Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis.
BACKGROUND
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.


METHODS
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.


METHODS
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 were excluded.


METHODS
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.


RESULTS
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.
Paulson
James F
JF
Department of Pediatrics, Eastern Virginia Medical School, E. V. Williams Hall, 855 W Brambleton Ave, Norfolk, VA 23510, USA. paulsojf@evms.edu
Bazemore
Sharnail D
SD
D003863:Depression / Q000453:epidemiology*; D019052:Depression, Postpartum / Q000453:epidemiology*; D005220:Fathers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D011264:Pregnancy Trimesters; D015995:Prevalence; D012307:Risk Factors