Got daddy issues? Fathers impact on perinatal outcomes

Mothers’ genetics as well as their environment, behaviors, and social determinants of health are all important factors influencing short and long term childhood outcomes. There is an emerging body of literature investigating the extent to which fathers also contribute to their offspring's future health. We review fathers’ impact on short term birth outcomes, longer term health, and neurodevelopment to emphasize the inter-relatedness of individual paternal traits. Factors that are linked to offspring outcomes include paternal demographics, race, stress, marriage and support, mental health, and the baseline health and behaviors of fathers. Several methodologic issues exist in current research such as maternal report of paternal information. Mechanisms proposed regarding paternal effect on progeny health range from genetic to reduction of stress of mothers through support. These are varied, possibly inter-related, and difficult to isolate as a single etiology. Future initiatives need to support fathers to allow them to support their families.     

Psychological correlates of depression in fathers and mothers in the first postnatal year

This study investigated psychological correlates of depression in fathers and mothers in the first postnatal year, using a mixed, mainly clinically referred sample and a cross-sectional design. The Edinburgh Postnatal Depression Scale (EPDS) was used for depression screening for mothers, and the EPDS, Beck Depression Inventory (BDI) and General Health Questionnaire (GHQ) for fathers. A total of 75 mothers (47.5%) had EPDS scores > 12, and 45 fathers (48.9%) exceeded the threshold on one or more of the three screening instruments. Most of the variance in paternal and maternal depression was accounted for by neuroticism. However, while mothers appeared primarily influenced by their own personality, perinatal and infant-related factors, fathers appeared more influenced by mothers' personality difficulties and unresolved past events, and mothers' current mental health and infant-related problems, as well as the state of the marital/ de facto relationship. The BDI and EPDS seemed to measure more severe pervasive forms of paternal depression than the GHQ, and the EPDS appeared to tap some items more specifically associated with perinatal psychological risk than the BDI. Depression in one partner was moderately correlated with depression in the other. High rates of paternal depression and anxiety in mothercraft settings suggest the need to routinely assess the mental state of both parents in these settings, and to include fathers in postnatal depression intervention programmes. The mother's negative perceptions of her infant's temperament are significantly associated with maternal and paternal depression, suggesting an important focus for intervention.     

Paternal postnatal depression in Ireland: Prevalence and associated factors

Backgroundit is well established that fatherhood has a long term positive and protective effect on men's health. However, there is also evidence that the transition to fatherhood can be complex and demanding and can lead to distress, anxiety and increased risk of depression.Objectivethis study aimed to investigate the prevalence of paternal postnatal depression, and to examine associations with a range of demographic and clinical factors.Methodsa cross-sectional study design was used to collect primary data from 100 fathers, whose partner gave birth to an infant in the previous 12 months. Data were collected using the Edinburgh Postnatal Depression Scale.Resultsthe prevalence of paternal postnatal depression was 12% using the Edinburgh Postnatal Depression Scale cut off score of 12 or above, when the cut off score was reduced to 9 or above the prevalence was 28%. The factors found to increase the risk of paternal postnatal depression included having an infant with sleep problems, a previous history of depression, a lack of social support, poor economic circumstances, not having paternity leave and not being married.Conclusionthe results add to the growing body of evidence that paternal postnatal mental health is a significant public health issue, and indicates a need for assessment and support for fathers during this life stage.     

Birth of a child with congenital heart disease: emotional reactions of mothers and fathers according to time of diagnosis

Abstract

Objective: To evaluate emotional distress, depression and quality of life in parents of infants with severe congenital heart disease (CHD) during their first hospitalization.

Methods: A pilot study for 38 parental couples of infants with CHD hospitalized within the 3 months of life. Parents filled up three self-administered questionnaires. We compared differences in the variables measuring emotional distress, depression and quality of life between mothers and fathers, and between prenatal and postnatal diagnosis.

Results: Stress and depression levels were significantly higher in mothers than in fathers (stress: 81.8% mothers versus 60.6% fathers; depression: 45.7% mothers versus 20.0% fathers). No difference were found between prenatal and postnatal groups in any field tested but, in percentage, mothers receiving prenatal diagnosis were more depressed, whereas those receiving postnatal diagnosis were more stressed. Fathers showed same tendency.

