James F. Paulson, PhD; Sharnail D. Bazemore, MS
Context It is well established that maternal prenatal and
postpartum depression is prevalent and has negative personal, family,
and child developmental outcomes. Paternal depression during this
period may have similar characteristics, but data are based on an
emerging and currently inconsistent literature.
Objective To describe point estimates and variability in
rates of paternal prenatal and postpartum depression over time and its
association with maternal depression.
Data Sources Studies that documented depression in fathers
between the first trimester and the first postpartum year were
identified through MEDLINE, PsycINFO, EMBASE, Google Scholar,
dissertation abstracts, and reference lists for the period between
January 1980 and October 2009.
Study Selection Studies that reported identified cases
within the selected time frame were included, yielding a total of 43
studies involving 28 004 participants after duplicate reports and data
Data Extraction Information on rates of paternal and
maternal depression, as well as reported paternal-maternal depressive
correlations, was extracted independently by 2 raters. Effect sizes
were calculated using logits, which were back-transformed and reported
as proportions. Random-effects models of event rates were used because
of significant heterogeneity. Moderator analyses included timing,
measurement method, and study location. Study quality ratings were
calculated and used for sensitivity analysis. Publication bias was
evaluated with funnel plots and the Egger method.
Data Synthesis Substantial heterogeneity was observed among
rates of paternal depression, with a meta-estimate of 10.4% (95%
confidence interval [CI], 8.5%-12.7%). Higher rates of depression were
reported during the 3- to 6-month postpartum period (25.6%; 95% CI,
17.3%-36.1%). The correlation between paternal and maternal depression
was positive and moderate in size (r = 0.308; 95% CI, 0.228-0.384). No
evidence of significant publication bias was detected.
Conclusions Prenatal and postpartum depression was evident
in about 10% of men in the reviewed studies and was relatively higher
in the 3- to 6-month postpartum period. Paternal depression also
showed a moderate positive correlation with maternal depression.
Author Affiliations: Department of Pediatrics, Eastern Virginia
Medical School, Norfolk.
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