Neurobiological insights into perinatal depression: a multi-dimensional integration of brain structure, function, and metabolism

Objective: Perinatal depression (PND) represents a significant challenge to maternal and infant health. In recent years, the rapid advancement of neuroimaging techniques has offered critical insights for elucidating the neurobiological mechanisms underlying PND. This review aims to systematically synthesize the research progress on structural, functional, and metabolic abnormalities in specific brain regions of patients with perinatal depression, as well as the underlying pathological mechanisms, thereby providing a theoretical basis for early screening of PND. Methods: A systematic search was conducted in the PubMed and Web of Science databases for studies published up to January 2026, including those that compared characteristics between patients with perinatal depression and healthy controls. Results: Perinatal depression is a disorder with a robust neurobiological foundation, characterized by structural and functional alterations, as well as metabolic imbalances in key brain regions. These are manifested as reduced activity in regulatory centers and hyperactivity in emotional processing areas. Such abnormalities are the result of a complex interplay among genetic, neuroendocrine, immunological, and environmental factors. Conclusion: PND involves complex dysfunction within emotional and cognitive networks. These findings enhance the understanding of its neural basis and may inform future diagnostic and therapeutic strategies.