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Cited by 117Maternal Mental Health During Pregnancy and PostpartumFamily Dynamics and RelationshipsMaternal and Neonatal Healthcare

Anxiety in fathers in the perinatal period: A systematic review

Open access
Philpott, Lloyd Frank, Savage, Eileen, FitzGerald, Serena, Leahy-Warren, Patricia·2019·Midwifery
DOI 10.1016/j.midw.2019.05.013
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Abstract

fatherhood in the perinatal period can be a time of great excitement, happiness and joy. However, a growing body of literature indicates that fathers are at risk for elevated levels of anxiety symptoms during the perinatal period. the purpose of this systematic review is to determine the prevalence and levels of anxiety in fathers during the perinatal period, identify the risk factors and impact of anxiety, and establish if there are effective interventions that reduce father's anxiety. Systematic review. A systematic review protocol was developed and registered with PROSPERO (reference number: CRD42017073760). The review was guided by the PRISMA reporting process. Electronic databases Medline, CINAHL, Embase, the Cochrane Library, PsycARTICLES, PsycINFO, and Psychology were searched to identify eligible studies. Studies that researched fathers during the perinatal period were included if anxiety was the primary focus of the research or was an outcome or dependent variable. Data were extracted and presented in narrative form including tables and figures. Thirty-four studies met the inclusion criteria. Findings from these studies indicate that fathers experience anxiety in the perinatal period, particularly at the time of birth. Anxiety increased from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. The prevalence of anxiety ranged between 3.4% and 25.0% during the antenatal period and 2.4% and 51.0% during the postnatal period. Factors contributing to anxiety included lower education levels, lower income levels, lower co-parenting support, lower social support, work-family conflict, a partner’ anxiety and depression, and being present during a previous birth. Anxiety had a negative impact on fathers’ mental health, physical health, social relationships and parenting skills. Anxiety contributed to stress, depression, fatigue and lower paternal self-efficacy. Five studies reported on interventions to reduce anxiety and all the studies found that anxiety significantly decreased following the intervention. Fathers experience increased anxiety from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period. Anxiety during the perinatal period that can impact negatively on fathers physical and mental health, and social relationships.

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  • Protective factors include higher education, stable relationships, and first-time fatherhood, whereas lower socioeconomic status, limited social support, poor relationship quality, additional caregiving responsibilities, and maternal psychological distress have been associated with poorer paternal mental health.

    “Protective factors include higher education, stable relationships, and first-time fatherhood, whereas lower socioeconomic status, limited social support, poor relationship quality, additional caregiving responsibilities, and maternal psychological distress have been associated with poorer paternal mental health [24,29,48,55].”

    From Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety (2026) · cites this paper as [24]

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  • Previous reviews suggest that anxiety levels may decrease from pregnancy to postpartum period, although many studies do not specify gestational timing at recruitment or child birth.

    “Consistent with our findings, previous reviews suggest that anxiety levels may decrease from pregnancy to postpartum period, although many studies do not specify gestational timing at recruitment or child birth [24,50].”

    From Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety (2026) · cites this paper as [24]

    The review reports that fathers’ anxiety generally decreased from the antenatal to the postnatal period (longitudinal-study findings; Discussion). But its Measurement tools used and assessment time points section says only one study did not specify an assessment time point; it does not support the claim that many studies omitted gestational timing at recruitment or childbirth. (LLM, conf=0.86)

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  • Pregnancy poses a significant risk for parental psychopathology, particularly internalizing problems.

    “Pregnancy, therefore, poses a significant risk for parental psychopathology, particularly internalizing problems (i.e., depression and anxiety [5, 6, 7]).”

    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 [6]

    The Introduction (page not available in our copy) says a significant proportion of fathers experience mental-health problems during the perinatal period, and Table 5 reports anxiety during pregnancy. The source supports the concern about paternal anxiety, but it does not establish that pregnancy itself poses a significant risk of psychopathology for parents generally. (LLM, conf=0.85)

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Cites

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1 of the 112 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Higgins, J.P.T., Green S., (Eds.) 2011. Cochrane handbook for systematic reviews of interventions. Version 5.1.0. (Updated March 2011). The Cochrane Collaboration, 2011.
  2. Shri, R., 2010. Anxiety: cause and management. The Journal of Behavioral Science 5, 100- 118.
  3. Spielberger, C.D., 1983. Manual for the State-Trait Anxiety Inventory (Form Y). Consulting Psychologists Press, Palo Alto.

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Authors
Philpott, L. F., Savage, E., FitzGerald, S., & Leahy-Warren, P.
Affiliations
University College Cork (IE)
Corresponding author
Philpott, Lloyd Frank
ORCID
Venue
Midwifery
Publisher
Elsevier BV
Published
2019-09
Volume
76
Pages
54-101
ISSN
0266-6138 (ISSN-L)
DOI
10.1016/j.midw.2019.05.013
OpenAlex
W4210961490
Cited by
112
References
112
Citations by year
2026: 9 · 2025: 13 · 2024: 18 · 2023: 19 · 2022: 23 · 2021: 20 · 2020: 9 · 2019: 1
FWCI
2.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Midwifery (publishedVersion, other-oa)
  • Cork Open Research Archive (University College Cork, Ireland) (acceptedVersion, cc-by-nc-nd)
  • Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-nd)
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 › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
paternal anxiety, fathers, perinatal period, prenatal anxiety, postpartum anxiety, anxiety prevalence, risk factors, social support, work-family conflict, paternal self-efficacy, anxiety intervention, paternal mental health, parenting skills

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