The Fathers' Fear of Childbirth Scale: a Turkish validity and reliability study

PURPOSE

Fathers' Fear of Childbirth Scale (FFCS) was developed specifically to measure fathers' fear of childbirth. The aim of this study was to investigate the Turkish validity and reliability of the FFCS.

DESIGN

This study used a cross-sectional and methodological design.

METHODS

The population of the study consists of 315 pregnant spouses who were registered at a hospital in Ankara, Turkey, between August 11 and 5 November 2021. The mean age of expectant fathers are 31.57 (5.88). After translating the FFCS to Turkish, a confirmatory factor analysis was conducted to examine its construct validity. Concurrent validity was established by examining the correlation between the FFCS-Turkish with the Fear of Birth Scale (FOBS) and the male version of the Childbirth Fear-Prior to Pregnancy scale (M-CFPP). Both internal consistency and test-retest reliability were examined for the FFCS-Turkish. Results: The scope validity index of the scale was found to be 0.96. Based on the results of confirmatory factor analysis, a two-factor structure with 17 items was verified. The fit indices were found to be χ2 = 309.610, χ2/df = 2.76, root mean square error = 0.075, goodness of fit index = 0.89, comparative fit index = 0.93, and adjusted goodness of fit index = 0.86. All fit indices were at good levels. A strong correlation was found between the FFCS and the FOBS and M-CFPP scales within the scope of concurrent validity. Cronbach's alpha reliability coefficient for the entire scale was 0.93. The test-retest reliability was also high.

CONCLUSIONS

The FFCS is a valid and reliable scale and measurement tool that can be used on Turkish expectant fathers.

Fathers' needs of breastfeeding support: Perspective of health nurses

PURPOSE

To explore the improvement of health education on father's participation in breastfeeding from the perspective of maternal and child health nurses.

METHODS

Qualitative phenomenological research was used, and 15 maternal and child health nurses who provided breastfeeding support were invited. With semi-structured deep interviews and on-site recordings, data were analyzed through content analysis.

RESULTS

Four main themes were extracted, including 'cultivating fathers' awareness of participation in breastfeeding', 'collaboration of multiple disciplines to improve health education on breastfeeding for fathers in hospital', 'Simulated scenarios to develop fathers' skills in solving breastfeeding problems', and 'establishing a hospital-community interface network to improve breastfeeding continuation care after hospital discharge'.

CONCLUSIONS

Medical and health care departments should attach importance to guidance on health education for fathers' breastfeeding participation, cultivate fathers' awareness of participation in breastfeeding, provide multi-disciplinary collaboration-based health education on breastfeeding for fathers from the prenatal period and improve post-discharge health education on breastfeeding. The additional education being suggested would contribute to fathers being able to play an important role in breastfeeding.

Taiwanese fathers' experiences of caring for their children during childhood cancer treatment

PURPOSE

Parents must manage their own stress and help their child with cancer during the treatment process, both physically and emotionally. With the increased involvement of fathers in caring for the family, how fathers adjust to the stress and play a role in care responsibilities is unknown. This study aimed to explore the fathers' experiences of caring for their ill child during the cancer diagnosis and treatment process.

METHOD

This study adopted a qualitative descriptive design and conducted in-depth interviews with 21 fathers with a diagnosed child recruited from a northern Taiwan medical center. Data were managed and analysed using content analysis.

RESULTS

Two main categories in the Taiwanese fathers' experiences of caring for their ill child during the cancer diagnosis and treatment process emerged: 1) the maintainer of family stability, and 2) thoughts and value adjustment. Each main category consists of 3-4 generic categories. They make the necessary adjustments between work and family, actively participate in caring for the entire family, and redefine family values. They convey information about the illness to their children, pay attention to the physical and psychological development of the child with cancer, and cherish the time spent together as a family.

CONCLUSIONS

During the cancer treatment process, fathers play the roles of the protector and maintainer of family stability and adjust their attitudes and thoughts toward the family members and family life. Healthcare professionals can offer the fathers comprehensive support and improve the family's overall well-being during this demanding period.

No 'delete' key

Assisted reproductive technology (ART) has emerged in recent years as a point of significant innovation in the medical field but is also controversial from a bioethical and legal standpoint. In the Italian context, this matter is regulated by Law 40/2004, which specifically requires that informed consent should be obtained from both members of a couple before proceeding with any ART procedure. This consent is deemed irrevocable at the moment of egg fertilization. Recently, a ruling by the Italian Constitutional Court on this matter elicited controversy. The decision permitted embryo transfer even in a case of parental separation, notwithstanding the father's explicit opposition. The Court emphasized the priority of the woman's psychophysical health over the man's, highlighting the traumatic consequences of interrupting the undertaken path. As a result, both the man's right to self-determination regarding the decision to become a father and the need for informed consent at every stage of medical procedures have been downplayed. Moreover, the extensive utilization of procedures like embryo cryopreservation, with associated parental implications, particularly concerning the time frame and the actuality of informed consent, is posing challenges to the initial application framework of Law 40/2004. The objective of this Commentary is to scrutinize and discuss the issues mentioned above.

The association of family size and birth order in adolescence to the likelihood of developing psychotic disorders in young adulthood: A follow-up study of former adolescent inpatients

This is a clinical follow-up study of 508 former adolescent psychiatric inpatients admitted to hospital between 2001 and 2006 in Northern Finland. The participants were interviewed using the K-SADS-PL and the EuropASI instruments. Until 2016, the national Finnish Care Register for Health Care provided data on psychiatric diagnoses. Using logistic regression analysis, we examined how birth order and childhood family size affected the incidence of schizophrenia spectrum disorder (SSD) and other psychotic disorders by young adulthood. Participants were separated into three diagnostic subgroups 1) participants with SSD (n = 76), 2) participants with a psychotic disorder other than SSD (n = 107) and 3) participants with only one nonpsychotic depressive episode (n = 118). The main conclusions were that large family size in adolescence (six or more children), male sex and father having psychiatric problems or being unemployed, were significantly associated with a higher likelihood of SSD among study participants. Large family size also associated to a higher likelihood of developing other psychotic disorders. Being the first born or an only child reduced the likelihood of psychotic disorders other than SSD. When diagnosing and treating children and teenagers with psychotic symptoms, information regarding their family size and sibling position may be relevant.

Missed opportunities for prenatal family-centered care during the COVID-19 pandemic: a qualitative study

BACKGROUND

The purpose of this study was to describe the impact of COVID-19 on fatherhood experiences during pregnancy.

METHODS

A semi-structured interview guide was developed to collect qualitative data from fathers about their experiences in pregnancy and prenatal care, how they communicated with providers, strategies for information seeking, and social support they received during the pregnancy. One-time, virtual interviews were conducted via Zoom with fathers that were either expecting a baby or fathers who had a baby after March 2020 and were 18 years or older. Thematic analysis was used to identify themes that highlighted the fatherhood experience.

RESULTS

In total, 34 interviews with new or expectant fathers were completed. Two central themes that highlight the experiences of fathers: missed opportunities to shift toward family-centered care and inequity in the parent dyad during pregnancy. Additional supporting themes included: limited patient-provider relationship, lack of telemedicine use, inadequate uncertainty management for parents, unidirectional information sharing between parents, and limited opportunities for achieving role attainment during pregnancy.

