title: Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis.
abstract: BACKGROUND
  Perinatal distress is a significant public health problem that adversely impacts the individual and their family. The primary objective of this systematic review and meta-analysis was to identify factors that partners can modify to protect each other from developing perinatal depression and anxiety.
  
  
  METHODS
  In accordance with the PRISMA statement, we reviewed the risk and protective factors associated with perinatal depression and anxiety symptoms that partners can potentially modify without professional assistance (PROSPERO reference CRD42014007524). Participants were new or expectant parents aged 16 years or older. The partner factors were sub-grouped into themes (e.g., instrumental support) based on a content analysis of the scale items and measure descriptions. A series of meta-analyses were conducted to estimate the pooled effect sizes of associations.
  
  
  RESULTS
  We included 120 publications, reporting 245 associations with depression and 44 with anxiety. Partner factors with sound evidence that they protect against both perinatal depression and anxiety are: emotional closeness and global support. Partner factors with a sound evidence base for depression only are communication, conflict, emotional and instrumental support, and relationship satisfaction.
  
  
  CONCLUSIONS
  This review is limited by the lack of generalizability to single parents and the inability to systematically review moderators and mediators, or control for baseline symptoms.
  
  
  CONCLUSIONS
  The findings suggest that future prevention programs targeting perinatal depression and anxiety should aim to enhance relationship satisfaction, communication, and emotional closeness, facilitate instrumental and emotional support, and minimize conflict between partners.
authors.affiliation: School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia. Electronic address: pam.pilkington@acu.edu.au.
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Pilkington
authors.affiliation: School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Milne
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Australia.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Cairns
authors.affiliation: School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Lewis
authors.affiliation: School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Whelan
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control*; D001008:Anxiety Disorders / Q000209:etiology / Q000517:prevention & control*; D003142:Communication; D003220:Conflict, Psychological; D019052:Depression, Postpartum / Q000209:etiology / Q000517:prevention & control*; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010290:Parents / Q000523:psychology*; D010549:Personal Satisfaction; D011247:Pregnancy; D058028:Research Report / Q000592:standards; D018570:Risk Assessment; D012307:Risk Factors; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology; D055815:Young Adult
keywords: Anxiety; Depression; Meta-analysis; Partner; Perinatal