Association between paternal perinatal depression and internalizing and externalizing problems in children and adolescents: A meta-analysis

Background: Recently, there has been a growing interest in perinatal psychological problems, especially paternal perinatal depression (PPND). However, while many studies have confirmed that PPND has a significant impact on internalizing and externalizing problems in children and adolescents, there are still some studies that have not found a clear association. This highlights the need for a comprehensive synthesis of existing evidence to clarify the relationship. Method: We conducted a systematic literature search across four major databases (PubMed, Cochrane Library, Web of Science, and Embase), without language restrictions, to identify studies examining the association between PPND and internalizing and externalizing problems. Effect sizes for all outcomes were odds ratios (ORs) and 95 % confidence intervals (CIs). Result: A total of 12,515 articles were identified in the preliminary electronic search, and we finally included 18 eligible articles. All subjects included in the study were 0-18 years of age. Children and adolescents exposed to paternal prenatal depression are more likely to have internalizing (OR: 1.11, 95 % CI [1.06, 1.17]) and externalizing problems (OR: 1.13, 95 % CI [1.07, 1.18]) than children and adolescents not exposed. Meanwhile, children and adolescents exposed to paternal postnatal depression are more likely to have internalizing (OR: 1.06, 95 % CI [1.02, 1.09]) and externalizing problems (OR: 1.15, 95 % CI [1.06, 1.24]) than children and adolescents not exposed. Conclusion: Our findings underscore the significant impact of PPND on the psychological well-being of children and adolescents. In the future, enhancing paternal mental health screening, early intervention, and long-term follow-up.