Conclusions: Parents of newborns with severe CHD, especially mothers, need psychological support during their child’s hospitalization. Parents of children diagnosed prenatally may need counseling throughout pregnancy to help them recover from the loss of the imagined healthy child.     

The inter-relationship between depressive,anxiety and stress symptoms in fathers during the antenatal period

Objective: The aim of this study was to examine whether depressive symptoms predict anxiety and stress or whether anxiety and stress precede depressive symptoms in fathers during the antenatal period. Background: The findings of previous studies suggest that there is an association between paternal depression, anxiety and stress during the antenatal period. However, the temporal inter-relationship between these variables has yet to be investigated. Method: Data were collected from 150 expectant couples at approximately 18, 25 and 33 weeks’ gestation. Results: After accounting for the relative stability of depression, anxiety and stress over time, for men higher levels of anxiety earlier in pregnancy predicted higher levels of depression and stress in middle pregnancy, which predicted higher depression during late pregnancy. A similar relationship remained after partialling out the effects of partner’s depression, perceived social support and sleep quality. Further analyses also revealed significant differences in the manifestation of distress symptoms between men and women, but not between first-time and non-first-time fathers. Conclusion: Our findings indicated a possible inter-relationship between depression, anxiety and stress for men antenatally. Our findings also showed that men who reported elevated depression, anxiety and stress earlier in the antenatal period also reported elevated symptomology at later time points. Finally, the current findings revealed that antenatal paternal stress may play a key role in the development of depression and anxiety later in pregnancy. Therefore, it may be important to screen for early levels of antenatal stress in men, as well as depression and anxiety.     

Comparative levels of psychological distress,stress symptoms,depression and anxiety after childbirth--a prospective population-based study of mothers and fathers

Objective To compare maternal and paternal psychological responses following birth of a healthy baby; and to explore predictors of parental psychological distress.
Design A prospective, longitudinal, population-based cohort study.
Setting A Norwegian district general hospital.
Population One hundred and twenty-seven mothers and 122 fathers were included.
Methods Eligible consenting parents were enrolled. The assessments, which were performed zero to four days after birth, at six weeks and at six months, included General Health Questionnaire-28 (GHQ-28), State Anxiety Inventory and Impact of Event Scale. The response rates at the three occasions were 97%, 85% and 71%.
Main outcome measures Symptoms of intrusion, avoidance, arousal and psychological distress including anxiety, depression, social dysfunction and somatisation.
Results Clinically important psychological distress was reported by 37% of the mothers and 13% of the fathers a few days after childbirth (   P < 0.001  ). Severe intrusive stress symptoms were reported by 9% and 2% of mothers and fathers, respectively (   P = 0.002  ). Level of intrusive stress was the outcome that differed most clearly between mothers and fathers at all three points of time. Being a single parent, multiparity and a previous traumatic birth were significant independent predictors of acute maternal psychological distress. After six weeks and six months, the level of psychological distress including symptoms of depression fell to levels found in the general population.
Conclusions Childbirth does not seem to trigger long term psychological distress in most parents. Clinically important psychological distress occurred more frequently in mothers than in fathers. Acute maternal psychological distress was predicted by being a single parent, being multiparous, and having a previous traumatic birth.     

Attitudinal barriers to help-seeking and preferences for mental health support among Australian fathers

Objective: To (a) identify attitudinal barriers to help-seeking for mental health difficulties among fathers of young children; (b) explore the relationships between perceived barriers to help-seeking and mental health difficulties (i.e. depressive, anxiety, stress symptoms); (c) identify socio-demographic factors associated with barriers to help-seeking; and (d) identify fathers’ preferences for mental health support.

Background: One in 10 Australian fathers experience mental health difficulties in the early parenting period. Low rates of help-seeking and under-utilisation of health care services are key issues for the provision of mental health support to fathers at this important life stage.

