Significant paternal symptoms of depression and trauma following poor fetal, neonatal, and maternal outcomes

1. High paternal rates of distress seen in fathers exposed to poor fetal, neonatal and maternal outcomes

2. Support systems in place for these fathers may help prevent poor mental health outcomes

Evidence Rating Level: 3 (Average)

The impacts of traumatic perinatal events are well described in mothers, however limited research has been done on the psychological consequences in fathers, and paternal stress reactions have not been extensively studied. Fathers who experience traumatic events such as fetal loss may experience post-traumatic stress symptoms (PTSS); after a fetal loss, previous studies have found up to 16% of fathers developing post-traumatic stress disorder in a subsequent pregnancy. This prospective study included 28 fathers whose partners had experienced a pregnancy or childbirth complicated significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the NICU or special care nursery or significant maternal morbidity, such as a life-threatening postpartum haemorrhage or an emergency postpartum hysterectomy.  The participants were then screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Event Scale-revised (IES-R) was used to assess the distress in response to trauma. Scales were administered 2-3 weeks (timepoint 1) and then 3-4 months after the event, and those who had high scores were offered immediate mental health referrals. 14 of the 28 fathers suffered fetal loss. 59.3% of fathers had overall high EPDS at timeline 1 and in 40% of fathers at timeline 2. None of the fathers who had low EPDS and IES-R scores at timepoint 1 had high scores at timepoint 2, but it is to be noted that some fathers developed worsening of previously high scores. A strong correlation between IES-R and EPDS scores were seen at both timepoints (timepoint 1: ρ = 0.787, p<0.001; timepoint 2: ρ = 0.859, p<0.001). Although this study was small in sample size, it does indicate that fathers with traumatic perinatal experiences may have high levels of distress. Future studies should identify appropriate support systems and screening systems for men who experience adverse perinatal outcomes, as well as long term mental health consequences. 

Click to read the study in BMC Pregnancy and Childbirth

Image: PD

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