Depression is a common condition affecting up to 20% of all pregnant women, and is associated with subsequent developmental and behavioral problems in children, such as conduct disorder and ADHD. One proposed mechanism underlying these associations is modification of the fetal hypothalamic pituitary adrenal (HPA)-axis and the autonomic nervous system (ANS), resulting in altered responses to stress. This review examined the evidence regarding altered HPA-axis and ANS reactivity in children prenatally exposed to high maternal depressive symptoms. A systematic search was conducted in the electronic databases MEDLINE, EMBASE and PsycINFO, for studies published till 25 July 2017. A total of 13 studies comprising 2271 mother-infant dyads were included. None of the studies were suitable for meta-analysis. Risk of bias assessment showed low risk for four studies. Only three studies described an independent association between exposure to high maternal prenatal depressive symptoms and altered stress reactivity in children. There is limited evidence of an independent association between prenatal exposure to maternal depression and altered HPA or ANS reactivity in children.

抑郁症是一种常见疾病，影响多达 20% 的所有孕妇，并与儿童随后的发育和行为问题有关，例如品行障碍和多动症。这些关联的一种提议机制是改变胎儿下丘脑垂体肾上腺 (HPA) 轴和自主神经系统 (ANS)，从而导致对压力的反应发生改变。本综述检查了产前暴露于高母性抑郁症状的儿童的 HPA 轴和 ANS 反应性改变的证据。在电子数据库 MEDLINE、EMBASE 和 PsycINFO 中对截至 2017 年 7 月 25 日发表的研究进行了系统搜索。共纳入 13 项研究，包括 2271 对母婴。没有一项研究适合进行荟萃分析。四项研究的偏倚风险评估显示低风险。只有三项研究描述了暴露于高产前抑郁症状与儿童压力反应改变之间的独立关联。有限的证据表明产前暴露于母亲抑郁症与儿童 HPA 或 ANS 反应性改变之间存在独立关联。