The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index.
Factors Influencing Paternal Postpartum Depression: A Systematic Review and Meta-Analysis
Abstract
Background Postpartum period is a critical time that requires adjustments not only for mothers but also for fathers and may pose risk for depression. Studies show that the prevalence of paternal postpartum depression (PPD) is between 1.2% and 25.5%. PPD is an under-recognized public health issue and its reported influencing factors are still inconclusive.Objective The purpose of this paper is to extend the literature by examining influencing factors that affect paternal PPD and describe the strength their associations.Methods We conducted keyword search of Web of Science, PubMed, Embase, the Cochrane Library and PsycARTICLES electronic databases up to Jan 17, 2020, without language restrictions, for observational studies investigating the factors influencing paternal PPD and its effects. Fixed or random effect model was used to pool odds ratio (OR) and 95% confidence intervals (CI) with Stata software 12.0. Heterogeneity between studies was evaluated using Cochran's chi-squared test (Cochran's Q) and I 2 values.Results Nineteen cross-sectional studies and eighteen cohort studies published from 1996 to 2019 were included in this review and seventeen studies in the meta-analysis. Factors affecting paternal PPD can be classified into paternal, maternal, infant and family factors. In Meta-analysis, 9 of 17 influencing factors were revealed to be statistically significant: 1) paternal factors: unemployment OR= 2.59 (95%CI:1.42-4.74), low social support OR=1.05 (95%CI:1.03-1.08), negative life events OR=1.45 (95%CI:1.13-1.87), perceived stress OR=1.08 (95%CI:1.03-1.12), financial strain OR=2.07 (95%CI:1.13-3.81), history of mental illness OR=3.48 (95%CI:2.49-4.86); 2) maternal factors: parity OR=1.36 (95%CI:1.13-1.65) and maternal postnatal depression OR=1.17 (95%CI:1.03-1.33); 3) family factors: low marital satisfaction OR=1.40 (95%CI:1.22-1.61). No statistically significant association with infant factors was found in the meta-analysis.Limitations There was publication bias since we only included English studies. Samples were under-represented in low-and middle-income countries. The meta-analysis results are subject to unobserved confounding factors and cannot explain causality.Conclusion This overview of the evidence suggests a relationship between paternal employment, psychological status, history of maternal mental illness, first pregnancy, marital relationship and paternal PPD. The low number of studies for some infant factors in meta-analysis leaves gaps in knowledge that need to be addressed. The mechanisms underlying the reported associations and their causal relationship still remain unclear. The awareness of the serious long-term consequences of paternal PPD should encourage better identification of those at risk and the development of effective interventions to protect fathers from PPD.
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“financial strain (i.e., low income and unemployment) is associated with maternal depression and anxiety [15, 35], as well as paternal depression [34].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [34]
In the citing paper
“stress is a robust predictor of maternal and paternal depression [34, 37, 38, 39, 40] and, to a lesser extent, maternal anxiety [15].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [34]
In the citing paper
“maternal depression is also a risk factor for paternal perinatal depression [16, 34, 41].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [34]
In the citing paper
“Finally, contextual factors related to the intimate relationship, namely poorer relationship quality and lack of social support, have been linked to maternal depression and anxiety [13, 15, 40], as well as paternal depression [32, 34, 42].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [34]
In the citing paper
“a history of psychiatric problems (e.g., depression) has consistently been identified as a predictor of maternal perinatal depression and anxiety [13, 15, 37, 38, 40], as well as paternal postpartum depression [34].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [34]
In the citing paper
“Finally, contextual factors related to the intimate relationship, namely poorer relationship quality and lack of social support, have been linked to maternal depression and anxiety [13, 15, 40], as well as paternal depression [32, 34, 42].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [34]
Citations
Cites
PRISMA-P Group, Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015) · Systematic Reviews · doi:10.1186/2046-4053-4-1 · Cited by 26,223
Diagnostic and Statistical Manual of Mental Disorders(DSM)
Leong, F. T. L. (2008) · Sage eBooks · doi:10.4135/9781412963978.n182 · Cited by 10,861
Predictors of Postpartum Depression
