (M=87.33, SD = 10.54) compared with controls (M = 95.06, SD = 11.78, p = .037) which attenuated after controlling for maternal concurrent depression.
Conclusions: These data contribute to the growing literature investigating the impact of antenatal depression on infant cognitive, language and motor development within the first postnatal year. The association between maternal depression and lower infant motor scores highlights the importance of early intervention for both mothers and infants in situations where maternal well-being is at risk.
Discussion 
This study demonstrates that infants of mothers with a diagnosis of clinical depression during pregnancy had lower motor development scores at six months after controlling for maternal concurrent depres- sion. At twelve months, infants of mothers in the MDD group had lower language scores which attenuated after controlling for maternal de- pression scores. The inclusion of a group with a history of depression is a novel aspect of this study and represents a group which is largely neglected in the research literature, despite being at the highest risk for developing depression across the perinatal period. 
The results of this study indicate that, despite significantly higher depression scores during pregnancy and at six months post-partum for mothers in the History group, there were no differences observed for infant develop- ment in this group compared with either the MDD or Control groups.
At twelve months there were significant differences between the MDD and Control group for infant language scores, which attenuated after controlling for postnatal depression. Determining differences in infant development which arise as a result of exposure to antenatal depression, postnatal depression or as a consequence of the continua- tion of depression across the perinatal period are difficult to ascertain in studies using a case-control methodology. In studies of this nature, in- cluding postnatal depression as a confounding variable eliminates group differences due to depression being the factor under which par- ticipants were allocated to those groups in the first instance. In the literature, language delays have previously been reported in older children born to mothers with antenatal depression and in children whose mothers had postnatal depression. 
It is possible that postnatal depression may potentially have an indirect effect on language development through maternal behaviour. Mothers with postnatal depression express more negative affect, focus less on infant experience within interactions and show less acknowledgement of infant agency  
Mothers with postnatal depression also demonstrate impaired caregiving ability and read to their children less than non- depressed mothers both of which have a negative impact on language development 
The outcomes reported in this study raise the question of whether the chronicity of symptoms leading from the antenatal period to the postnatal period has a greater impact on infant development than just antenatal depression alone. Recent studies, investigating the trajectory of maternal symptoms across the perinatal period have examined the timing of perinatal depression in predicting infant developmental out- come. 
These patterns reflected mothers whose symptoms in- creased, decreased or remained low across this period of time. The children of mothers whose depression decreased over this period had equivalent behavioural and executive function scores to those in the low symptom group, whereas those in the increasing group had poorer scores at each time-point. The pattern that the chronicity of depression constitutes a major factor for infant outcomes fits with the findings of the current study. However, further analyses stratifying those women who were depressed at particular time-points were not possible within this dataset due to the limited sample size. Missing data, a common issue in longitudinal research, provided further limitations for statis- tical analysis in this study. Lastly, the inclusion of a further measure of maternal socio-economic status (e.g. total household income), in ad- dition to that of maternal education, would have been of benefit in the interpretation of the results of this study.
To conclude, the data in this study demonstrates that infants of mothers with a diagnosis of clinical depression during pregnancy had lower motor development scores at six months. At twelve months, in- fants of mothers in the MDD group had lower language scores which attenuated after controlling for maternal concurrent depression scores.
This study highlights the im- portance of considering the chronicity of maternal depression from the antenatal into the postnatal period and the importance of early inter- vention, be it during pregnancy or in the early postpartum period, in situations where maternal well-being or infant development may be at risk.
Does maternal postpartum depression affecct children’s developmental outcomes? 
(Aoyagi & Tsuchiya)
Abstract
Aim: The etiology of maternal postpartum depression (PPD) remains inconclusive, and there is no consen- sus concerning whether maternal PPD affects children’s developmental outcomes. Consequently, in this liter- ature review, we examined whether maternal PPD affects children’s physical, neuromotor, language and general cognitive development.
Methods: We conducted an electronic search using PubMed to select case–control and cohort studies that addressed maternal depression, depressive episodes or depressive symptoms among postpartum (within 6 months) women. We omitted studies that focused on a specific population (e.g. preterm infants).
Results: The methodological problems of prior studies indicate that their findings must be interpreted with caution. Insufficient and or inconsistent evidence has supported associations between maternal PPD and children’s developmental trajectories. Nevertheless, some key studies have revealed findings that require fur- ther analysis, including the associations between maternal PPD and children’s stunted growth/being under- weight in developed countries, the slight delay in children’s fine motor development, and in children’s language development.
Conclusion: Although several studies have investigated the longstanding effects of maternal PPD on chil- dren’s physical and neurodevelopment, no conclusive evidence has elucidated a relationship between mater- nal PPD and all four domains of child development – physical, neuromotor, language and general cognitive ability. Therefore, large-scale, longitudinal studies with a long-term follow-up period – extending to school age and beyond – are needed. Moreover, confounding factors should be carefully considered. Specifically, household income, parental education, breastfeeding, bonding/attachment and paternal mental health may be associated with maternal mental health and children’s neurodevelopment.
Summary and Future Directions
Although several studies have investigated the longstanding effects of maternal PPD on children’s physical and neurodevelopment, no conclusive evi- dence has elucidated a relationship between maternal PPD and all four domains of child development – physical, neuromotor, language and general cognition.
