New fathers can get new baby depression too

Depression symptoms among men before and after the birth of their children were identified by recent research from the University of Auckland’s Centre for Longitudinal Research – He Ara Ki Mua.

The results in brief

  • Paternal antenatal depression symptoms were measured using the Edinburgh Postnatal Depression Scale and postnatally by the 9-item Patient health Questionnaire. Elevated depression symptoms were defined as scores higher than 12 and 9, respectively.
  • The results reported are based on face to face interviews with 3523 men during the third trimester of their partner’s pregnancy and again nine months after the child’s birth.
  • Rates of paternal antenatal depression and postnatal depression were 2.3 percent (n=82) and 4.3 percent (n=153) respectively.
  • Paternal depression was more prevalent during the postnatal period with men who were no longer in a relationship with the child’s mother being the most vulnerable.

The study found that expectant fathers were at risk if they felt stressed or were in poor health.  Elevated depression symptoms following their child’s birth were linked to social and relationship problems.

The study, published today in the Journal of the American Medical Association Psychiatry investigated depression symptoms in more than 3,500 New Zealand men during the third trimester of their partner’s pregnancy and again nine months after their child’s birth.

Study author, Dr Lisa Underwood from the University of Auckland, says that while maternal antenatal and postnatal depression are recognised and known to be associated with poor outcomes for women and children, there has been little done to identify perinatal depression symptoms in men.

“As in many other countries, New Zealand women are assessed for postnatal depression following childbirth,” says Dr Underwood. “There is no routine screening of women during pregnancy and none for fathers before or after the birth of their children, since they are not usually engaged in routine perinatal care.

“In the present study of fathers, self-reported poor health and self-perceived stress during the pregnancy were consistently linked to paternal depression during the pregnancy,” she says.

“Additional risks only associated with paternal postnatal depression included a history of depression, unemployment, relationship status and family environments during the postnatal period. Of these, the strongest predictor of paternal depression was no longer being in a relationship with the child’s mother,” says Dr Underwood.

“Increasingly, we are becoming aware of the influence that fathers have on their children’s psychosocial and cognitive development. Given the potential for paternal depression to have direct and indirect effects on children, it is important that we recognise and treat symptoms among fathers early.

“Arguably, the first step in doing this is to raise awareness about factors that lead to increased risks among fathers themselves.”

Combined with two recent papers reporting on New Zealand mothers’ antenatal and postnatal depression, this study provides a view of the separate and common risk factors for depression in parents which, if detected early and appropriately managed could limit the impact on their child’s wellbeing.

All studies drew on interviews with families involved in the contemporary, longitudinal study Growing Up in New Zealand, which is tracking the development of more than 6000 children born in 2009 and 2010.

“The Growing Up in New Zealand cohort gives us a unique context in which to identify risk factors for parental depression symptoms around the time of birth and follow long term effects on children’s health and wellbeing,” says Dr Underwood.

“It provides policymakers with evidence that is relevant to New Zealand families of today and can be used to better target those who may benefit from extra support to avoid downstream problems.”

During the perinatal period (from the third trimester of pregnancy to nine months after birth), 217 (6.2 percent) of the men in the study experienced symptoms of depression compared with 3306 who did not have elevated depression symptoms.

Around one in 25 men reported symptoms of postnatal depression while antenatal depression only affected about one in 50.

By comparison, more mothers suffered depression symptoms before than after the birth of their children.

One in six of the mothers interviewed in the Growing Up in New Zealand study cohort reported significant depressive symptoms at either the antenatal interview or when their children were nine months old.

One in eight experienced antenatal depression symptoms with one in 12 experiencing symptoms postnatally, although these were not always the same mothers.

One in four women who had antenatal depression also experienced postnatal depression and more than one in three with postnatal depression had experienced antenatal depression.

“In our studies focusing on mothers, increased risks of experiencing depressive symptoms were associated with Pacific or Asian ethnicity, stress, anxiety, a previous history of doctor-diagnosed depression and difficult relationships and family environments,” says Dr Underwood.

Download the publication

Underwood L, Waldie KE, Peterson E, D’Souza S, Verbiest M, McDaid F, Morton S. (2017) Paternal depression symptoms during pregnancy and after childbirth among participants in the Growing Up in New Zealand study. JAMA Psychiatry 74(4): 1-10. Doi:10.1001/jamapsychiatry.2016.4234

Published online ahead of print

Related publications

Underwood L, Waldie KE, D’Souza S, Peterson ER, Morton SMB (2016). A Longitudinal Study of Pre-pregnancy and Pregnancy Risk Factors Associated with Antenatal and Postnatal Symptoms of Depression: Evidence from Growing Up in New ZealandMaternal and Child Health Journal. online article. doi: 10.1007/s10995-016-2191-x

Waldie KE, Peterson ER, D’Souza S, Underwood L, Pryor JE, Atatoa Carr PE, Grant CC, Morton SMB (2015). Depression symptoms during pregnancy: Evidence from Growing Up in New Zealand. Journal of Affective Disorders. 186: 66–73. doi: 10.1016/j.jad.2015.06.009