Method: The sample consisted of 154 fathers of young children (aged 0–8 years) participating in an Australian online survey on parent wellbeing and parenting. The Barriers to Help-Seeking Scale assessed fathers’ attitudinal barriers to help-seeking for mental health support. Socio-demographic factors related to fathers’ employment, education, and family composition were assessed.

Results: The most common attitudinal barriers to help-seeking were: (a) the need for control and self-reliance in managing one’s own problems, (b) a tendency to downplay or minimise problems, and (c) a sense of resignation that nothing will help. A range of demographic (i.e. age, educational attainment) factors were associated with these barriers. The most common preferences for support were internet-based information resources, followed by support provided by general practitioners and maternal child health nurses.

Conclusions: These findings have important implications for health promotion, health services and clinical approaches to promoting the health and wellbeing of fathers.     

Latent class analysis of health,social, and behavioral profiles associated with psychological distress among pregnant and postpartum women during the COVID-19 pandemic in the United States

Background

There is a growing body of literature documenting negative mental health impacts from the COVID-19 pandemic. The purpose of this study was to identify risk and protective factors associated with mental health and well-being among pregnant and postpartum women during the pandemic.

Methods

This was a cross-sectional, anonymous online survey study distributed to pregnant and postpartum (within 6 months) women identified through electronic health records from two large healthcare systems in the Northeastern and Midwestern United States. Survey questions explored perinatal and postpartum experiences related to the pandemic, including social support, coping, and health care needs and access. Latent class analysis was performed to identify classes among 13 distinct health, social, and behavioral variables. Outcomes of depression, anxiety, and stress were examined using propensity-weighted regression modeling.

Results

Fit indices demonstrated a three-class solution as the best fitting model. Respondents (N = 616) from both regions comprised three classes, which significantly differed on sleep- and exercise-related health, social behaviors, and mental health: Higher Psychological Distress (31.8%), Moderate Psychological Distress (49.8%), and Lower Psychological Distress (18.4%). The largest discriminatory issue was support from one's social network. Significant differences in depression, anxiety, and stress severity scores were observed across these three classes. Reported need for mental health services was greater than reported access.

Conclusions

Mental health outcomes were largely predicted by the lack or presence of social support, which can inform public health decisions and measures to buffer the psychological impact of ongoing waves of the COVID-19 pandemic on pregnant and postpartum women. Targeted early intervention among those in higher distress categories may help improve maternal and child health.     

Longitudinal study on the predictors of parental stress in mothers and fathers of toddlers

Aim. Longitudinal study on the predictors of parental stress in mothers and fathers of toddlers.

Background. To study whether anxiety, depression, or marital problems increase the parenting stress in parents of toddlers.

Methods. At early pregnancy, 2 – 3 months, and 2 – 3 years after delivery, 214 low-risk couples filled in questionnaires on their marital relationship, social support, child's temperament, and self-evaluated competence in routine care-taking. In hierarchical regression analyses, they were used as predictors of parental stress.

Results. Those mothers who in early pregnancy had adequate social support, adaptive social strategies, and high self-esteem, and who had given birth vaginally, enjoyed breastfeeding, and whose spouse supported breastfeeding reported less stress 2 – 3 years later. Pregnancy-related anxiety, depression, general anxiety, neuroticism, and vulnerability in early pregnancy, as well as child's temperament and low self-estimated competence in routine care-taking measured at both 2 – 3 months and 2 – 3 years after childbirth predicted parental stress. Depression and living alone in early pregnancy, and the child-related variables (temperament and care-taking, measured both at 2 – 3 months and 2 – 3 years after childbirth) predicted high parenting stress in fathers of toddlers.

Conclusions. Parental stress in toddlers' parents was predicted both by the temperament of the child, and by the parents' depression, self-esteem, and anxiety, as well as by lack of support and low self-evaluated competence in routine care-taking.     

Complexity of parental prenatal attachment during pregnancy at risk for preterm delivery

Objective: To clarify the links between parents’ prenatal attachment and psychosocial perinatal factors such as maternal depression, anxiety and social support.

