A meta-analysis examining the association between maternal perfectionism and perinatal depression and anxiety

Background: Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety. Method: We followed PRISMA guidance (PROSPERO: 42019143369 ), estimated weighted effect sizes and tested possible moderators: timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age; and rated study quality. Results: 14 studies met eligibility criteria. Perfectionism as a whole, and the perfectionistic concerns dimension, were moderately correlated with common maternal perinatal mental health difficulties r= 0.32 (95% Confidence Interval = 0.23 to 0.41). In sub-group analyses, perfectionistic concerns were associated with depression (r=.35, 95% CI = 0.26 – 0.43). We found no evidence of significant moderation of associations. Limitations: Included studies had methodological and conceptual limitations. Studies inconsistently examined both perfectionistic concerns and strivings, nor anxiety as well as depression. Conclusions: Perfectionism, especially perfectionistic concerns, appears to be an important feature of common maternal perinatal mental health problems. While further research is warranted, screening and identification of perfectionism in the perinatal period may help focus resources for intervention, reducing the prevalence of perinatal mental health difficulties.