Beck, C. T. (2001) · Nursing Research · doi:10.1097/00006199-200109000-00004 · Cited by 1,960
Paulson, J. F., & Bazemore, S. D. (2010) · JAMA · doi:10.1001/jama.2010.605 · Cited by 1,337
Luchini, C., Stubbs, B., Solmi, M., & Veronese, N. (2017) · World Journal of Meta-Analysis · doi:10.13105/wjma.v5.i4.80 · Cited by 977
Goodman, J. H. (2004) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2003.02857.x · Cited by 660
Paternal and maternal depressed mood during the transition to parenthood
Matthey, S., Barnett, B. E. W., Ungerer, J. A., & Waters, B. G. H. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(99)00159-7 · Cited by 500
Depression in men in the postnatal period and later child psychopathology: a population cohort study
Ramchandani, P., Stein, A., O'Connor, T., Heron, J., Murray, L., & Evans, J. (2008) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/chi.0b013e31816429c2 · Cited by 471
Resilience in the Context of Chronic Stress and Health in Adults
Schetter, C. D., & Dolbier, C. L. (2011) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2011.00379.x · Cited by 341
Vismara, L., Rollè, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S., Neri, E., Prino, L. E., Odorisio, F., Trovato, A., et al. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00938 · Cited by 292
Edmondson, O., Psychogiou, L., Vlachos, H., Netsi, E., & Ramchandani, P. G. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.01.069 · Cited by 262
Correlates of Postnatal Depression in Mothers and Fathers
Areias, M. E., Kumar, R., Barros, H., & Figueiredo, E. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.169.1.36 · Cited by 261
Rao, W.-W., Zhu, X.-M., Zong, Q.-Q., Zhang, Q., Hall, B. J., Ungvari, G. S., & Xiang, Y.-T. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.10.030 · Cited by 253
Epifanio, M. S., Genna, V., Luca, C. D., Roccella, M., & Grutta, S. L. (2015) · Pediatric Reports · doi:10.4081/pr.2015.5872 · Cited by 209
Figueiredo, B., & Conde, A. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.02.007 · Cited by 185
Edhborg, M., MATTHIESEN, A. ‐., Lundh, W., & Widström, A.-M. (2005) · Archives of Women s Mental Health · doi:10.1007/s00737-005-0097-5 · Cited by 180
Causal Inference in Developmental Origins of Health and Disease (DOHaD) Research
Gage, S. H., Munafò, M. R., & Davey Smith, G. (2016) · Annual Review of Psychology · doi:10.1146/annurev-psych-122414-033352 · Cited by 173
Sad dads: paternal postpartum depression.
Kim, P., & Swain, J. E. (2007) · PubMed Central · Cited by 164
Psychological correlates of depression in fathers and mothers in the first postnatal year
Dudley, M., Roy, K., Kelk, N., & Bernard, D. (2001) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646830124397 · Cited by 160
Gender differences in postpartum depression: a longitudinal cohort study
Escribà‐Agüir, V., & Artazcoz, L. (2010) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.085894 · Cited by 153
Cox, J. (2019) · The British Journal of Psychiatry · doi:10.1192/bjp.2018.245 · Cited by 150
Influences of maternal postpartum depression on fathers and on father–infant interaction
Goodman, J. H. (2008) · Infant Mental Health Journal · doi:10.1002/imhj.20199 · Cited by 149
Bringing birth-related paternal depression to the fore
Schumacher, M. V., Zúbaran, C., & White, G. (2008) · Women and Birth · doi:10.1016/j.wombi.2008.03.008 · Cited by 148
Pinheiro, R. T., Magalhães, P. V. D. S., Horta, B. L., Pinheiro, K. A. T., da Silva, R. A., & Pinto, R. H. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00708.x · Cited by 123
An integrative review of paternal depression
Edward, K.-L., Castle, D., Mills, C., Davis, L., & Casey, J. (2015) · American Journal of Men's Health · doi:10.1177/1557988314526614 · Cited by 122
Unintended pregnancy and depressive symptoms among first-time mothers and fathers.
Leathers, S. J., & Kelley, M. A. (2000) · American Journal of Orthopsychiatry · doi:10.1037/h0087671 · Cited by 118
Paternal postnatal depression in Ireland: Prevalence and associated factors
Philpott, L. F., & Corcoran, P. E. (2017) · Midwifery · doi:10.1016/j.midw.2017.10.009 · Cited by 116
Paternal Depression in the Postnatal Period and Early Father–Infant Interactions
Sethna, V., Murray, L., Netsi, E., Psychogiou, L., & Ramchandani, P. G. (2015) · Parenting · doi:10.1080/15295192.2015.992732 · Cited by 109
Risk factors of paternal depression in the early postnatal period in Japan
Nishimura, A., & Ohashi, K. (2010) · Nursing and Health Sciences · doi:10.1111/j.1442-2018.2010.00513.x · Cited by 108
Bergström, M. (2013) · Birth · doi:10.1111/birt.12026 · Cited by 99
Nishimura, A., Fujita, Y., 勝田, 真., Ishihara, A., & Ohashi, K. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0552-x · Cited by 98
Carlberg, M., Edhborg, M., & Lindberg, L. (2018) · American Journal of Men s Health · doi:10.1177/1557988317749071 · Cited by 97
Risk factors for paternal perinatal depression and anxiety: A systematic review and meta-analysis.
