A study of the relationship between paternal mental health, maternal factors and impact on paternal-fetal attachment: a longitudinal study

Abstract

The present study aims at determining the prevalence of paternal mental health problems including paternal anxiety, depression, perceived stress, psychosomatic symptoms and fatigue and identifying risk factors across early pregnancy, late pregnancy and six week postpartum in Hong Kong and to fill the gap on the impact of paternal mental health problems on paternal-fetal attachment. 622 expectant fathers were recruited from regional hospitals in early pregnancy and were followed up at 36 gestational weeks and six weeks postpartum. Risk factors examined included demographic (age, family income and education level), psychosocial (unplanned pregnancy, marital dissatisfaction, poor self-esteem, poor social support, work family conflict) and maternal-related (partners’ depression and anxiety) risk factors. The risk factors, the outcome variables including paternal anxiety, depression, perceived stress, psychosomatic symptoms, fatigue and paternal-fetal attachment were assessed using standardized and validated psychological instruments. Findings showed that a significant proportion of expectant fathers manifested anxiety, and depressive symptoms, high level of perceived stress, psychosomatic symptoms and fatigue during the perinatal period. Low family income was associated with paternal psychological distress including anxiety, depression and perceived stress and higher occurrence of psychosomatic symptoms. Psychosocial risk factors were consistently associated with poor mental health outcomes in different time points. Unplanned pregnancy predicted higher level of paternal depression in late pregnancy and perceived stress in early pregnancy. Maternal depression and anxiety were predictors of paternal psychological distress, psychosomatic symptoms and fatigue severity. Findings also showed that paternal mental health problems had a detrimental effect on paternal-fetal bonding across perinatal periods. The present study indicates that paternal mental health problems is highly prevalent and Is related to maternal well-being and paternal-fetal attachments and therefore needs greater research and clinical attention. The results contributed to the theoretical understanding of risk factors, paternal mental health and paternal fetal attachment and have important implications for the design of clinical strategies against these clinical problems.