CONCLUSION

The COVID-19 pandemic created a decision point for prenatal care. Instead of focusing on family-centered practices, prenatal care exclusively centered on the mother and fetus, resulting in problematic experiences for fathers including limited access to information about the pregnancy and health of the mother and fetus, heightened stress related to COVID-19 safety requirements, and few opportunities to attain their role as a father. Prenatal care should actively seek robust strategies to improve family-centered care practices that will withstand the next public health emergency.

Paternal Activation as a Protective Factor against Problem Behaviors in Early Childhood

Activation parenting includes behaviors that challenge children to approach novel situations, explore their environments, and take physical and socioemotional risks through a balance of encouragement and limit-setting. Although components of activation parenting have been linked to lower levels of children's problem behaviors, comprehensive measures of activation parenting and longitudinal research on families from low socioeconomic backgrounds are lacking. The goal of the present study was to test associations between paternal activation parenting at age 3 and children's externalizing and internalizing problems at age 5 in a sample of low-income, ethnically diverse fathers. Participating fathers (N = 171; 9% Black, 47% white, 8% Latinx; mean household income = $25,145) and their children (51% female) were drawn from the Early Steps Multisite Study. Activation parenting during a teaching task at child age 3 was associated with lower levels of internalizing problems at age 5 and decreases in externalizing problems from baseline (age 2). Implications of the current findings are presented for future research on associations between activation parenting and child problem behaviors, including the potential for the development of prevention and intervention programs.

Child development education in the Neonatal Unit: Understanding parent developmental literacy needs, priorities and preferences

OBJECTIVE

To describe child development knowledge needs, priorities, and preferences for education to enhance developmental literacy among parents with children admitted to the neonatal unit (NNU).

METHODS

Two separate cohorts completed a survey; 1) Parents with children graduated from Australian NNUs (n = 316); 2) Parents with infants' inpatient at two South Australian NNUs (n = 209).

RESULTS

Parents considered it extremely important to understand child development (Graduates: 80%; Inpatients: 71%). Inpatient parents reported lower child development knowledge. Almost half (42%) of graduate parents described the child development education provided by neonatal staff as poor or inadequate. There was consistency in preferences for developmental literacy education provision. Parents desired education to commence during NNU and continue post discharge. Priorities included content specific to preterm birth and how to support child development over the first two years of life. Individualised education by a Neonatal Nurse/Midwife was most preferred.

CONCLUSION

Mothers and fathers value guidance to support their child's development during NNU admission and early childhood. Our study highlights the importance of improved early developmental literacy education for parents with children admitted to the neonatal unit.

PRACTICE IMPLICATIONS

Our findings can be used to inform the creation of future educational resources targeting improved parent developmental literacy.

Maternal and paternal emotion expression and youths' negative emotions: The moderation of resting respiratory sinus arrhythmia

OBJECTIVE

We investigated whether college students' resting Respiratory Sinus Arrhythmia (RSA) would moderate the association between parental negative dominant and submissive emotion expression and their negative emotions.

METHODS

Participants were 97 Chinese college students (28.87% male, Mage = 19.11, SD =.89). Participants reported their perceived maternal and paternal emotion expression, as well as their negative emotions. Resting RSA was assessed during a laboratory visit.

RESULTS

Parental negative dominant emotion expression was positively related to students' negative emotions. Additionally, the association between paternal negative dominant emotion expression and negative emotions was stronger among students with low (versus high) levels of resting RSA. Nonetheless, no similar association was found in maternal negative emotion expression.

CONCLUSIONS

Our findings contribute important information regarding the different roles of maternal and paternal negative emotion expression in college students' emotional outcomes, and signify the interaction between parental socialization and individual characteristics in human developmental process.

Association between parental behaviors and structural plasticity in the brain of male rodents

In recent decades, human fathers across the globe have shown a substantial increase in their engagement in paternal caregiving behaviors. Despite the growing interest, the precise neurobiological mechanisms underlying caregiving behaviors in males remain unclear. Neurobiological studies conducted on rodents have advanced our understanding of the molecular, cellular, and circuit-level mechanisms. Typically, sexually naïve males exhibit aggression toward offspring, while fathers display parental behaviors. This drastic behavioral plasticity may be associated with changes in connections among specific regions or cell types. Recent studies have begun to describe this structural plasticity by comparing neural connections before and after fatherhood. In this Perspective, we summarize the findings from four well-studied rodent species, namely prairie voles, California mice, laboratory rats, and laboratory mice, with a view toward integrating past and current progress. We then review recent advances in the understanding of structural plasticity for parental behaviors. Finally, we discuss remaining questions that require further exploration to gain a deeper understanding of the neural mechanisms underlying paternal behaviors in males, including their possible implications for the human brain.

Examining online information-seeking behaviours and antenatal anxiety of expectant fathers

This study was designed to examine online information-seeking behaviours of expectant fathers regarding pregnancy and birth and their antenatal anxiety. The present study was conducted using 120 expectant fathers who accompanied their wives to the maternity outpatient clinic in western Turkey, İzmir Province. The fathers' anxiety levels were assessed using a trait anxiety subscale of the State-Trait Anxiety Inventory (STAI), which is a validated test for scoring trait anxiety (basal anxiety, STAI-T). The results showed that 92.5% of the expectant fathers searched for information online during pregnancy. They most frequently searched for the following topics: foetal development, complications to pregnancy and nutrition. The mean total trait anxiety scale score of the expectant fathers was 47.35 ± 6.98 (range = 31-62). The anxiety scores of the expectant fathers who searched for information on topics related to vaccination during pregnancy, exercise, antenatal tests, labour pain and childbirth signs were high. Health professionals should consider the information needs and concerns of expectant fathers during pregnancy while providing family-centred care.

[Fathers, patients in mother and baby unit? Thinking about family-based approach in perinatal care]

BACKGROUND

The perinatal period is a psychic risk for fathers because of multiple overhauls. Fathers' place in perinatal medicine has evolved these last few years but continues to be poorly limited. These psychic difficulties are barely investigated and diagnosed in everyday medical practice. The prevalence of depressive episodes by new fathers was high in the most recent research studies. This thus is a public health problem with consequences on the family system both in the short and the long-term.

REVIEW

In the mother and baby unit, the father's psychiatric care is often secondary. But with societal modifications, there is the question of impact of separation between the father and the mother and the baby. With the family based approach, care by the father is indispensable for the care of the mother, baby, and the family's as a whole.

OBJECTIVE

In our mother and baby unit located in Paris, fathers were also hospitalized as patients. Therefore difficulties in the familial dynamic, between each member of the triad and mental health difficulties of fathers were able to be treated.

CONCLUSION

Following the hospitalization of a few triads with a positive evolution, a reflection process is now in progress.