Methods: Cross-sectional study including 43 couples with high-risk pregnancy (RP) and 37 with physiologic pregnancy (PP). Self-report measures (depression, anxiety, social support and prenatal attachment) are completed by mothers, prenatal attachment questionnaire by fathers.

Results: Depression (p?<?0.001) and state anxiety (p?<?0.001) are higher in RP. Both, maternal and paternal antenatal attachment is significantly lower in RP (p?<?0.001; p?<?0.005) but not related to depression or anxiety. Paternal antenatal attachment is strictly related to the maternal attachment scale in both groups (PP: r?<?0.034; RP: r?<?0.004) and paternal antenatal scores in RP have a negative significant correlation with mothers’ depression (r?<?0.095).

Conclusion: Hospitalized expecting parents at risk of preterm delivery develop less attachment to the fetus and higher levels of anxiety and depression compared to the physiologic pregnancy group. Maternal antenatal attachment is an independent variable related to the diagnosis of a possible preterm delivery. The promotion of prenatal psychological well-being and attachment for future mothers and fathers may serve to improve maternal health practices, perinatal health and neonatal outcome.     

Stress, social support, and emotional distress in a community sample of pregnant women

Emotional distress in women during pregnancy has been shown to increase the risk of adverse outcomes for women and newborns. Increasingly, assessment and management of mood and anxiety problems during pregnancy entail consideration of life stress and interpersonal relationships with partners, friends, and family members. This study describes cross-sectional relations between life stress, perceived social support, and symptoms of depression and anxiety as well as the mediating influence of social support on relations between stress and symptoms. A community sample of women (N = 2,052) provided self-report data during their second trimester of pregnancy. Empirical fit was found for a structural equation model that depicted the combined influences of sociodemographic factors (i.e., socioeconomic status, age, parity), stress (partner conflict and life events), and social support on symptoms of depression and anxiety, chi2 (df 51) = 310.65, p <.05; CFI=.91. Women who reported low levels of social support showed stronger relations between stress and symptoms than women who reported high levels of social support--indicative of a mediating effect of social support. Consistent with previous studies, results suggest that dyadic psychosocial assessment of pregnant women and their partners may facilitate interventions to augment support networks, thereby reducing the risk of emotional distress.     

Stress in fathers in the perinatal period: A systematic review

Backgrounddespite the evidence that fatherhood has a long-term positive and protective effect on men's health, there is also evidence that fatherhood in the perinatal period can be complex and demanding. Due to the potential increase in stressors in the perinatal period, there is reason to hypothesise that it is a time of increased stress for fathers. However, it is not clear how significant a problem stress is for fathers during this stage of life. This is in part, due to the fact that the available research has not been systematically reviewed.Purposethe purpose of this systematic review was to critically appraise the empirical evidence that examined stress in fathers in the perinatal period.Designsystematic review.Methodsa systematic review protocol was developed and registered with PROSPERO (Reference number: CRD42016035821). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology and Behavioural Sciences Collections were searched to identify studies that met the inclusion criteria. Studies that researched fathers in the perinatal period were included if stress was the principal focus of the research, if stress was in the title and/or aim of the study or if stress was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures.Findingseighteen studies met the inclusion criteria. The findings indicate that fathers experience stress in the perinatal period, particularly at the time of birth. Stress levels were found to increase from the antenatal period to the time of birth, with a decrease in stress levels from the time of birth to the later postnatal period. There are a number of factors that contribute to stress in fathers in the perinatal period and these included negative feelings about the pregnancy, role restrictions related to becoming a father, fear of childbirth and feelings of incompetence related to infant care. The review found that stress has a negative impact on fathers, with higher stress levels contributing to mental health issues such as anxiety, depression, psychological distress and fatigue.Key conclusionduring the perinatal period fathers experience stress and face unique stressors that can impact negatively on their health and social relationships.     

