From Maternal Depression to Autism Risk: Shared Neurobiological Mechanisms Across the Perinatal Period

Perinatal depression (PND) is a subtype of major depressive disorder with onset during the peripartumperiod or up to one year after childbirth in clinical practice. It is the most prevalent complicationduring the postpartum period with a global prevalence between 10-20%. Emerging research hasshown that PND can exert long term effects on child development through the disruption of bothbiological signaling (e.g., oxytocinergic and GABAergic system dysfunction, HPA axis dysregulationand inflammatory state) and maternal-infant social bonding. These disruptions have been linked toadverse cognitive, social, and behavioural outcomes, including impaired emotional attachment.Consequently, there is an increasing imperative to evaluate the potential association between maternalPND and the development of autism spectrum disorder (ASD) in offspring, particularly in light of therising global prevalence, mostly due to higher awareness and increased diagnostic recognition.While recent literature has explored this association using mainly observational prospective studies, acomprehensive synthesis of the evidence is currently lacking. This review aims to analyze availableliterature regarding the association between PND and the development of ASD in the offspring,focusing primarily on a possibly shared pathophysiology, which includes alterations in theoxytocinergic and GABAergic system together with epigenetic changes and the inflammatory profile.