Paternal bonding in pregnancy and early parenthood: a qualitative study in first-time fathers

The birth of an infant marks a period of profound change in first-time parents. Parental love and warmth, however, already begin to develop during pregnancy. Also for fathers, the development of bonding to the infant may be a unique process. The current qualitative study aimed to explore views and experiences of first-time fathers on the origins and development of paternal bonding during pregnancy and early childhood. In total, 30 in-depth semi-structured interviews were conducted with expectant fathers (second or third trimester of pregnancy; n = 10) and fathers of infants (0-6 months postpartum; n = 11) and toddlers (2-3 years of age; n = 9). Two major themes were uncovered from the data: feelings of bonding and facilitators of bonding. The first theme was supported with three subthemes: 1) from abstract to concrete, 2) positive emotions, and 3) uncertainties and worries. The second theme, facilitators of bonding, was supported with four subthemes: 1) experiencing the foetus, 2) meeting the child, 3) interaction, and 4) communication. Similar to previous studies, our results suggested that, in most fathers, paternal bonding originates in pregnancy and that it evolves over time. Seeing or feeling the child, both during pregnancy and postpartum, as well as interacting or communicating with the child, appears to facilitate fathers' feelings of bonding. Involving fathers in pregnancy, childbirth, and parenting may be essential for their bonding process.

Association between gestational levels of toxic metals and essential elements and cerebral palsy in children

Introduction

Cerebral palsy (CP) is the most common motor disability in childhood, but its causes are only partly known. Early-life exposure to toxic metals and inadequate or excess amounts of essential elements can adversely affect brain and nervous system development. However, little is still known about these as perinatal risk factors for CP. This study aims to investigate the associations between second trimester maternal blood levels of toxic metals, essential elements, and mixtures thereof, with CP diagnoses in children.

Methods

In a large, population-based prospective birth cohort (The Norwegian Mother, Father, and Child Cohort Study), children with CP diagnoses were identified through The Norwegian Patient Registry and Cerebral Palsy Registry of Norway. One hundred forty-four children with CP and 1,082 controls were included. The relationship between maternal blood concentrations of five toxic metals and six essential elements and CP diagnoses were investigated using mixture approaches: elastic net with stability selection to identify important metals/elements in the mixture in relation to CP; then logistic regressions of the selected metals/elements to estimate odds ratio (OR) of CP and two-way interactions among metals/elements and with child sex and maternal education. Finally, the joint effects of the mixtures on CP diagnoses were estimated using quantile-based g-computation analyses.

Results

The essential elements manganese and copper, as well as the toxic metal Hg, were the most important in relation to CP. Elevated maternal levels of copper (OR = 1.40) and manganese (OR = 1.20) were associated with increased risk of CP, while Hg levels were, counterintuitively, inversely related to CP. Metal/element interactions that were associated with CP were observed, and that sex and maternal education influenced the relationships between metals/elements and CP. In the joint mixture approach no significant association between the mixture of metals/elements and CP (OR = 1.00, 95% CI = [0.67, 1.50]) was identified.

Conclusion

Using mixture approaches, elevated levels of copper and manganese measured in maternal blood during the second trimester could be related to increased risk of CP in children. The inverse associations between maternal Hg and CP could reflect Hg as a marker of maternal fish intake and thus nutrients beneficial for foetal brain development.

The impact of paternal mental illness on child development: an umbrella review of systematic reviews and meta-analyses

Whilst there is growing evidence highlighting the importance of paternal mental illness (PMI) on child development, this relationship still remains under-studied and often over-looked. Considering the increasingly active role of fathers in their children's upbringing, a comprehensive overview of the impact of PMI on child development is overdue. This study aimed to combine and synthesise currently available evidence on the relationship between PMI and multiple domains of child development. Narrative synthesis of systematic reviews and meta-analyses on the relationship between PMI and child development (mental health and social, emotional, language, cognitive or adaptive behaviour), published between 1980 to December 2021, was conducted in line with PRISMA 2020 guidelines. Review quality was assessed based on AMSTAR-2 criteria and respective study confidence was interpreted in line with GRADE scoring. All relevant meta-analytic effect sizes were converted to odds ratios (OR) and grouped using a random effects model. Grouped meta-analyses saw PMI to have a significant, detrimental effect on all studied domains of child development [OR: 1.54; 95% CI (1.36-1.74)]. Subgroup analyses saw PMI affecting both internalising [OR: 1.62; 95% CI (1.27-2.08)] and externalising [OR: 1.63; 95% CI (1.28-2.08)] child behaviours to a similar extent. However, included reviews were of poor methodological quality, demonstrating either low or critically low confidence. These results show a consistent and influential effect of PMI on child development. The relationship between fathers' mental illness and child development warrants further investigation, as current research is limited in scope, particularly regarding cognitive domains of child development and non-affective PMI diagnoses.

Paternal Medications in Inflammatory Bowel Disease and Male Fertility and Reproductive Outcomes: A Systematic Review and Meta-analysis

BACKGROUND & AIMS

Studies evaluating reproductive outcomes among male patients with inflammatory bowel disease (IBD) are limited. We evaluated use of IBD medications and association with semen parameters, a proxy of male fertility, and adverse pregnancy outcomes (early pregnancy loss [EPL], preterm birth [PB], congenital malformations [CM]).

METHODS

We searched Medline, Embase, Scopus, and Web of Science (PROSPERO CRD42020197098) from inception to April 2022 for studies reporting semen parameters and adverse pregnancy outcomes among male patients exposed to biologics, thiopurine, or methotrexate. Standardized mean difference, prevalence, and odds ratios (ORs) of outcomes were pooled and analyzed using a random effects model.

RESULTS

Ten studies reporting semen parameters (268 patients with IBD) and 16 studies reporting adverse pregnancy outcomes (over 25,000 patients with IBD) were included. Biologic, thiopurine, or methotrexate use were not associated with decreased sperm count, motility, or abnormal morphology compared with nonexposed patients. The prevalence of adverse pregnancy outcomes with paternal biologic (5%), thiopurine (6%), or methotrexate (6%) exposure was comparable to nonexposed patients (5%). Biologic use was not associated with risk of EPL (OR, 1.26; I2 = 0%; P = .12), PB (OR, 1.10; I2 = 0%; P = .17), or CM (OR, 1.03; I2 = 0%; P = .69). Thiopurine use was not associated with risk of EPL (OR, 1.31; I2 = 19%; P = .17), PB (OR, 1.05; I2 = 0%; P = .20), or CM (OR, 1.07; I2 = 7%; P = .34). Methotrexate use was not associated with risk of PB (OR, 1.06; I2 = 0%; P = .62) or CM (OR, 1.03; I2 = 0%; P = .81).

CONCLUSIONS

Biologic, thiopurine, or methotrexate use among male patients with IBD are not associated with impairments in fertility or with increased odds of adverse pregnancy outcomes.

Breastfeeding and presence of the companion of woman's choice during COVID-19 pandemic in Italy: regional population-based routine data and best practices at birth

OBJECTIVES

to describe the monthly trend of breastfeeding during hospitalization and the presence of companion of woman's choice during labour and birth, and the key regional responders' perspective of homogeneity/heterogeneity of the presence of the support person, before, during (February-May 2020), and after the first COVID-19 pandemic wave in a few Italian Regions.

DESIGN

two-phase study.

SETTING AND PARTICIPANTS

data from the italian birth certificate of six Italian Regions between 01.01.2019 and 31.03.2021 were analysed. Semi-structured interviews were conducted with the key regional respondents.

MAIN OUTCOME MEASURES

the frequency distributions of breastfeeding and the presence of companion of woman's choice were calculated as a whole and for each Region.

