Understanding Parental Representations Across the Perinatal Period: A Systematic Review of Empirical Findings and Clinical Implications

Highlights: What are the main findings? Parental mental representations (PMRs) develop during pregnancy and continue to evolve in the postnatal period. The current literature shows significant methodological heterogeneity and an underrepresentation of fathers and dyadic perspectives. What is the implication of the main finding? Early identification of nonbalanced PMRs may help prevent relational difficulties and promote secure attachment. Future studies should adopt longitudinal, systemic, and culturally inclusive approaches to better capture the complexity of early parenthood and inform preventive mental health strategies. Background/Objectives: Parental mental representations play a crucial role in shaping early parent–child relationships, particularly during the perinatal period. These internal models influence caregiving behaviors, emotional attunement, and the intergenerational transmission of attachment. The present systematic review aims to address this gap by examining the nature of both maternal and paternal mental representations in the perinatal period (involving pregnancy and the first postnatal time), with a particular emphasis on reflective functioning, and by outlining the variables that are influenced by these representations. Methods: Following PRISMA guidelines, eligible peer-reviewed studies were identified through a comprehensive literature search of major scientific databases (Scopus, Web of Science, PsychArticle/PsycInfo). Qualitative assessment and detailed description were carried out. Results: In total, 28 studies were selected and analyzed. Findings reveal that while representations tend to organize around shared psychological domains—such as expectations regarding the child, parental identity, and the anticipated relationship—there is significant heterogeneity in how these are conceptualized and measured across studies. Risk factors such as maternal depression, low social support, and adverse life experiences were consistently linked to disengaged or distorted representations, whereas balanced representations were associated with greater RF, emotional availability, and protective relational contexts. Conclusions: Overall, the review highlights the clinical relevance of assessing parental mental representations and RF during the perinatal period, suggesting that early, targeted interventions may enhance parental sensitivity and promote secure parent–infant bonds. Future research should adopt integrated theoretical models, include diverse family configurations, and evaluate the efficacy of preventive programs that support reflective and adaptive representations.