Background: Studies have reported conflicting findings on the association between maternal pre- and perinatal depression and autism spectrum disorder (ASD) in offspring.

Aims: To examine and consolidate the existing evidence on the association between maternal pre- and perinatal depression and the risk of ASD in children and adolescents.

Method: In this systematic review and meta-analysis, we searched PubMed, Medline, EMBASE, Scopus, CINAHL and PsycINFO from the database inception to 21 February 2024. A meta-analysis was performed using random-effect models, and summary effect estimates were presented as odds ratios with 95% confidence intervals. Heterogeneity was assessed with Cochran's Q and the I²-statistic test. Additionally, subgroup analysis was conducted to identify the source of potential heterogeneity within the included studies. A funnel plot and Egger's regression test were employed to evaluate publication bias.

Results: Twelve studies involving over 1.6 million mother-offspring pairs were included in the final analysis. A random-effects meta-analysis of these studies revealed a 52% increased risk (odds ratio 1.52, 95% CI 1.13-1.90) of ASD in the offspring of mothers experiencing pre-pregnancy depression, a 48% increased risk (odds ratio 1.48, 95% CI 1.32-1.64) in those experiencing antenatal depression and a 70% increased risk (odds ratio 1.70, 95% CI 1.41-1.99) in those with postnatal depression.

Conclusions: This systematic review and meta-analysis found that offspring born to mothers with depression before, during and after birth have a higher risk of developing ASD. Our findings underscore the need for early screening and targeted intervention programmes for at-risk children.

Keywords: Antenatal depression; autism spectrum disorder (ASD); postnatal depression; pre-pregnancy depression.

背景： 有关孕期和围产期抑郁与后代自闭症谱系障碍（ASD）之间关联的研究报告了相互矛盾的结果。

目的： 本研究旨在审查并整合现有证据，探讨母亲孕前及围产期抑郁与儿童和青少年患ASD风险之间的关系。

方法： 在这项系统评价和荟萃分析中，我们搜索了PubMed、Medline、EMBASE、Scopus、CINAHL 和 PsycINFO 数据库，时间范围从这些数据库的建立到2024年2月21日。使用随机效应模型进行荟萃分析，并以比值比（OR）和95%置信区间的形式展示汇总效果估计值。利用Cochran的Q统计量和I²检验评估异质性。此外，还进行了亚组分析，以识别潜在异质性的来源。采用漏斗图和Egger回归测试来评价发表偏倚。

结果： 最终分析共纳入了12项研究，涉及超过160万对母子。随机效应荟萃分析结果显示，在孕前经历抑郁的母亲的后代中，ASD的风险增加了52%（OR 1.52，95% CI 1.13-1.90），在孕期经历抑郁的女性中，该风险增加了48%（OR 1.48，95% CI 1.32-1.64），而在产后经历抑郁的母亲的孩子中，该风险增加了70%（OR 1.70，95% CI 1.41-1.99）。

结论： 这项系统评价和荟萃分析发现，出生前、期间及之后经历抑郁的母亲的后代患ASD的风险更高。我们的研究结果强调了对高风险儿童进行早期筛查和针对性干预计划的重要性。

关键词： 孕期抑郁；自闭症谱系障碍（ASD）；产后抑郁；孕前抑郁。