Do Hookups Hurt? Exploring College Students’ Experiences and Perceptions

Introduction: Hookups refer to a range of sexual or physically intimate behaviors characterized by a lack of any expectation of a relationship or emotional intimacy. This study was designed to assess college students’ experiences and perceptions about hookups as related to mental/emotional and physical health issues. Methods: Students at a 2‐year liberal arts college in the southeastern United States participated. A survey was created using current evidence on hookups and health issues. Random sampling invited 300 students to take the anonymous online survey. Responses to open‐ended questions were analyzed quantitatively; content analysis was used to assess responses to 2 open‐ended questions. Results: Participants (N = 210) reported their own or their friends’ experiences as a result of a hookup. Feelings included sexual regret (reported by 62%), relationship/interpersonal conflict (48%), negative emotional reactions (47%), negative social repercussions (41%), learning to “shut down” emotionally (33%), psychological distress (31%), loss of friend(s) or peer group (28%), anxiety (28%), depression (21%), and sexually transmitted infections (19%). Most students (60%) had at least one hookup experience; more than half (55%) had mixed feelings/ambivalence about these experiences. Qualitative analysis identified 6 themes regarding reasons for sexual regret: regret over choice of partner, negative social repercussions, hopes for relationship did not materialize, moral issues, too much/too fast/too drunk, and suboptimal sexual performance/experience. Discussion: The findings indicate that a significant level of negative health issues is experienced in conjunction with hookups, and health care providers should be aware and educate patients appropriately.     

Stress,social support,and emotional distress in a community sample of pregnant women

Emotional distress in women during pregnancy has been shown to increase the risk of adverse outcomes for women and newborns. Increasingly, assessment and management of mood and anxiety problems during pregnancy entail consideration of life stress and interpersonal relationships with partners, friends, and family members. This study describes cross-sectional relations between life stress, perceived social support, and symptoms of depression and anxiety as well as the mediating influence of social support on relations between stress and symptoms. A community sample of women (N?=?2,052) provided self-report data during their second trimester of pregnancy. Empirical fit was found for a structural equation model that depicted the combined influences of sociodemographic factors (i.e., socioeconomic status, age, parity), stress (partner conflict and life events), and social support on symptoms of depression and anxiety, χ² (df 51)?=?310.65, p?&lt;?.05; CFI?=?.91. Women who reported low levels of social support showed stronger relations between stress and symptoms than women who reported high levels of social support - indicative of a mediating effect of social support. Consistent with previous studies, results suggest that dyadic psychosocial assessment of pregnant women and their partners may facilitate interventions to augment support networks, thereby reducing the risk of emotional distress.     

Not identifying with postnatal depression: a qualitative study of women’s postnatal symptoms of distress and need for support

Abstract

Introduction: Diagnoses and symptoms of postnatal mental health problems are associated with adverse outcomes for women and their families. Current classification and assessment of postnatal mental health problems may not adequately address the range or combination of emotional distress experienced by mothers. This study aims to explore symptoms of mental health problems reported by new mothers and their experiences of being assessed for these.

Methods: In-depth interviews with 17 women in southeast England with a baby under 1-year old who experienced a postnatal mental health problem. Data were analyzed using inductive thematic analysis.

Results: Women described a lack of identification with the concept of postnatal depression and felt that other forms of emotional distress were not recognized by the healthcare system. Women felt that support seeking for postnatal mental health problems needed to be normalized and that support should be available whether or not women were diagnosed. Assessment needs to be well timed and caringly implemented.

Discussion: Identification and recognition of symptoms and disorders other than postnatal depression need to be improved. Awareness of multiple types of distress needs to be raised both for women experiencing such distress, and for healthcare professionals, to enable them to support women at this time. Different approaches to assessment that include the range of symptoms reported should be piloted.     

