Parents of infants admitted to the neonatal intensive care unit (NICU) face a number of challenges, including mental health, when navigating care for their infant. It is well-documented that mothers of premature infants are at much higher risk of postpartum depression (PPD) compared to mothers of term infants, rates of which decrease over time.1-4 However, what is the risk of depressive symptoms in fathers of premature infants, and how does it progress over time?
To answer that question, Pediatrics has early released an article this month entitled, “Maternal and Paternal Depression Symptoms During NICU Stay and Transition Home” (10.1542/peds.2020-042747). Craig F. Garfield, MD, MAPP and his colleagues at Ann and Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine examined the trajectory of depression symptoms among 431 mothers and fathers of premature infants using the Edinburgh Postnatal Depression Scale at several timepoints from NICU admission to thirty days post NICU discharge. The authors found that while mothers were initially more depressed than fathers, they showed improvement in depression symptoms over time, while fathers stayed the same. Furthermore, screening during the NICU stay had improved 30-day depressive symptom predictions.
So, what does this mean for neonatologists and for outpatient pediatricians? To answer that question, we invited Dr. Michael W. Yogman from Harvard Medical School’s Cambridge Hospital, an expert and advocate for the father-infant relationship, to share his thoughts in the accompanying commentary (10.1542/peds.2021-051136). Dr. Yogman calls neonatologists to action to identify the potential for depressive symptoms in mothers and fathers in the NICU and to provide interventions and coordinate follow up after discharge; additionally, he calls pediatricians to action to screen fathers at the 4-month through the 12-month well visit for depressive symptoms. From a policy perspective, Dr. Yogman recommends advocating for paternal family leave and the development of a pediatric workforce with expertise in paternal mental health.
Both this study and the commentary highlight the importance of addressing an “underscreened, underdiagnosed, and undertreated” condition in fathers of premature infants, in addition to the need for future research. I look forward to future articles on this topic.
- Vigod SN, Villegas L, Dennis CL, Ross LE. Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology.2010;117(5):540-550.
- O'Brien M, Asay JH, McCluskey-Fawcett K. Family functioning and maternal depression following premature birth. Journal of Reproductive & Infant Psychology. 1999;17(2):175.
- Morawski Mew A, Holditch-Davis D, Belyea M, Shandor Miles M, Fishel A. Correlates of Depressive Symptoms in Mothers of Preterm Infants. Neonatal Network. (5):51-60.
- Pace CC, Spittle AJ, Molesworth CML, et al. Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period. JAMA Pediatrics. 2016;170(9):863-870.