Elsevier

The Lancet

Volume 365, Issue 9478, 25 June–1 July 2005, Pages 2201-2205
The Lancet

Articles
Paternal depression in the postnatal period and child development: a prospective population study

https://doi.org/10.1016/S0140-6736(05)66778-5Get rights and content

Summary

Background

Depression is common and frequently affects mothers and fathers of young children. Postnatal depression in mothers affects the quality of maternal care, and can lead to disturbances in their children's social, behavioural, cognitive, and physical development. However, the effect of depression in fathers during the early years of a child's life has received little attention.

Methods

As part of a large, population-based study of childhood, we assessed the presence of depressive symptoms in mothers (n=13 351) and fathers (n=12 884) 8 weeks after the birth of their child with the Edinburgh postnatal depression scale (EPDS). Fathers were reassessed at 21 months. We identified any subsequent development of behavioural and emotional problems in their children (n=10 024) at age 3·5 years with maternal reports on the Rutter revised preschool scales.

Findings

Information was available for 8431 fathers, 11 833 mothers, and 10 024 children. Depression in fathers during the postnatal period was associated with adverse emotional and behavioural outcomes in children aged 3·5 years (adjusted odds ratio 2·09, 95% CI 1·42–3·08), and an increased risk of conduct problems in boys (2·66, 1·67–4·25). These effects remained even after controlling for maternal postnatal depression and later paternal depression.

Interpretation

Our findings indicate that paternal depression has a specific and persisting detrimental effect on their children's early behavioural and emotional development.

Introduction

The findings of research done in people and in animals indicate that early maternal influences are crucial in the development of offspring.1, 2, 3, 4 Maternal postnatal depression affects the quality of maternal care and predicts disturbances in children's later social, behavioural, cognitive, and physical development.5, 6, 7, 8 However, the effect of depression in fathers during the early months of their children's lives has received little attention.

There is research9, 10 to show that adolescent children of depressed fathers have increased rates of psychopathology, but little is known about the possible effects of paternal depression early in children's lives.10, 11 This gap in knowledge is of concern for various reasons. First, depression is a major worldwide health problem. It is the fourth biggest cause of disability and, by 2020, the global burden of depression will probably be second only to cardiovascular disease.12 Depression often affects parents and is associated with an adverse effect on their children's development.5, 7, 13 A proportion of fathers do report depression after the birth of a child,14 suggesting it could be an important health issue. Second, there is good evidence5 that maternal postnatal depression affects children's development across a range of domains. Symptoms of depression, including low mood, irritability, and feelings of hopelessness, in either mothers or fathers, are likely to interfere with the ability to provide responsive parenting. The quality and sensitivity of parenting during a child's first year of life could have persisting effects on development.2 Third, research and some governmental policy—for example, the National Service Framework for Children, Young People, and Maternity Services in England15—are beginning to recognise the important role that many fathers play in their children's early development16 and are encouraging greater involvement of the father in their upbringing.

Our aim, therefore, was to assess paternal depression after childbirth. We postulated that paternal depression in the postnatal period would be associated with an increased risk of behavioural and emotional problems in children aged 3·5 years. In view of research findings17, 18, 19 that boys might be more vulnerable to the effects of postnatal depression in their mothers, we further hypothesised that the effect of paternal depression at this age would be greater in boys than in girls.

Section snippets

Participants

The Avon Longitudinal Study of Parents and Children (ALSPAC)20 is a longitudinal cohort study set up to collect comprehensive data on a large population sample of children and their parents from early pregnancy through childhood. Pregnant mothers were recruited from the Bristol area of the UK. All pregnant women due to deliver their baby between April 1, 1991, and Dec 31, 1992, were eligible, and an estimated 85–90% were recruited.

We sent questionnaires to mothers and fathers at regular points

Results

The overall ALSPAC cohort consisted of 13 822 women with live children 28 days after birth. 13 351 mothers agreed to participate in the study and were sent a questionnaire 8 weeks after the birth of their child. 12 884 of respondents had partners. Data were available on mothers' postnatal depressive symptoms for 11 833 (89%) of these women, and on fathers' postnatal depressive symptoms in 8431 of 12 884 (65%) male partners. More than 99% of these men were identified as the father of the child.

Discussion

Our findings indicate that children of fathers who have depression during the postnatal period are at increased risk of behavioural problems at age 3·5 years, even after maternal depression and other factors had been controlled for. The increased risk associated with depression in fathers during the infant's early months also remains after controlling for later paternal depression, suggesting that paternal depression in the early months of a child's life might be a particular risk factor for

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