The Relationship between Maternal Depression and Stunting in Children: A Systematic Review

Background: Maternal health is essential for the growth and development of the child.  Mothers' depression can cause great harm to their children. Many studies have investigated stunting in children and its relationship with maternal depression. However, these studies have yielded different results. This systematic review aims to answer the question of "what is the relationship between maternal depression and stunting in children" in published articles. Methods: This study used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The databases used included Sciencedirect, PubMed, ProQuest, and Cochrane Library by setting the publication period between 2010 and 2021. The studies with observational designs, measuring maternal depression at any stage after childbirth, and examining child (under five) stunting status, using z-score or percentile were included. Quality of the studies was assessed using Down and Black tool, and the risk of bias was evaluated by the Cochrane Collaboration's Risk of Bias Tool. Two authors extracted the data independently and the findings were synthesized qualitatively. Results: The literature search yielded 611 articles, and only 14 articles were found to meet the inclusion criteria after removing duplicates, dissertations, editorials, comments, not full texts, and case reports. A total of 8 articles showed a significant relationship between maternal depression and stunting. In contrast, the remaining 6 studies did not show an association between these variables. It seems that the tools for measuring depression and age difference of children participating in the studies were important factors that affected the outcome of the relationship between maternal depression and children's stunting. Also, episodic maternal depression does not appear to be associated with stunting. Conclusion: The findings suggest that to prevent childhood stunting, initiatives may be needed to identify and support mothers with chronic depression. Future systematic reviews are suggested to investigate the relationship between maternal depression and children's stunting in urban and rural communities or in high-income and low-income countries in a broader time frame.