The effects of maternal depression on child development are fairly well known and both women and their children can be affected. Many women are more fragile during the first postpartum months, and this can impact a child’s development. And depressed mothers, it has been found, “generally show less attentiveness and responsiveness” than non-depressed mothers.
This problem can be particularly prevalent during pregnancy, with many women struggling with the dilemma of whether or not to continue taking antidepressants. Although antidepressants can be a vital support tool for women struggling with mental illness during pregnancy, there is also evidence they can slightly increase the risk of babies developing heart defects, as well as increasing risk of miscarriage and premature birth.
What we don’t know, however, is whether paternal depression can affect a child in the same way. But now a new study claims paternal depression can also cause premature birth.
Looking at over 350,000 births in Sweden between 2007 and 2012, researchers claim to have found a link between paternal depression and the incidence of very preterm birth (between 22 and 31 weeks gestation) or moderately preterm birth (32 to 36 weeks). Depression was defined, in both men and women, as having had a prescription of antidepressants or receiving out or inpatient care in a hospital. Episodes were placed into two categories — “new” depressive episodes, for those who had not experienced depression in the year prior to diagnosis, and “recurrent” depression for those with more frequent depressive episodes.
The study confirmed that maternal depression was linked to preterm births, with an increased risk of 30 to 40 percent, but also found new paternal depression was associated with a 38 percent increased risk of very preterm birth. Recurrent depression in fathers was not associated with preterm birth.
The study suggests that many of the premature births attributed to antidepressants may actually have been linked to stress — dealing with caring for a depressed partner may increase stress levels in mothers. Researchers believe that men with recurrent depression are more likely to have a support network in place, meaning stress is reduced in mothers — hence the lack of association between recurrent depression and preterm births.
Anders Hjern, who led the study, described paternal depression as “a substantial source of stress” for an expectant mother. “This may result in the increased risk of very preterm birth seen in our study,” he said.
“Paternal depression is also known to affect sperm quality, have epigenetic effects on the DNA of the baby, and can also affect placenta function.”
“Our results suggest that both maternal and paternal depression should be considered in preterm birth prevention strategies, and both parents should be screened for mental health problems. Since men are less likely to seek professional help, a proactive approach towards targeting the wellbeing of expectant fathers may be beneficial”.
The researchers claim that “the stress level of the mother is expected to increase” when living with a partner with depression — a fairly uncontroversial and perhaps self-evident statement. But limitations of the study may mean the impact paternal depression had on births was overestimated.
One problem with the research lies in its imprecise definition of depression. Despite the name, antidepressants are often taken for reasons other than preventing or treating depression, including anxiety or chronic pain, factors that were not included in the study. Many of the participants may also have experienced depression without receiving a diagnosis, hospital care or an antidepressant prescription — meaning the results may have been skewed. This is particularly significant in men, who are less likely than women to seek treatment or diagnosis.
Depression in men was also linked to preterm births only in certain situations — around the time of conception and in early pregnancy — meaning that results were only statistically significant for ‘new’ depression in preterm births. This excludes both recurring depression and new depression in moderately preterm births. No explanation was given for the difference in new and recurrent depressive episodes.
“Depression in pregnancy can be very serious for a woman and can also impact the health of her baby,” said Patrick O’Brien, spokesperson for the Royal College of Obstetricians. “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.
“Further progress is needed into the understanding of how depression of either parent affects pregnancy in order to help prevent preterm birth. 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.”