RESULTS

the infant feeding practices experienced smaller changes during COVID-19 pandemic than the presence of the companion of woman's choice during labour and birth, from January 2019 to March 2021. The highest value of exclusive breastfeeding was recorded in September 2020 (72.1%; 95%CI 71.3-72.8) in all Regions, while the lowest was recorded in March 2021 (62.5%; 95%CI 61.5-63.4). The presence of companion of woman's choice during labour and birth decreased during the pandemic and did not return to pre-pandemic levels. The highest value of presence of father during birth was recorded in March 2019 (59.0%; 95%CI 58.2-59.8), while the lowest in April 2020 (50.0%; 95%CI 49.1-50.8). The main emerging themes were: the existence of national, regional and local indications; the facilitators (e.g., Baby-Friendly Hospital Initiative implementation, strong motivation of the staff) and the critical points (e.g., inadequate analysis of the clinical-epidemiological context, inhomogeneous indications) of management of the support person presence.

CONCLUSIONS

the emergency has changed the provision of health services that not always guaranteed the application of best practices. It would be desirable to work for assessing the appropriateness of the birth certificate data to collect more accurate information and to provide clinical recommendations.

The experience of being a partner to a childbearing woman whose pregnancy is complicated by pre-eclampsia: A Swedish qualitative study

BACKGROUND

Pre-eclampsia affects 3-5% of all pregnant women and is among the leading causes of maternal morbidity and mortality as well as iatrogenic preterm birth worldwide. Little is known about the experience of partners of women whose pregnancy is complicated by pre-eclampsia.

AIM

To describe partners' experience of having a spouse whose pregnancy was complicated by pre-eclampsia.

METHODS

A qualitative study with in-depth interviews. Eight partners of women whose pregnancy was complicated by pre-eclampsia were interviewed and data were analysed using content analysis.

FINDINGS

Partners found themselves in an unfamiliar and unexpected situation. They experienced an information gap in which they tried to make sense of the situation by interpreting subtle signs. The situation left them feeling emotionally stretched, feeling like an outsider while trying to provide support for their extended family. The partners experienced a split focus after the baby was born, prioritising the baby while worrying about their spouse. Post-partum, they expressed needing time to process and heal after childbirth. A need for professional support was highlighted and concerns about a future pregnancy were voiced.

CONCLUSION

Having a spouse who is diagnosed with pre-eclampsia is challenging and overwhelming. Our findings imply a need to develop a model of care for women with pre-eclampsia that includes their partner, i.e., the other parent.

A systematic review and narrative synthesis of fathers' (including migrant fathers') experiences of pregnancy and childbirth

OBJECTIVE

The purpose of this review was to consider factors that influence the experiences of pregnancy and childbirth by fathers including migrant fathers.

METHOD

A systematic review and narrative synthesis were conducted as per the PRISMA guidelines. The spider tool was used to build a search strategy which was used to conduct literature search in eight identified electronic databases: ASSIA, CINAHL, EMBASE, MEDLINE, PsycINFO, PUBMED, Sage and Scopus. Grey literature was searched through the King's Fund Library database, Ethos, The North Grey Literature Collection, Social Care Online and other charity websites such as the Refugee Council and Joseph Rowntree Foundation. The search was conducted across all the databases in the week commencing January 7, 2019, and restricted to studies published in the English language.

RESULTS

The search across all the eight electronic databases identified 2564 records, 13 records through grey literature databases/websites and an additional 23 records identified through hand-searching/forward citation. The number of records after duplicates were removed was 2229. Record screening based on titles and abstracts identified 69 records for full text screening. Dual screening of these full text records identified 12 full records from 12 separate studies, eight of which were qualitative studies, three of which were quantitative studies and one mixed method study.

FINDINGS

This review has revealed three main themes: influence of society and health professionals; adjustment to a new life of fatherhood; and involvement in maternity care. However, the literature has focused on non-migrant father's experiences of pregnancy and childbirth, with little attention paid to fathers who may be migrants.

KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE

This review has exposed a dearth of research on migrant fathers' experiences of pregnancy and childbirth in an era of increasing globalisation and migration between countries. Midwives and other health professionals should be alert to the needs of any father when providing maternity care. More research is needed which considers experiences of migrants and how choosing to move to a new country or being forced to move could influence migrant father's experiences and therefore their needs.

Investigating Maternal Perspectives of Breastfeeding Support Targeted Towards Fathers in the Milk Man Mobile App Intervention

BACKGROUND

The support of her infant's father is one of the most important factors influencing a mother's breastfeeding success, and an increasing number of interventions are targeted towards fathers. Engaging fathers as agents to influence a maternal behavior is potentially problematic, yet few studies report on maternal experiences.

OBJECTIVE

This study aims to explore mothers' perspectives of their partners' use of Milk Man, a father-focused breastfeeding smartphone app, and the acceptability of this approach.

MATERIALS AND METHODS

New mothers (N = 459) whose partners had access to the app completed a questionnaire at six weeks postpartum. These data were used to determine knowledge, use and perspectives of the app. A sentiment analysis was conducted on responses to an open-ended question seeking maternal perspectives of the app.

RESULTS

Just over a quarter of mothers (28%) had been shown something from the app, and 37% had discussed something from Milk Man with their partner. There were 162 open-ended responses related to mothers' perspectives of the app. Relevant responses (n = 129) were coded to an overall sentiment node and then to a total of 23 child nodes (sub-nodes). Most comments were positive (94), with a smaller number either negative (25) or neutral (21). Negative comments related to the usability of the app and not its intent or content.

CONCLUSION

Mothers found the father-focussed breastfeeding app to be acceptable. When designing interventions targeting one group to affect the behaviour of another, inclusion of measures to gain the perspectives of both should be seen as an imperative.

The long-term association between paternal involvement in infant care and children's psychological well-being at age 16 years: An analysis of the Japanese Longitudinal Survey of Newborns in the 21st Century 2001 cohort

BACKGROUND

Some studies conducted in the United Kingdom have shown long-term associations between paternal involvement in childcare and adolescents' mental health issues. However, findings were inconsistent, and similar epidemiologic studies have not been conducted in other countries in Europe or Asia. Thus, we aimed to examine this association using Japanese population-based cohort study data.

METHODS

The Japanese Longitudinal Survey of Newborns in the 21st Century commenced in 2001. Data from 18,568 16-year-olds enrolled in the survey were analyzed. Poor psychological well-being was assessed using the WHO-5 Well-being Index. Paternal involvement in childcare-in tasks such as changing diapers-was assessed at the children's 6 months of age. We created four groups from least involvement to most active involvement based on the frequency of fathers' performing the tasks.

RESULTS

The risk of poor psychological well-being was lower among more active involvement groups compared with the least involvement group, after adjusting for potential confounders (risk ratios = 0.90 [95 % confidence intervals: 0.85, 0.95] for the most active group).

LIMITATIONS

Due to 16 years of follow-up, loss to follow-up may have caused a selection bias.

CONCLUSIONS

Our study is the first in Asian countries to show that fathers' active involvement in childcare is associated with poor psychological well-being in adolescence. Encouraging fathers' involvement in childcare may ameliorate prevalent issues of school refusals and withdrawals in the long term in Japan.