Parental characteristics, parenting style, and behavioral problems among chinese children with down syndrome, their siblings and controls in taiwan

Background/Purpose: The literature has documented maternal distress and behavioral problems among children with Down syndrome (DS), however, little is known about paternal adjustment and behavioural problems among the siblings of children with DS. Here, we examined parental psychopathology, parenting style and emotional/behavioral problems among children with DS, their siblings, and controls in Taiwan. Methods: We recruited 45 families of children with DS (age, 2-4 years) and 50 families of normally developing children (age, 3-5 years). If there were more than two children in the case family, the sibling whose age was closest to the child with DS was recruited (age, 3-8 years). Both parents completed self-administered measures of their personality characteristics, psychopathology, family functioning, parenting styles, and child behavioral problems, using the Chinese versions of the Maudsley Personality Inventory, Brief Symptom Rating Scale, Family Adaptability and Cohesion Evaluation Scale, Parental Bonding Instrument, and Child Behavioral Checklist, respectively. Results: Children with DS demonstrated significantly more severe symptoms than normal children of a wide range of behavioral problems such as attention problems, delinquency, social problems, somatic complaints, thought problems, and withdrawal compared with the other two groups, and obtained similar parental treatment, except for paternal overprotection. Their parents suffered from more psychopathology and their mothers were less often employed than their counterparts. The siblings of children with DS obtained less overprotection from their mothers than children with DS and less maternal care and control than normal children. There was no difference in emotional/behavioral problems between the siblings and normal controls. Conclusion: Our findings suggest that in addition to the physical, educational and psychological needs of children with DS, the psychological care of their mothers, fathers and siblings also needs to be evaluated. Moreover, parenting counseling should focus not only on children with DS, but their siblings as well.     

Attitudes to emotional expression,social support and postnatal adjustment in new parents

The study investigated whether perceived antenatal social support and attitudes to emotional expression are associated with postnatal distress in new parents and whether attitudes to emotional expression are themselves linked with perceptions of social support. Eighty‐six women and 66 men expecting their first baby completed the DUKE‐UNC Functional Social Support Questionnaire (FSSQ) and the Attitudes Towards Emotional Expression (AEE) both antenatally and postnatally. Depressive symptoms and well‐being were measured using the Hospital Anxiety and Depression Scale (HADS) and the Well‐being Questionnaire (WBQ), respectively, in the third trimester and at 6 weeks postnatally. The Edinburgh Postnatal Depression Scale (EPDS) was also used to measure depressive symptoms in the postnatal period. Both mothers and fathers reporting higher perceived social support in pregnancy reported significantly lower levels of distress 6 weeks postnatally. Perceptions of emotional support for fathers and both practical and emotional social support for mothers decreased between pregnancy and the postnatal period. Parents with more positive attitudes towards emotional expression reported significantly higher social support. Attitude towards emotional expression was not associated with distress postnatally.

Perceived social support may be protective for new fathers as well as mothers. Further research regarding the link between the psychological health of new fathers, and the transition of the couple to a family is needed.     

Suspension of fertility treatment during the COVID-19 pandemic: views,emotional reactions and psychological distress among women undergoing fertility treatment

Research questionWhat are the views and emotional reactions of patients towards the suspension of fertility treatment during the COVID-19 pandemic, and what are the factors affecting their psychological distress?DesignA cross-sectional study conducted in an academic fertility centre. Online questionnaires were distributed between 18 April 2020 and 23 April 2020 to patients whose treatment cycle had been postponed or discontinued. The outcome measures included agreement with the reproductive society guidelines to postpone treatments; willingness to resume treatments, given the choice; patients’ emotional reactions; and psychological distress level, measured by the Mental Health Inventory validated scale. A multivariate linear regression was conducted to identify factors associated with psychological distress.ResultsBecause of the small number of male respondents, only women were included in the analysis (n = 181). Forty-three per cent expressed disagreement with the guidelines and 82% were willing to resume treatments, given the choice. Sadness and anxiety were the most common emotional reactions expressed towards the guidelines. In the multivariate analysis, COVID-19-related anxiety (B = 0.145, P = 0.04) and disagreement with treatment suspension (B = –0.44, P = 0.001) were found to be significantly associated with patients' psychological distress. Background characteristics of patients did not contribute significantly to their distress.ConclusionsSuspension of fertility treatment during the initial phase of the COVID-19 pandemic was associated with patients' negative emotional reactions. Anxiety related to COVID-19 and disagreement with treatment suspension were found to be significantly associated with psychological distress among women undergoing fertility treatment, regardless of their background characteristics. Our findings suggest the need to monitor the mental health of patients and provide psychological support should a shutdown of fertility care re-occur.