Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety.

Abstract

While it is established that preterm birth (PB) increases the risk of psychological distress in fathers postpartum, the impact of a threatened PB on peripartum depressive and anxiety symptoms, as well as their course over time, remains insufficiently studied. We assessed 116 men during their partner's pregnancy (T1) and 6 weeks postpartum (T2), using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety-Depression Inventory. Participants were categorized into a control group (CG) with term birth and two risk groups based on PB occurrence: 33 men with partners at risk of PB who had a term birth (RG-TB), and 38 men with partners at risk of PB who experienced a PB (RG-PB). Psychological distress was analyzed using multi-sample latent growth curve modeling. During pregnancy, psychological distress varied across groups: fathers in the RG-PB had elevated levels of depression and anxiety compared to the CG, while the RG-TB presented only weak evidence of heightened depressive but not anxiety symptoms. Notably, both risk groups had higher rates of elevated depressive symptoms than the CG. Postpartum, depressive symptoms did not differ between groups. However, fathers in the RG-PB had higher anxiety scores than fathers in the CG. Although trajectory analyses revealed no distinct group-specific patterns, the RG-TB consistently showed intermediate levels of distress between RG-PB and CG. Threatened PB is associated with increased prenatal psychological distress in fathers, regardless of birth outcome. The combination of threatened and actual PB is linked to persistently elevated anxiety symptoms postpartum. Threatened PB identifies fathers at risk for psychological distress, warranting antenatal and follow-up screening, particularly due to persistent anxiety after PB. Fathers experiencing threatened PB followed by term birth remain vulnerable, as antenatal and postpartum emotional distress suggest the need for continued postpartum screening. ClinicalTrials.gov: NCT01974531.