Associations Between Parents' Cognitions About Child Anxiety and Emotion Dysregulation in Clinically Anxious Children: The Unique Contribution of Fathers

This study examined the influence of parental cognition, including attitudes, beliefs, and understanding of anxiety, on emotion dysregulation in children with anxiety disorder. A total of 47 clinically anxious children (6-17 years old) and their parents were involved in the current study. The mothers and fathers separately completed a self-reported questionnaire assessing their attitudes, beliefs, and understanding of their children's anxiety, while the children completed a self-report questionnaire assessing emotion dysregulation. Pearson correlation and hierarchical regression analyses were used for data analysis. The results indicated that only fathers' higher levels of unhelpful attitudes, beliefs, and understanding of anxiety were positively and significantly associated with greater emotion regulation (ER) difficulties in anxious children. Furthermore, fathers' unhelpful cognitions regarding anxiety uniquely predicted their children's emotion regulation difficulties. These findings highlight the importance of including fathers in preventive and therapeutic interventions in promoting ER abilities in children with anxiety disorder.

Attitudes of parents in the role of a father in Turkey toward child sex education and their sexual communication with their children

BACKGROUND AND PURPOSE

The study aimed to evaluate the attitudes of parents in the role of a father in Turkey toward child sex education and their sexual communication with their children.

METHODS

This descriptive and cross-sectional study was conducted with the fathers of children in the pediatric outpatient clinic at a state hospital between December 30, 2021, and April 15, 2022. The study was reported based on STROBE. The data were collected from 297 fathers using the Descriptive Information Form, the Attitudes Scale Toward Sex education (ASTSE), and the Sexual Communication Scale for Parents(SCSP).

RESULTS

Sample statistics demonstrate that 67.7% of the participants did not receive sex education in their childhood, and 57.4% stated that their children received sex education only from their mothers. Higher attitudes toward sexual education were found in the fathers with a university or higher education degree (χ² = 15.396; p < 0.01), and those giving sex education to their children (χ² = 18.388;p < 0.001). Higher total scores were obtained on the sexual communication scale by fathers with university and higher education degrees (χ² = 12.898;p < 0.01) and those who received sex education in their childhood (t = 2.330;p = 0.021). There is a highly significant positive correlation between the mean scores of the role of a parent subscale of the ASTSE and the mean total score of the SCSP (r = 0.81;p < 0.001).

CONCLUSIONS

There is a positive correlation between fathers' parental role attitudes toward sex education and their sexual communication with their children.

PRACTICE IMPLICATIONS

Supporting fathers' sexual communication with their children can positively affect fathers' attitudes and communication toward sex education.

Prenatal paternal stress predicts infant parasympathetic functioning above and beyond maternal prenatal stress

BACKGROUND

Paternal stress is often assessed by maternal report and is posited to influence infant development indirectly by contributing to a mother's stress and experiences during pregnancy. Far less is known about how direct effects of prenatal paternal stress, as described by fathers themselves, are related to an infant's physiological functioning. We assessed fathers' own experiences of stress and examined its direct impact on infant respiratory sinus arrhythmia (RSA), a biological index of self-regulation, at seven-month postpartum.

METHOD

During the third trimester of pregnancy, the UCLA Life Stress Interview was conducted to assess chronic stress in mothers and fathers (N = 90). Infant baseline RSA and RSA reactivity in response to the Still-Face paradigm were assessed at seven-month postpartum.

RESULTS

Infants of fathers with high prenatal stress showed lower baseline RSA, possibly reflective of poor infant psychophysiological regulation. The predictive role of paternal stress remained significant after controlling for maternal stress.

CONCLUSIONS

Our findings provide emerging empirical evidence to support the influence of prenatal paternal stress on infant RSA, highlighting the important role of fathers for child development.

The Relationship Between Paternal Postpartum Depression and Psychosocial Variables: A longitudinal Study in Iran

Objective

This study aimed to investigate and identify the psychosocial factors that are associated with paternal postpartum depression.

Materials and methods

A longitudinal correlation study with 150 fathers was performed with three time frames (late pregnancy, postpartum, and four weeks postpartum). The Edinburgh Postnatal Depression Scale assessed those with depression (38.7%; n=58) and those without depressive symptoms (61.3%; n=92). Psychological variables related to paternal depression were also assessed through questionnaires.

Results

Psychological variables such as marital adjustment and stress had a significant relationship with paternal depression. In addition, depressed fathers experienced less marital compatibility and more tension than non-depressed fathers.

Conclusion

These findings emphasize the importance of considering the psychosocial variables that affect paternal psychological health. Mental health professionals may be able to reduce mental disorders, stress, psychological distress, and marital maladjustment in fathers with appropriate psychological interventions.

How to support fathers of preterm infants in early parenthood - An integrative review

PROBLEM

Preterm birth is a stressful event. Paternal experiences of having a preterm infant indicate a need for tailored support. However, it is unclear which interventions work best. This review presents the evidence on existing healthcare interventions to support fathers of preterm infants in early parenthood, how effective they are and paternal experiences with the interventions.

ELIGIBILITY CRITERIA

The integrative review process of Whittemore and Knafl was used to guide the study. A structured and comprehensive literature search was conducted in PubMed (MEDLINE), Embase, CINAHL, PsycInfo, Cochrane, Scopus, Web of Science, SweMed+, and Proquest Dissertation & Thesis Global.

SAMPLE

A total of 18 qualitative and quantitative studies were included in the review. The Mixed Methods Appraisal Tool was used to assess quality.

RESULTS

Three overall themes were identified in the analysis: 1) Skin-to-skin contact supported interaction between infant and father, 2) information impacted paternal experiences of stress, anxiety, and development of fatherhood, 3) fathers' relationships with the nurses oscillated between conflict and assistance.

CONCLUSIONS

Our findings show that targeted interventions could support father-infant interaction and reduce stress among fathers of preterm infants.

IMPLICATIONS

Fathers of preterm infants rely on nurses to support their engagement in early parenthood, while nurses facilitate the interventions that engage the fathers. It is also essential to develop a culture within the neonatal intensive care unit that encourages the presence of fathers and enhances educational nursing strategies for supporting fathers of preterm infants during early parenthood.

[Mother's experience of planned caesarean section in the absence of the father or companion: Impact of Covid-19 pandemic-related lockdown]

BACKGROUND

The presence of the father or companion during planned caesarean section presents several benefits. However, we found no study regarding the mother's experience of his presence or absence.

MATERIAL AND METHODS

We conducted an observational, prospective, two-centre study based on the data of women who had a planned caesarean section in Bel Air and Mercy Maternities between November 17th 2020 and June 4th 2021. Two groups were formed : a control group, including women who had a c-section in the presence of the father or companion, and a case group, including women who had a c-section without the father or companion due to Covid-19 pandemic-related containment measures. The primary endpoint was to assess the mother's anxiety regarding the presence or absence of the father or companion during planned c-section, by the use of a numerical scale of stress and STAI YA inventory. The secondary endpoint was the appraisal of information given by the medical team concerning c-section and the containment measures.

RESULTS

Regarding the level of stress during the c-section, we did not find a significant difference by the use of the numerical scale of stress. With a mean of 53 in the case group and 49 in the focus group (P=0,048), the STAI YA scores showed a significant difference. Between the day before and the day of the c-section, we found no significant difference by the use of the numerical scale of stress. STAI YA scores showed a significant difference, with a delta of 5 in the case group against 1 in the focus group (P=0,01). Most patients estimated that the information given by the medical team helped to reduce their stress. 93 % of the patients in the focus group reckoned they would have been more stressed in the absence of the father or companion.

