Father's Mental Health During Pregnancy Affects His Child's Early Life Behavioral and Emotional Difficulties

A new study shows that higher levels of emotional distress in expectant fathers are associated with higher levels of emotional and behavioral problems in children during their early years. This adds to previous evidence that it's not only the mother's diet that matters. The father's in the weeks and months before conception can impact the future health of his child through the process of epigenetics.

Dad's Distress May Make for Troubled Toddler

By Cole Petrochko, Staff Writer, MedPage Today

• Published: January 07, 2013
• Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

Action Points

• An expectant father's mental health problems may be linked to his child's behavioral and emotional difficulties early in life.
• Point out that higher levels of emotional distress in expectant fathers were associated with higher levels of emotional and behavioral problems in children.

An expectant father's mental health problems may be linked to his child's behavioral and emotional difficulties early in life, researchers found.

A Norwegian cohort found paternal psychological distress was associated with a small but positive risk of a child developing behavioral difficulties (P=0.02), emotional difficulties (P< 0.001), and impaired social functioning at age 36 months (P=0.007), according to Anne Lise Kvalevaag, PhD candidate, of Helse Fonna HF in Haugesund, Norway, and colleagues.

Higher levels of emotional distress in expectant fathers were associated with higher levels of emotional and behavioral problems in children, they wrote online in Pediatrics.

Earlier research has found ties between psychiatric disorders in mothers and "increased risk of socioemotional and behavioral problems in their children," the authors noted.

"The current study demonstrates that there is a consistent positive predictive association between fathers' parental mental health status and their children's socioemotional and behavioral development at 36 months of age," they concluded. "The findings are of importance for clinicians and policymakers in their planning of healthcare in the perinatal period because this represents a significant opportunity for preventive intervention."

The researchers examined associations between paternal mental health and children's socioemotional and behavioral development through a prospective, population-based cohort of 31,663 kids in the Norwegian Mother and Child Cohort Study.

Fathers' mental health information was acquired through the self-reported Hopkins Symptoms Checklist (SCL-5) at weeks 17 or 18 of gestation. SCL-5 is an indicator of level of global mental distress, mainly symptoms of anxiety and depression, and the cutoff point for SCL-5 is 2.00, they authors explained.

Data on the child's emotional and behavioral development -- as well as the mother's pre- and postnatal mental health -- were taken at 36 months after birth. Maternal mental health was evaluated through the same questionnaire fathers filled out. Child development was evaluated through three parental-response questionnaires on mental health, socioemotional problems, and behavior.

The mean SCL-5 score for the fathers was 1.13. Three percent of the fathers had a score above the cutoff of 2.00.

In a crude analysis with behavioral difficulties as the dependent variable, paternal psychological distress was significantly associated with a child's behavioral (odds ratio 1.28, 95% CI 1.04 to 1.58) and emotional difficulties (OR 1.65, 95% CI 1.36 to 2.00) at age 36 months, as well as social functioning (OR 1.32, 95% CI 1.08 to 1.62).

This association persisted after adjustment for age, education, marital status, somatic conditions, alcohol and tobacco use, physical activity, and maternal mental health.

When the model was fully adjusted, associations between behavioral difficulties and father's distress lost significance (OR 1.13, 95% CI 0.91 to 1.40, P=0.3), though the other associations remained significant.

The authors noted "a number of possible mechanisms could account for this association" including a prenatal genetic effect of paternal psychological distress, negative outcomes of depression on mothers resulting in negative outcomes for the child, and prenatal health predicting postnatal health, which "may account for some of the associations seen."

The authors noted several limitations with their study. The cohort had a 38.5% participation rate, which could have resulted in selection bias. Additionally, survey answers were self-reported and can be affected by rater bias.

The Norwegian Mother and Child Cohort Study is supported by grants from the Norwegian Ministry of Health and the Ministry of Education and Research, the NIH's National Institute of Environmental Health Sciences and the National Institute of Neurological Disorders and Stroke, and the Norwegian Research Council/Functional Genomics in Norway.

The authors declared no conflicts of interest.

Source reference:
Kvalevaag AL, et al. (2013). Paternal mental health and socioemotional and behavioral development in their children. Pediatrics; DOI: 10.1542/peds.2012-0804.