Citation

Yogman MW. Pediatrics 2021; 148(2): e2021-051136.

Copyright

(Copyright © 2021, American Academy of Pediatrics)

DOI

10.1542/peds.2021-051136

PMID

unavailable

Abstract

In this issue of Pediatrics, Garfield et al1 present new findings on depression symptoms among mothers and fathers who are parents of preterm infants during the NICU stay and the 30 days after discharge from the hospital. The data reveal that when preterm infants are hospitalized in the NICU, mothers are initially more depressed than fathers (higher scores on Edinburgh Postpartum Depression Scale), but maternal scores have decreased 30 days after discharge in contrast to paternal scores.1 With this study, the authors contribute to a growing literature on the importance of paternal postpartum depression better referred to as paternal perinatal affective disorder (PPAD),2 which encompasses both pre- and postnatal anxiety and depression. Whereas maternal postpartum depression (PPD) is increasingly recognized, PPAD is underscreened, underdiagnosed, and undertreated despite a prevalence of 8% to 20% in some surveys.2-4 Moreover, data suggest PPAD has adverse effects on mothers, their children, and the parental relationship.4,5 Risk factors include adverse childhood experiences,6 previous history of affective disorder, comorbid maternal PPD, unemployment, and low socioeconomic status, among others.4,5 PPAD peaks at 6 months postpartum, continues through 12 months postpartum, and may approach prevalence rates of 20% when preterm infants are less than 32 weeks' gestational age and 40% when nonresident fathers are included in surveys.7

Our improved understanding of the impact of safe, stable, nurturing relationships in buffering toxic stress makes the management of PPAD critically important for pediatricians. Recent studies of paternal grief8 highlight the presence of a term called "toxic masculinity,"9 whereby fathers are less likely to report sadness and weepiness and more likely to discourage breastfeeding and to demonstrate externalizing symptoms such as anger, irritability, substance use, and domestic violence.2 Although the Edinburgh Postpartum Depression Scale used in this study has been validated for fathers as well as for mothers, researchers are studying alternate screens that may better capture the symptoms with which fathers present. The Gotland scale is one such screen that attempts to capture the broader range of paternal symptoms of PPAD...

Language: en