Systematic review on maternal depression versus anxiety in relation to excessive infant crying: it is all about the timing

Johanna Petzoldt

Different types of studies suggest a link between maternal depression/anxiety and excessive infant crying (EC). However, comparability is hampered due to different designs, definitions and measurements. This systematic review investigates the specific role of maternal depression and anxiety considering them as preceding, concurrent and subsequent conditions of EC. A computerised literature search was conducted in January 2017 using Medline, PubMed, PsycINFO and Web of Science. After screening n = 399 records for inclusion/exclusion criteria, n = 33 records based on n = 30 projects were eligible for systematic qualitative data synthesis. All studies on maternal depression/anxiety and EC within the first 3 years of life were included. Included studies investigated predominantly maternal depression (25/30) and secondly maternal anxiety (17/30). Significant positive results were found in the majority of studies for maternal depression (21/25) as well as for maternal anxiety (12/17) in relation to EC. In-depth analyses further revealed that concurrent and subsequent maternal depression was robustly related with EC, whilst preceding maternal depression was not. In contrast, preceding and concurrent (but not subsequent) maternal anxiety was consistently related to subsequent EC. Maternal depression is more likely a correlate or even a consequence of EC, whereas anxiety is rather a temporally preceding condition and thus a potential risk factor or risk marker for both subsequent EC and associated maternal depression. Interventions for EC should address concurrent maternal depression, whilst preventive approaches might target preceding maternal anxiety as early as prior to or during pregnancy.