DISCUSSION AND CONCLUSION

The significant results of this study suggest the absence of the father or companion during planned caesarean section has an impact on mother's experience. Therefore, this should be considered in order to better our practices and improve mother's experience. In the long term, we could imagine making their presence possible during emergency caesarean sections as well (general anesthesia excluded). We could also envision adding to preparation courses to c-section to birth preparation courses, for mothers (to reduce psychological impact) but also for fathers or companions (to allow their presence in the operation room).

Early Adolescent Social Anxiety: Differential Associations for Fathers' and Mothers' Psychologically Controlling and Autonomy-Supportive Parenting

Although psychologically controlling and autonomy-supportive parenting are important indicators of social anxiety during early adolescence, less research has explored distinct roles of father and mother parenting, especially in interdependent-oriented culture. This 3-year longitudinal study examined the reciprocal associations between such parenting and early adolescent social anxiety from multi-informants in the Chinese context. A sample of 1,140 Chinese early adolescents (51.1% boys; M_age = 10.50 years) and their parents participated at Wave 1. The results did not reveal reciprocal relations between fathers' reported parenting and social anxiety, but indicated paternal parenting effects from boys' perceptions of autonomy support to social anxiety, and child effects from social anxiety to girls' perceived psychological control. Maternal parenting effects were present for boys' perceptions of autonomy support and girls' perceptions of psychological control. The findings highlight the distinct roles of father and mother parenting across child gender and suggest differentiated relations of parenting to social anxiety during early adolescence in the Chinese context.

Understanding parental physical activity support in parents of children with developmental disabilities across two different countries

BACKGROUND

It remains unclear if there is a difference between parental physical activity (PA) support in parents of children with developmental disabilities (DDs) and parental PA support in parents of children without DDs across countries.

AIMS

The purposes of the current study were to examine parental PA support in parents of children with and without DDs from the United States and South Korea and to examine their parental PA support mechanism based on the theory of planned behavior (TPB).

METHODS AND PROCEDURES

An online survey was used to measure demographic information, parental PA support, and four constructs of TPB in parents with and without DDs in the two countries (n = 277). One-way analysis of variance was used to compare parental PA support and the TPB constructs among the participants. Two separate path analyses were performed to examine associations between the TPB constructs and parental PA support in American parents of children with and without disabilities and South Korean parents of children with and without disabilities.

OUTCOMES AND RESULTS

Parental PA support was significantly higher in American parents of children with DDs than in South Korean parents of children with DDs. Intention was significantly associated with parental PA support, and attitude was the strongest predictor for intention in both pathway models.

CONCLUSIONS AND IMPLICATIONS

The difference in parental PA support between American parents of children with DDs and South Korean parents of children with DDs may exist. TPB-based intervention may be necessary in order to increase low parental PA support in South Korean parents of children with DDs.

Adolescent bullying victimization and psychosomatic symptoms: Can relationship quality with fathers buffer this association?

The present study explored racial/ethnic and sex differences in fathers' awareness and perceived ease of communication with fathers and how they are related to adolescent bullying victimization and psychosomatic symptoms. Data were drawn from the 2009 to 2010 Health Behavior in School-Aged Children study in the United States. The sample consists of 5,121 White, 1,497 African American, and 1,850 Hispanic adolescents in grades 5 to 10. For all three racial and ethnic groups, bullying victimization was positively associated with psychosomatic symptoms. A higher level of the child's perception of their father's awareness was found to be positively associated with lower levels of bullying victimization for White and Hispanic adolescents. African American, White, and Hispanic adolescents who perceived their fathers as easy to communicate with had a lower risk of bullying victimization. The child's perception of their father's awareness buffered the positive association between bullying victimization and psychosomatic symptoms for Hispanic adolescents. A higher child's perception of their father's awareness was related to lower bullying victimization for adolescents of both sexes. The child's perception of their father's awareness and their perceived ease of communication with their father were found to be associated with a decreased risk of psychosomatic symptoms for both sexes. Overall, the results support the importance of relationship quality with fathers as a protective factor against bullying victimization.

Children's sleep and fathers' health and wellbeing: A systematic review

Night-waking is typical across infancy and early childhood, inevitably disrupting family sleep. For some children, sleep problems develop and endure throughout childhood. This systematic review focused on fathers, and synthesised the evidence pertaining to the effects of children's sleep (from birth to 12 years) on fathers' health and wellbeing. A total of 29 studies were included. Key outcomes reported for fathers were: sleep and fatigue; mental and general health; and family functioning. An association between child sleep and father's sleep was observed when child's sleep was measured via actigraphy or paternal report, but not when measured via maternal report, suggesting that mothers may not always be aware of disruptions that awaken fathers. Findings showed poorer child sleep was associated with poorer general health and wellbeing among fathers, however, associations of poor child sleep with depression were fewer, and less frequent than those reported for mothers in the same households. Poor child sleep was negatively associated with the quality of family relationships, both within the couple and between parent and child. Future studies seeking to understand the interplay of child sleep and family wellbeing should apply objective measurement of sleep and integrate formal measures of family dynamics into the study design.

Association of child's disability status with father's health outcomes in Japan

Fathers' involvement in childcare has been increasing in recent years. However, very little is known about the health impact on fathers when they are caring for or living with a disabled child. This study aims to understand the psychological distress and subjective health outcomes among fathers living with a disabled child compared to fathers living without a disabled child. Data for this study were obtained from the Comprehensive Survey of the Living Conditions conducted by the Ministry of Health, Labour and Welfare in 2016. Multivariable logistic regression was used among 438 disabled-child and father dyads and 27,682 non-disabled-child and father dyads to analyse the association between a child's disability status with father's health outcomes. Fathers of disabled children had a higher prevalence of psychological distress (17% vs. 12%) and poor subjective health status (13% vs. 8%) than fathers of non-disabled children. A large proportion of disabled children were boys (70%) and had disability level 1 (47%). After adjusting for covariates, the odds ratio (OR) of having psychological distress (OR, 1.53; 95% CI, 1.19–1.97) and poor subjective health status (OR, 1.78; 95% CI, 1.34–2.36) among fathers of disabled children is significantly higher compared to fathers of non-disabled children. Unemployed fathers had a higher odds ratio of psychological distress (OR, 3.07; 95% CI, 2.49–3.79) and poor subjective health status (OR, 4.90; 95% CI, 3.95–6.09) compared to regular working fathers. Fathers of children with disabilities need greater physical and mental health and wellbeing support. They should be provided with additional support not just for their mental but also their subjective wellbeing.

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Fathers of disabled children have higher odds ratio of psychological distress.

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Fathers of disabled children have higher odds ratio of poor subjective health status.

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70% of disabled children were boys and 47% had mildest severity of disability.

Caring Dads intervention for fathers who have perpetrated abuse within their families: Quasi-experimental evaluation of child protection outcomes over two years

BACKGROUND

In Canada, two of the most common forms of maltreatment substantiated by child protective services are child exposure to domestic violence and child physical abuse. Fathers are identified as the parent responsible for a substantial proportion of this maltreatment.

OBJECTIVE

This study examined whether providing a group-based intervention program for fathers was associated with greater engagement of fathers in child protection case management and with lower rates of subsequent father-perpetrated abuse.

PARTICIPANTS

A quasi-experimental design compared child protection outcomes in families in which fathers were referred to an intervention program (Caring Dads) and either completed the group (n = 85) or remained on a waitlist for future service (n = 100).

