Paternal Depression During Pregnancy Increases Risk for Very Preterm Birth

New episodes of depression in expectant dads may significantly increase the risk for a very premature birth, according to a new study published in BJOG: an International Journal of Obstetrics and Gynaecology.

It is well-established that depression in expectant mothers is tied to low birth weight and increased risk of premature birth. This may be due to extreme stress, the death of a loved one, lack of social support, or a difficult or abusive relationship. However, there has been little research regarding the impact of paternal depression on the health of the mother or the unborn child.

In this study, researchers evaluated more than 350,000 births in Sweden between 2007 and 2012. They looked for cases of parental depression and incidences of either very preterm birth (between 22 and 31 weeks) or moderately preterm birth (32-36 weeks).

In both mothers and fathers, depression was defined as having had a prescription of antidepressant medication, or receiving outpatient/inpatient hospital care, from 12 months before conception to the end of the second trimester of pregnancy.

Participants with depression were classified as “new” cases if they had had no depression in the 12 months prior to diagnosis, all other cases were classified as “recurrent” depression.

While both new and recurrent depression in the mothers was tied to a greater risk of moderately preterm birth of around 30 percent to 40 percent, new depression in the fathers was linked to a 38 percent increased risk of very preterm birth. Recurrent depression in the fathers was not associated with preterm birth at all.

“Depression of a partner can be considered to be a substantial source of stress for an expectant mother, and this may result in the increased risk of very preterm birth seen in our study,” said Professor Anders Hjern at the Centre for Health Equity Studies in Stockholm (CHESS).

“Paternal depression is also known to affect sperm quality, have epigenetic effects on the DNA of the baby, and can also affect placenta function. However, this risk seems to be reduced for recurrent paternal depression, indicating that perhaps treatment for the depression reduces the risk of preterm birth.”

Hjern adds that both maternal and paternal depression should be considered in preterm birth prevention strategies and that both parents should be screened for mental health problems.

Furthermore, since men are less likely to seek professional help for mental health problems, a proactive approach that targets the wellbeing of expectant fathers may be beneficial, adds Hjern.

“This research is interesting as it finds that paternal mental health can also have an effect on the health of the baby. However, more research is needed to establish the mechanism behind this effect,” said Dr. Patrick O’Brien, an obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG).

“We encourage anyone, and particularly those planning a family or who are pregnant, and are experiencing a change in mood, irritability, or anxiety to seek advice. No one should suffer in silence — there is help and support available,” said O’Brien.

Source: Wiley
Preterm baby in the hospital photo by shutterstock.