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Perinatal depression: mums, dads, babies all at risk – London meta-analysis

A major study of the mental health of new parents in 15 countries has revealed that three or more in 100 couples are affected by mood disorders like anxiety or depression before or after their babies’ births.

Mothers as well as fathers are affected by these risks, which extend beyond the first three months of an infant’s life, the researchers from University College London showed in a systematic review and meta-analysis of 23 studies.

Dr Simone Honikman, director of the Perinatal Mental Health Project in Cape Town, said cases of perinatal depression and anxiety among women in lower- and middle-income countries, like SA, seemed to be much higher than in higher-income countries, reports TimesLIVE.

“In SA, about one in three to one in five women will have depression and/or anxiety in the perinatal period. We have a dearth of paternal data in SA, but similarly, it is likely to be higher,” said Honikman, a public mental health professor at the University of Cape Town.

The UK team analysed data from 29,286 couples over 21 years, reporting that perinatal anxiety and postnatal depression can affect mothers and fathers simultaneously, and that in about two in 100 couples both parents experienced antenatal depression (1.7%) and early postnatal depression (2.3% up to 12 weeks after birth); and three in 100 couples both parents suffered late postnatal depression (3-12 months after birth).

Lead author Dr Kara Smythe, from the college’s Institute of Epidemiology and Health, described the burden of depression as considerable in both parents.

“Mood disorders in one parent may affect the other parent, and there is evidence that paternal depression leads to increased symptoms of depression in mothers during pregnancy and in the first six postpartum months,” she says.

“Parental perinatal mood disorders are associated with adverse pregnancy outcomes, impaired bonding with the newborn and behavioural problems in their children.”

Developing a perinatal mood disorder was more common among mothers who endured psychosocial risks such as “early life stressors, limited social support and exposure to intimate partner violence”, the team noted.

“For fathers, the main factors associated with an increased risk of perinatal mood disorder were lower levels of education, unemployment, low social support and marital distress,” they found. Paternal anxiety tripled when the mother was depressed.

Women were three times more likely and men nine times more likely “to develop postnatal depression if they had experienced depression in the months before the child was born”, the UCL team noted.

Despite the frequency of mood disorders among new parents, up to 40% of new mothers did not get a postnatal check-up six to eight weeks after giving birth, while men had no such check-up scheduled.

Mutually reinforcing and difficult socioeconomic circumstances in SA are likely to be driving the risk of depression among pregnant women, new mothers and fathers, in Honikman’s view. She called for greater government investment in perinatal mental health services, which are widely available.

“The reason for the higher prevalence [of depression] in our settings is that mother are often facing multiple, coinciding risk factors such as poverty, food insecurity, violence and dysfunctional gender relations,” she said.

Study details

Prevalence of Perinatal Depression and Anxiety in Both ParentsA Systematic Review and Meta-analysis

Kara Smythe, Irene Petersen, Patricia Schartau.

Published in JAMA Network Open on 24 June 2022

Key Points

Question
How often do both mothers and fathers (parental dyad) experience perinatal mood disorders?

Findings
In this systematic review and meta-analysis of 23 studies with 29.286 couples, up to 3.18% of parental dyads (both mothers and fathers) experienced perinatal depression, and prevalence was higher in the late postnatal period (3-12 months). There were insufficient data on parental perinatal anxiety to draw any conclusions.

Meaning
These findings suggest health care workers caring for new or expectant parents should be aware that both parents can concurrently experience perinatal mood disorders, with consequences for their health and well-being as well as that of their infant.

Abstract

Importance
New and expectant parents experience perinatal mood disorders, with consequences to parenting ability, bonding with the neonate, interpersonal relationships, and health and well-being of parents. Research shows that maternal and paternal perinatal mood disorders are associated, but no recent systematic review has addressed the prevalence of perinatal mood disorders in both mothers and fathers (parental dyad).

Objective
To examine the prevalence of perinatal mood disorders in parental dyads and identify factors associated with perinatal mood disorders in parental dyads.

Main Outcomes and Measures
Prevalence of perinatal anxiety and perinatal depression in parental dyads.

Results
Twenty-three studies were included, with data from 29 286 couples. The pooled prevalence of antenatal depression in both parents was 1.72% (95% CI, 0.96%-2.48%; P < .001). The prevalence of early postnatal depression (up to 12 weeks post partum) was 2.37% (95% CI, 1.66%-3.08%; P < .001) and the prevalence of late postnatal depression (3-12 months post partum) was 3.18% (95% CI, 2.3-4.05; P < .001). Only 3 studies reported on perinatal anxiety in both parents, precluding a quantitative analysis.

Conclusions and Relevance
In up to 3.18% of couples, both parents may concurrently experience perinatal depression. Perinatal health care must consider the mental health needs of parents, both as individuals and as a parental dyad. Further research is needed to examine outcomes in families where both parents experience perinatal mood disorders.

 

JAMA Network Open article – Prevalence of Perinatal Depression and Anxiety in Both ParentsA Systematic Review and Meta-analysis (Open access)

 

TimesLIVE article – Perinatal depression puts babies and parents — yes, dads too — at risk (Open access)

 

See more from MedicalBrief archives:

 

South Africa’s strides in tackling post-partum depression

 

FDA’s first approval of a drug to treat postpartum depression

 

Postpartum depression influenced by birthing season

 

Moms’ maternal health is important for children too

 

 

 

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