METHODS

Data were collected from a retrospective review of administrative files over two years, starting from the time of referral to Caring Dads.

RESULTS

Initial comparisons found no significant differences in intervention and comparison group fathers in demographic characteristics, child protection concerns, and all but one area of risk and needs. Completing intervention, as compared to being waitlisted, was associated with a greater number of contacts between child protection workers and fathers over two years (M = 30.3 vs. M = 16.7), a difference that was significant and large in size (d = 0.81) and with lower rates of verified re-referral due to fathers' maltreatment (20.5% vs. 36.0%), a difference that was significant and between small and medium in size (V = 0.17).

CONCLUSIONS

Current results suggest that there may be significant benefits of involving fathers in child protection-linked intervention.

Paternal and maternal support of moderate-to-vigorous physical activity in children on weekdays and weekends: a cross-sectional study

Background

Most studies of associations between parental support behaviours for physical activity (PA) and children’s moderate-to-vigorous physical activity (MVPA) have been conducted in developed countries, and they have focused on maternal or parental support behaviours. Children’s MVPA time (i.e., weekdays vs. weekends) has not been adequately differentiated. This paper investigated the associations of paternal and maternal support behaviours for PA with the proportion of children who met the MVPA recommendations on weekdays and weekends in China.

Methods

Cross-sectional data of 517 father–child dyads and 1422 mother–child dyads were analysed. The children recorded PA diaries on 7 consecutive days to assess their MVPA time. The father or mother completed a questionnaire concerning their support for children’s PA. Multivariate logistic regression was used to investigate the independent effects of paternal and maternal support behaviours for PA on whether children met the MVPA recommendations for weekdays, weekends, and the whole week.

Results

Significantly fewer children met the MVPA recommendations on weekends (37.8%) than on weekdays (62.8%). Higher paternal (odds ratio [OR] = 1.098, 95% confidence interval [CI]: 1.009–1.195) and maternal (OR = 1.076, 95% CI: 1.021–1.134) total support behaviour scores were associated with higher odds of children meeting the MVPA recommendations on weekends, after controlling for covariates. Paternal PA knowledge-sharing with the child was positively associated with children meeting the MVPA recommendations on weekends (OR = 1.319, 95% CI: 1.055–1.649); it tended to be associated with children meeting the MVPA recommendations on weekdays and throughout the week, although these associations were not statistically significant. Maternal reservation of PA time for the child was positively associated with a higher likelihood of children meeting the MVPA recommendations on weekdays (OR = 1.160, 95% CI: 1.025–1.313), weekends (OR = 1.241, 95% CI: 1.097–1.403), and throughout the week (OR = 1.214, 95% CI: 1.076–1.369).

Conclusions

Paternal and maternal support behaviours for PA should be enhanced on weekends to increase children’s MVPA. Fathers should share PA knowledge with children and mothers should reserve PA time for children every day.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11730-8.

Longitudinal associations among adolescents' internalizing problems, well-being, and the quality of their relationships with their mothers, fathers, and close friends

RATIONALE

Internalizing problems (i.e., depressive and anxiety symptoms) are known to decrease adolescents' well-being, but knowledge about potential underlying mechanisms is limited. The qualities of adolescents' most proximal relationships with their parents and close friends are expected to play a role in the association between adolescents' internalizing problems and well-being.

OBJECTIVE

The present study was conducted to 1) investigate the indirect longitudinal association between internalizing problems and adolescents' well-being via the quality of adolescents' relationships with both their mothers and fathers and their close friends, and 2) test whether our findings were gender invariant.

METHODS

Data were collected via online questionnaires in two waves at a 12-month interval from adolescents attending three secondary schools in the Netherlands (N = 1298; M age = 13.7 years, 53.2% girls). The data were analyzed using a two-wave cross-lagged panel model in R. Multigroup analyses were performed to examine the gender invariance of the findings.

RESULTS

After controlling for baseline levels, results showed that (1) girls, but not boys, who reported more internalizing problems at T1 had lower well-being at T2; (2) girls and boys who reported more internalizing problems at T1 had lower-quality relationships with their mothers, fathers, and close friends at T2; and (3) boys, but not girls, who reported higher-quality friendships at T1 had higher well-being at T2. However, no significant indirect effects between internalizing problems and well-being via the quality of adolescents' relationships with their parents and close friends were detected.

CONCLUSIONS

The current study contributes to understanding internalizing problems as an important risk factor to the quality of adolescents' proximal social relationships (parents, friends) and their well-being. The findings support the importance of building high-quality relationships, particularly friendships, and recommend future research to study adolescents' internalizing problems and well-being including gender-specific examinations.

Paternal childcare in early childhood and problematic behavior in children: a population-based prospective study in Japan

BACKGROUND

There have been numerous reports on the effects of paternal childcare on children's behavioral development. However, little is known about these effects in Asian countries such as Japan, where fathers do not have sufficient time for childcare due to long working hours. This study explored the association between paternal childcare during toddlerhood in terms of childcare hours and the type of caregiving behavior and subsequent behavioral problems in children aged 5.5 years, stratified by sex.

METHODS

We analyzed data from the Longitudinal Survey of Newborns in the twenty-first Century (2001-2006), a population-based cohort survey in Japan (N = 27,870). Paternal childcare was assessed at 18 months in terms of paternal childcare hours on weekdays or weekends and the frequency of each type of childcare (feeding, changing diapers, bathing, putting the child to sleep, playing with the child at home, and taking the child outside). Based on the frequency or lack of paternal involvement, six categories of child behavioral problems were assessed when the children were 5.5 years old. Logistic regression analysis was applied to account for the known confounding variables.

RESULTS

Longer paternal childcare hours, on both weekdays and weekends in toddlerhood, had a protective effect on behavioral problems at 5.5 years of age. The dose-effect relationships were found between the frequency of fathers taking their children outside and behavioral problems in boys, and the frequency of fathers playing with their children at home and behavioral problems in both boys and girls.

CONCLUSIONS

Paternal childcare during toddlerhood could prevent subsequent behavioral problems in children. Several specific paternal caregiving behaviors, such as taking their children outside and playing with them at home, may play an important role in preventing subsequent behavioral problems.

A descriptive qualitative study exploring the experiences of fathers with partners suffering from maternal perinatal depression

OBJECTIVE

The onset of maternal perinatal depression poses many challenges for fathers, yet in Singapore and Asia, the topic remains largely unexplored. This study aimed to gain insight into the experiences of fathers whose partners suffer from perinatal depression in the Asian milieu.

DESIGN

A descriptive qualitative study design was adopted. Purposive and snowball sampling methods were used to recruit participants. Semi-structured, face-to-face interviews were conducted individually with participants to collect data, which were analysed using thematic analysis.

SETTING AND PARTICIPANTS

Twelve fathers were recruited for the study. Eleven were from a perinatal mental health service in a tertiary hospital in Singapore, while 1 father was recruited via snowball sampling.

FINDINGS

Five themes describing the fathers' journey through their partners' perinatal depression emerged from the analysis. The themes are: (1) feeling their world collapse; (2) struggling with the depression; (3) enduring the emotional toll; (4) coping with the situation; and (5) emerging from the other side.