Chhabra, J., McDermott, B., & Li, W. (2020) · Psychology of Men & Masculinities · doi:10.1037/men0000259 · Cited by 90
Costa, D. D., Danieli, C., Abrahamowicz, M., Dasgupta, K., Sewitch, M. J., Lowensteyn, I., & Zelkowitz, P. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.02.033 · Cited by 89
Predictors of maternal and paternal depressive symptoms at postpartum
Ngai, F.-W., & Ngu, S.-F. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.12.003 · Cited by 87
Paternal postpartum depression: how can nurses begin to help?
Melrose, S. (2010) · Contemporary Nurse · doi:10.5172/conu.2010.34.2.199 · Cited by 82
Predictors of Postpartum Depression in Partnered Mothers and Fathers from a Longitudinal Cohort
The APrON Team, Leung, B. M. Y., Letourneau, N. L., Giesbrecht, G. F., Ntanda, H. N., & Hart, M. J. (2016) · Community Mental Health Journal · doi:10.1007/s10597-016-0060-0 · Cited by 81
Anding, J. E., Röhrle, B., Grieshop, M., Schücking, B., & Christiansen, H. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.033 · Cited by 80
Koh, Y. W., Chui, C., Tang, C. S., & Lee, A. M. (2014) · Depression Research and Treatment · doi:10.1155/2014/127632 · Cited by 78
A comparison of postnatal depression and related factors between Chinese new mothers and fathers
Mao, Q., Zhu, L., & Su, X. (2011) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2010.03542.x · Cited by 75
Underwood, L., Waldie, K. E., Peterson, E. R., D’Souza, S., Verbiest, M. E. A., McDaid, F., & Morton, S. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.4234 · Cited by 72
Chen, Y., Huang, J., Au, H., & Chen, Y. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.08.042 · Cited by 72
Post partum depression and the psychosocial predictors in first-time fathers from northwestern China
Zhang, Y., Zhang, L., Wei, H., Zhang, Y., Zhang, C., & Porr, C. (2016) · Midwifery · doi:10.1016/j.midw.2016.01.005 · Cited by 71
Nath, S., Psychogiou, L., Kuyken, W., Ford, T. J., Ryan, E., & Russell, G. (2016) · BMC Public Health · doi:10.1186/s12889-016-3168-9 · Cited by 65
Postpartum Depressive Symptomatology in New Mothers and Fathers: Parenting, Work, and Support
Leathers, S. J., Kelley, M. A., & Richman, J. A. (1997) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199703000-00001 · Cited by 59
Massoudi, P., Hwang, C. P., & Wickberg, B. (2016) · Scandinavian Journal of Public Health · doi:10.1177/1403494816661652 · Cited by 59
Paternal Postnatal Depression Among Fathers of Newborn in Saudi Arabia
Shaheen, N. A., Alatiq, Y., Thomas, A., Alanazi, H. A., Alzahrani, Z., Younis, S., & Hussein, M. A. (2019) · American Journal of Men s Health · doi:10.1177/1557988319831219 · Cited by 56
Suto, M., Emi, I., Mizutani, F., Kakee, N., Misago, C., & Takehara, K. (2016) · Research in Nursing & Health · doi:10.1002/nur.21728 · Cited by 53
Postnatal depression in Mexican American fathers: Demographic, cultural, and familial predictors
Roubinov, D. S., Luecken, L. J., Crnic, K. A., & Gonzales, N. A. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.09.038 · Cited by 51
Partner report of paternal depression using the Edinburgh Postnatal Depression Scale-Partner
Fisher, S. D., Kopelman, R., & O’Hara, M. W. (2012) · Archives of Women s Mental Health · doi:10.1007/s00737-012-0282-2 · Cited by 49
Association between depression and neuropathy in people with type 2 diabetes: a meta‐analysis
Bartoli, F., Carrà, G., Crocamo, C., Carretta, D., La Tegola, D., Tabacchi, T., Gamba, P., & Clerici, M. (2016) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4397 · Cited by 44
Nishigori, H., Obara, T., Nishigori, T., Metoki, H., Mizuno, S., Ishikuro, M., Sakurai, K., Hamada, H., Watanabe, Z., Hoshiai, T., et al. (2018) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2018.1560415 · Cited by 41
Sipsma, H. L., Callands, T. A., Desrosiers, A., Magriples, U., Jones, K., Albritton, T., & Kershaw, T. (2016) · Maternal and Child Health Journal · doi:10.1007/s10995-016-2064-3 · Cited by 35
Risk, resilience, and depressive symptoms in low-income African American fathers.
