Mental health trajectories of fathers following very preterm birth: associations with parenting
Open accessAbstract
Objective: Mothers of infants born very preterm (VPT) are at high risk of mental health difficulties. However, less is known about the course of fathers’ depressive and anxiety symptoms over time, and the implications this may have for early parenting behaviors. Methods: In total, 100 fathers of 125 infants born VPT (<30 weeks’ gestation) completed questionnaires assessing depressive and anxiety symptoms shortly after their infant’s birth, and when their infant reached term-equivalent age, 3 months, 6 months, and 12 months’ corrected age. At 12 months’ corrected age, fathers’ parenting behaviors were assessed using the Emotional Availability Scales. Longitudinal latent class analysis was used to identify trajectories of fathers’ depressive and anxiety symptoms, and linear regression equations examined relationships between these trajectories and fathers’ parenting behaviors. Results: For both depressive and anxiety symptoms, two distinct trajectories were identified. For depression, most fathers were assigned to the persistently low symptom trajectory (82%), while the remainder were assigned to the persistently high symptom trajectory (18%). For anxiety, 49% of fathers were assigned to the persistently low symptom trajectory, while 51% were assigned to the trajectory characterized by moderate symptoms over the first postnatal year. There were no significant differences in parenting behaviors between fathers assigned to the different depressive and anxiety symptom trajectories. Conclusions: Fathers of infants born VPT are at risk of chronic depressive and anxiety symptoms over the first postnatal year, highlighting the need for screening and ongoing support.
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Various studies reported that between 4 and 16% of fathers experienced elevated depression symptoms during the first 12 months.
“Descriptive results showed that various studies have reported between 4 and 16 % of fathers experienced elevated depression symptoms during the first 12 months (Carson et al., 2015; McMahon et al., 2020; Vriend et al., 2021).”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as McMahon et al., 2020
The Descriptive Statistics and Missing Data section (p. 5, Table II) reports 12% of fathers with elevated depressive symptoms at six months, which falls within the cited range. But it reports 18% at 12 months and 44% shortly after birth, so this study does not support 4–16% as the range across the first year. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe occurrence of depression could be lower in fathers than in mothers of very preterm children.
“Although in term of prevalence, the occurrence of depression could be lower in fathers than in mothers of VPT children (Carson et al., 2015; Huhtala et al., 2014; McMahon et al., 2020)”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as McMahon et al., 2020
The Abstract (p. 1) reports that 18% of fathers followed a persistently high depressive-symptom trajectory and says mothers of VPT infants are at high risk of mental health difficulties. It does not give a maternal depression rate or establish that depression is less common in fathers than mothers. (LLM, conf=0.77)
Experimental — accuracy not yet measuredMcMahon et al. reported that approximately 50% of fathers experienced moderate levels of anxiety, while the other half experienced low but persistent anxiety throughout the first year postpartum.
“McMahon et al. [32], for instance, reported that approximately 50% of fathers experienced moderate levels of anxiety, while the other half experienced low but persistent anxiety throughout the first year postpartum.”
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 [32]
The trajectories section (p. 6) reports moderate anxiety symptoms in 51% of fathers and persistently low symptoms in 49% over the follow-up period. But the study concerns fathers of infants born very preterm, not fathers generally; the claim omits that population restriction. (LLM, conf=0.86)
Experimental — accuracy not yet measuredShortly after birth, 44% of fathers of VPT infants report elevated depressive symptoms and 53% anxiety symptoms.
“Prevalence: shortly after birth, 44 % and 53 % of fathers report elevated depressive and anxiety symptoms respectively.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as McMahon et al., 2020
At 6 months, 12% of fathers report elevated depressive symptoms and 16% anxiety symptoms.
“At 6 months, 12 % and 16 % of fathers fall in these same categories.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as McMahon et al., 2020
Depressive and anxiety symptoms showed the largest decline between shortly after birth and term-equivalent age before remaining relatively stable.
“Depressive and anxiety symptoms showed the largest decline between shortly after birth and term- equivalent age before remaining”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as McMahon et al., 2020
Persistent anxiety symptoms following PB have been observed from the third trimester through the early postpartum weeks and up to one year after birth.
“Persistent anxiety symptoms following PB have been observed from the third trimester through the early postpartum weeks [17] and up to one year after birth [25,32].”
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 [32]
Some fathers show declining depressive symptoms during the first year after birth, whereas others experience persistently elevated symptoms.
“Some fathers show declining depressive symptoms during the first year after birth [25,29,30], whereas others experience persistently elevated symptoms [31,32].”
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 [32]
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“Some fathers show declining depressive symptoms during the first year after birth [25,29,30], whereas others experience persistently elevated symptoms [31,32].”
Influential
- Authors
- McMahon, G. E., Anderson, P. J., Giallo, R., Pace, C. C., Cheong, J. L., Doyle, L. W., Spittle, A. J., Spencer-Smith, M. M., & Treyvaud, K.
- Affiliations
- Murdoch Children's Research Institute (AU)
- The University of Melbourne (AU)
- Royal Children's Hospital (AU)
- Royal Women's Hospital (AU)
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University
- Corresponding author
- Treyvaud, Karli
- ORCID
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-06-09
- Volume
- 45
- Issue
- 7
- Pages
- 725-735
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- OpenAlex
- W3033021346
- Cited by
- 20
- References
- 45
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 3
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Pediatric Psychology (publishedVersion)
- PubMed (publishedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Health and Medical Research Council
- Centre for Research Excellence in Newborn Medicine (1060733, 1024516, 1028822)
- Career Development Fellowship (1108714, 1141354)
- Senior Research Fellowship (1081288, 1176077)
- Australian Government Research Training Program Scholarship
- Victorian Government’s Operational Infrastructure Support Program
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Keywords
- paternal mental health, depressive symptoms, anxiety symptoms, symptom trajectories, parental behavior, postpartum depression, postpartum anxiety, longitudinal trajectories, Emotional Availability Scales, preterm birth
- MeSH terms
- Anxiety, Depression, Fathers, Female, Humans, Infant, Infant, Newborn, Male, Mental Health, Mothers, Parent-Child Relations, Paternal Behavior, Pregnancy, Parenting, Infant, Very Low Birth Weight, Premature Birth
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