On the other hand, some key studies with meth- odological advantages have supported associations between maternal PPD and children’s stunted growth or being underweight in developed countries, with a slight delay in children’s fine motor development, and in children’s language development. However, large-scale, longitudinal studies with a long-term follow-up period – extending to school age and beyond – are needed.
Other design issues should be addressed in future studies. Confounding factors should be carefully considered. Household income, parental education, breastfeeding, and bonding/attachment have been suggested in the literature; in addition, paternal mental health and paternal parenting practices may be associated with maternal mental health as well as with children’s developmental consequences.
Parental Postnatal Depression in COVID: A Systematic Review of Its Effects on the Parent-Child Relationship and the child’s Developmental Outcomes
(Frederica et al., 2023)
Abstract
The international literature has shown that maternal and paternal postnatal depression (PND) is one of the most common mental illnesses in the perinatal period, with significant con- sequences for parent–infant relationships and infant development. The COVID-19 pandemic has increased the rates of prevalence of PND, exacerbating the mental health risk for new families. This systematic review aims to examine the effect of maternal and paternal PND on parent–infant rela- tionships and children’s development in the first 36 months after childbirth during the COVID-19 outbreak. Eligible studies were identified using the following databases: Medline, CINAHL, SCOPUS, PsycINFO, PsycARTICLES, ScienceDirect, and Web of Science. Of the 1252 studies considered, 10 studies met the inclusion criteria. Results showed that maternal PND significantly affected the quality of the early mother–infant relationship and the infant’s motor, self-regulation, and socio-emotional development. In addition, the detrimental impact of maternal PND on the quality of early mother– infant relationships seems to become stronger as COVID-19 concerns increase. No studies included fathers. These findings strengthened the importance of planning targeted prevention and treatment strategies to prevent PND and its short- and long-term consequences, especially in the case of stressful and traumatic events. They also suggested the urgent need for further exploration of fathers.
Bibliography
Ahun, M. N., Geoffroy, M.-C., Herba, C. M., Brendgen, M., Séguin, J. R., Sutter-Dallay, A.-L., Boivin, M., Tremblay, R. E., & Côté, S. M. (2017). Timing and Chronicity of Maternal Depression Symptoms and Children’s Verbal Abilities. The Journal of Pediatrics, 190, 251–257. https://doi.org/10.1016/j.jpeds.2017.07.007
Aoyagi, S., & Tsuchiya, K. J. (2019). Does maternal postpartum depression affect children’s developmental outcomes? The Journal of Obstetrics and Gynaecology Research, 45(9), 1809–1820. https://doi.org/10.1111/jog.14064
Çelen Yoldaş, T., & Özmert, E. N. (2021). Communicative Environmental Factors Including Maternal Depression and Media Usage Patterns on Early Language Development. Maternal and Child Health Journal, 25(6), 900–908. https://doi.org/10.1007/s10995-021-03125-3
CLIFFORD, B. N., STOCKDALE, L. A., COYNE, S. M., RAINEY, V., & BENITEZ, V. L. (2022). Speaking of State of Mind: Maternal Mental Health Predicts Children’s Home Language Environment and Expressive Language. Journal of Child Language, 49(3), 469–485. https://doi.org/10.1017/S0305000921000131
Federica, G., Renata, T., & Marzilli, E. (2023). Parental Postnatal Depression in the Time of the COVID-19 Pandemic: A Systematic Review of Its Effects on the Parent-Child Relationship and the Child’s Developmental Outcomes. International Journal of Environmental Research and Public Health, 20(3), 2018-. https://doi.org/10.3390/ijerph20032018
Kawai, E., Takagai, S., Takei, N., Itoh, H., Kanayama, N., & Tsuchiya, K. J. (2017). Maternal postpartum depressive symptoms predict delay in non-verbal communication in 14-month-old infants. Infant Behavior & Development, 46, 33–45. https://doi.org/10.1016/j.infbeh.2016.11.006
O’Leary, N., Jairaj, C., Molloy, E. J., McAuliffe, F. M., Nixon, E., & O’Keane, V. (2019). Antenatal depression and the impact on infant cognitive, language and motor development at six and twelve months postpartum. Early Human Development, 134, 41–46. https://doi.org/10.1016/j.earlhumdev.2019.05.021
Oyetunji, A., & Chandra, P. (2020). Postpartum stress and infant outcome: A review of current literature. Psychiatry Research, 284, 112769–112769. https://doi.org/10.1016/j.psychres.2020.112769
Scheiber, F. A., Ryckman, K. K., & Demir-Lira, Ö. E. (2022). Maternal depressive symptoms and maternal child-directed speech: A systematic review. Journal of Affective Disorders, 297, 194–207. https://doi.org/10.1016/j.jad.2021.10.015
Wu, P.-C., de Banate, M. A., Kim, H., Viner-Brown, S., & High, P. (2024). The Association Between Maternal Depressive Symptoms and Toddlers’ Developmental and Behavioral Problems: A Population-Based Study. Clinical Pediatrics, 63(4), 494–505. https://doi.org/10.1177/00099228231179672