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Clinicians should be aware that often enough, perinatal depression occurs simultaneously in both mothers and fathers, according to a systematic review and meta-analysis.

In the pooled analysis of 23 studies involving nearly 30,000 couples, antenatal depression occurred in both of the expectant parents 1.72% of the time (95% CI 0.96-2.48, P<0.001), reported Kara Smythe, MD, MSc, of University College London in England, and colleagues.

Early postnatal depression occurred concurrently in new mothers and fathers 2.37% of the time (95% CI 1.66-3.08, P<0.001), while late postnatal depression was prevalent in 3.18% of couples (95% CI 2.30-4.05, P<0.001).

"This has consequences for the individual's health and well-being, their ability to parent their child, as well as the mental and physical health of their children," the group wrote in . "Parental perinatal mood disorders also increase relationship discord and risk of separation."

Evidence suggests "that a healthy father-child relationship can mitigate against poorer child outcomes in cases of maternal depression," Smythe's team noted, and vice versa in cases of paternal depression.

"However, when both parents are depressed, this buffering effect is lost, further increasing the risk for poor mental and physical health outcomes for their child," the group wrote. "Awareness of the coexistence of common mental health disorders in both members of a parental dyad allows for a paradigm shift in the provision of perinatal care."

Writing in an , Susan Garthus-Niegel, PhD, of MSH Medical School Hamburg in Germany, and coauthors noted that "maternal depression, anxiety, or [post-traumatic stress disorder] symptoms may negatively impact birth and breastfeeding outcomes and increase the risk for emotional or behavioral problems, symptoms of attention deficit hyperactivity disorder, or impaired cognitive development in the child."

They also highlighted how paternal perinatal mental health has received "fairly little attention" from both researchers and clinicians. "Similar to (expectant) mothers, (expectant) fathers also have an elevated risk of depression and anxiety disorders and PTSD during the perinatal period," Garthus-Niegel and coauthors wrote. "Indeed, perinatal depression is reported by approximately 8% to 10% of fathers."

The meta-analysis from Smythe's group included 23 cohort and cross-sectional studies based on a literature search from 1990 to 2021, which included 29,286 couples in total.

The studies were conducted in 15 mostly high-income countries. Six of the studies examined antenatal parental depression and included 1,210 couples; 18 assessed early (0-12 weeks) postnatal parental depression and included 20,229 couples, and five studies assessed late (3-12 months) postnatal depression, with 9,493 couples.

Various methods were used for examining mental health and mood disorders, including the Edinburgh Postnatal Depression Scale (EPDS) most commonly, the Beck Depression Inventory (Second Edition), the Center for Epidemiologic Studies Depression Scale, and the General Health Questionnaire. (A , published in conjunction with the current meta-analysis, evaluated 10 different patient-reported outcome measures for maternal postpartum depression and suggested EPDS to be the best available option.)

Limitations of the meta-analysis included a lack of information on perinatal anxiety involving both parents, which the researchers had attempted to examine, and most of the studies included were cross-sectional in design. The inclusion of mostly studies conducted in high-income countries also limits the generalizability.

"Despite the large body of research on maternal perinatal mental health, most studies are conducted in samples of white, highly educated women, of middle to high socioeconomic background, and with planned or wanted singleton pregnancy," Garthus-Niegel's group pointed out.

Beyond the need to study perinatal outcomes for parents living in low- and middle-income nations, the editorialists also highlighted the need for research involving "teenage pregnancy, single motherhood, multiple pregnancies, adoption, and so forth."

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