Bamishigbin, O. N., Schetter, C. D., Guardino, C. M., Stanton, A. L., Schäfer, P., Shalowitz, M. U., Lanzi, R. G., Thorp, J. M., & Raju, T. N. K. (2016) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000088 · Cited by 29
Factors associated with paternal perinatal depression in fathers of newborns in Nigeria
Ayinde, O. O., & Lasebikan, V. O. (2017) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2017.1398726 · Cited by 29
Postnatal depression in fathers
Cox, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67372-2 · Cited by 28
Dépression paternelle du post-partum : revue de la littérature
Gressier, F., Tabat-Bouher, M., Cazas, O., & Hardy, P. (2015) · La Presse Médicale · doi:10.1016/j.lpm.2014.09.022 · Cited by 24
Depresión posparto en padres: ¿por qué también es importante?
Pérez, F., & Brahm, P. (2017) · Revista chilena de pediatría · doi:10.4067/s0370-41062017000500002 · Cited by 21
Cockshaw, W. D., Muscat, T., Obst, P. L., & Thorpe, K. J. (2014) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/0167482x.2014.959920 · Cited by 20
Paternal Postpartum Depression
Stadtlander, L. (2015) · ScholarWorks (Walden University) · Cited by 18
Predictors of postpartum depression in first-time fathers
Howarth, A. M., & Swain, N. (2020) · Australasian Psychiatry · doi:10.1177/1039856220924324 · Cited by 18
Maleki, A., Faghihzadeh, S., & Niroomand, S. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.044 · Cited by 17
Paternal Depressive Symptoms and Marital Quality: A Meta‐Analysis of Cross‐Sectional Studies
Cheung, K., Theule, J., Hiebert‐Murphy, D., & Piotrowski, C. C. (2019) · Journal of Family Theory & Review · doi:10.1111/jftr.12341 · Cited by 16
Williams, T. T., Mance, G. A., Caldwell, C. H., & Antonucci, T. C. (2012) · Journal of Black Psychology · doi:10.1177/0095798411433842 · Cited by 12
Fentz, H. N., Simonsen, M., & Trillingsgaard, T. (2019) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2019.38.7.545 · Cited by 6
Postpartum Depression Risk in Husbands of Women Who Had Caesarean Section Deliveries in Turkey
Koç, G., & Ergöl, Ş. (2018) · Issues in Mental Health Nursing · doi:10.1080/01612840.2018.1466941 · Cited by 5
Clément, M., Menand, V., Piché, G., & Dubeau, D. (2018) · The Canadian Journal of Psychiatry · doi:10.1177/0706743718815882 · Cited by 2
Research works printed but not linked: 4
- Perez, 2017, Paternal postpartum depression. Why is it also important?, Revista Chilena De Pediatria-Chile, 88, 582
- Clement, 2019, Prevalence and associated factors of depression symptoms in fathers of children aged 6 months to 17 years in Quebec, Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie, 64, 550
- Leung, 2017, Predictors of Postpartum Depression in Partnered Mothers and Fathers from a Longitudinal Cohort, Community Ment. Health J., 53, 420, 10.1007/s10597-016-0060-0 · DOI
- Dudley, 2001, Psychological correlates of depression in fathers and mothers in the first postnatal year, J Reprod Infant Psychol, 19, 187, 10.1080/02646830124397 · DOI · Paper page
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Financial strain and depression in the U.S.: a scoping review
Ettman, C. K., Fan, A. Y., Philips, A. P., Adam, G. P., Ringlein, G., Clark, M. A., Wilson, I. B., Vivier, P. M., & Galea, S. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02460-z · Cited by 78
Qi, W., Wang, Y., Wang, Y., Huang, S., Li, C., Jin, H., Zuo, J., Cui, X., Wei, Z., Guo, Q., et al. (2025) · Journal of Translational Medicine · doi:10.1186/s12967-025-06289-6 · Cited by 75
Hormones and neuroplasticity: A lifetime of adaptive responses
Been, L. E., Sheppard, P. A. S., Galea, L. A. M., & Glasper, E. R. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.11.029 · Cited by 58
Chhabra, J., Li, W. W., & McDERMOTT, B. M. (2022) · American Journal of Men s Health · doi:10.1177/15579883221079489 · Cited by 38
Metadata
- Authors
- Wang, D., Li, Y.-L., Qiu, D., & Xiao, S.-Y.
- Affiliations
- Central South University (CN)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 293
- Pages
- 51-63
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3168175097
- Cited by
- 167
- References
- 67
- Citations by year
- 2026: 27 · 2025: 45 · 2024: 33 · 2023: 40 · 2022: 18 · 2021: 4
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology of the People's Republic of China (2016YFC0900802)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Demography › Family Dynamics and Relationships
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Keywords
- paternal postpartum depression, risk factors, paternal unemployment, social support, perceived stress, financial stress, postpartum depression, parity, marital satisfaction, infant factors, family factors, fathers' mental health, postpartum period
- MeSH terms
- Cross-Sectional Studies, Fathers, Female, Humans, Infant, Male, Mothers, Pregnancy, Depression, Postpartum, Postpartum Period
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