KEY CONCLUSIONS

The findings of this study highlighted the struggles, coping methods, and support needs of fathers whose partners suffer from perinatal depression. Fathers were often unable to identify perinatal depression in their partners. Notably, they testified to the need to tolerate verbal and sometimes violent outbursts from their partners, and requested for more available information, resources, and peer support groups.

IMPLICATIONS FOR PRACTICE

The findings underscore a need for pre-emptive education on maternal perinatal depression and more accessible resources. Healthcare professionals should assess fathers' emotional responses to parenthood and their partners' depression.

The Premise and Promise of Activation Parenting for Fathers: A Review and Integration of Extant Literature

Although research on fathers tends to focus on mother-derived conceptualizations of caregiving, such as sensitivity, it has been theorized that fathers play a unique role in opening their children to the world by encouraging exploration and risk-taking. However, extant research on these forms of paternal caregiving is scattered across multiple related but distinct domains, namely rough-and-tumble play, challenging parenting behavior, and the activation relationship. Based on the overlap in theory and operationalizations of these domains, the present review aimed to define and operationalize a new caregiving construct: activation parenting (AP). Fathers who exhibit frequent and high-quality AP behaviors encourage children to take risks, challenge children physically and socioemotionally, and set appropriate limits during stimulating interactions to ensure safety and prevent over-arousal. Using Belsky's (1984) process of parenting model as a foundation, associations between paternal AP and characteristics of the father, his environment, and his child are reviewed, with a focus on early childhood (i.e., ages 0-5 years). The present review found some support for paternal AP occurring more frequently, but not necessarily with higher quality, when fathers had children older than one years old. Unexpectedly, the frequency and quality of paternal AP did not differ much by paternal age or indicators of socioeconomic status, or by child age or gender. In line with underlying theories, higher quality paternal AP in early childhood has been found to be associated with children's self-regulation skills and lower levels of internalizing and externalizing problems. Limitations of the current paternal AP literature are discussed and future directions for research, policy, and clinical work are proposed.

Fathers' Experience of Perinatal Obsessive-Compulsive Symptoms: A Systematic Literature Review

Perinatal Obsessive-Compulsive Disorder (pOCD) refers to the onset/exacerbation of Obsessive-Compulsive Disorder (OCD) during the perinatal period. This disorder has been studied in mothers, with limited research conducted on fathers. The aim of the current study was to conduct the first systematic review of research investigating the experience of pOCD in fathers. A systematic review was conducted via electronic searches of Scopus, ProQuest, APA PsychNet, PubMed, and EBSCOhost. There were 523 articles identified and screened for eligibility, resulting in six eligible studies included in the final review. All studies reported the presence of subclinical obsessive-compulsive symptoms in fathers during the perinatal period, with the prevalence comparable to mothers. Compared to mothers, however, fathers were found to report less intrusion-related distress. Two studies reported a correlation between dysfunctional beliefs, negative appraisal of intrusions, and pOCD symptoms. Common categories of obsessive thoughts and compulsions experienced by fathers were also identified. Fathers appear susceptible to pOCD, which is consistent with the Cognitive-Behavioral Theory of OCD. Future research is recommended, therefore, to investigate clinical prevalence and severity of pOCD in fathers, particularly relative to mothers, and further investigate the role of dysfunctional beliefs in the development of pOCD.

The buffering role of paternal parenting stress in the relationship between maternal parenting stress and children's problematic behaviour

The present study aimed at exploring the relationship between parenting stress and children's problematic behaviour in the families of 99 children aged 8–11 years. Parenting stress was assessed by parents, using the Parenting Stress Index, and children's problematic behaviour was assessed by teachers, using the Strengths and Difficulties Questionnaire. A moderation regression analysis showed a conditioning effect of paternal parenting stress in the relationship between maternal parenting stress and children's problematic behaviour. In the presence of high levels of paternal parenting stress, the relationship between maternal parenting stress and children's problematic behaviour was significant and strong (p = .01). When paternal parenting stress levels were low, the relationship between maternal parenting stress and children's problematic behaviour was not significant (p = .49). The results underlined that paternal parenting stress may buffer the relationship between maternal parenting stress and children's problematic behaviour. Clinical implications are discussed.

Psychosocial interventions and support programs for fathers of NICU infants - A comprehensive review

The experience of having a child in the neonatal intensive care unit (NICU) is often unexpected, traumatic, and presents numerous stressors for new fathers. Past research has shown that parents of all genders with children in the NICU experience clinically significant psychological symptoms, yet the bulk of research and intervention efforts to date have focused on the needs of mothers. This paper will provide a review of the literature, outline current knowledge about the specific needs of men with children in the NICU, and recommend areas of focus for future research. The paper will also highlight the need to tailored interventions that specifically address the unique needs of fathers.

Imagining the baby: Neural reactivity to infant distress and mind-mindedness in expectant parents

Neural and psychological processes in pregnancy may be important antecedents for caregiving postpartum. Employing event-related potentials, we examined neural reactivity to infant emotional faces during the third trimester of pregnancy in expectant mothers (n = 38) and expectant fathers (n = 30). Specifically, expectant parents viewed infant distress and infant neutral faces while electroencephalography was simultaneously recorded. As a psychological measure, we assessed prenatal mind-mindedness towards the unborn child and examined whether neural processing of infant cues was associated with levels of mind-mindedness. Expectant fathers evidenced greater P300 reactivity to infant distress, relative to neutral, faces than expectant mothers. Furthermore, P300 reactivity to infant distress, relative to infant neutral, faces was associated with levels of prenatal mind-mindedness in expectant fathers but not expectant mothers. These findings indicate significant sex differences in the prenatal neural processing of infant cues and relations between neural reactivity to infant distress and the emergence of parental mind-mindedness.

How domestically violent Fathers impact children's social-emotional development: Fathers' psychological functioning, parenting, and coparenting

BACKGROUND

Most children exposed to father-perpetrated domestic violence (DV) continue to have contact or live with fathers, yet there is little research on the impact of fathering in the context of domestic violence.

OBJECTIVE

This paper aimed to identify pathways from children's exposure to father-perpetrated DV to compromised social-emotional outcomes. Based on extant literature on fathering and domestic violence, psychological, parenting, and coparenting features in DV fathers were identified as potential mediators of the relationship between child exposure to DV and their social-emotional outcomes.

PARTICIPANTS AND SETTING

Participants were 123 fathers with confirmed histories of DV perpetration and 101 comparison fathers without such histories.

METHODS

Fathers completed self-report measures during two assessment sessions held at the university. Simple mediation analyses were used to examine pathways between fathers' DV perpetration and child internalizing and externalizing difficulties through potential mediators.

RESULTS

Paternal depression, hostility, and coparenting difficulties significantly mediated the relationship between child exposure to DV and child internalizing and externalizing difficulties. Low paternal warmth was associated with child externalizing difficulties but did not function as a mediator. Paternal over-reactivity and laxness, in contrast, were not significantly correlated with DV perpetration or with child internalizing or externalizing outcomes.

CONCLUSIONS

This study suggests that fathers' emotion regulation and coparenting difficulties are important correlates of his DV perpetration and of their children's psychological symptoms and should be considered as potential foci for parenting intervention with this population.

Parental ADHD in pregnancy and the postpartum period - A systematic review

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders worldwide, and in the majority of patients persists into adulthood. However, it remains unclear how maternal ADHD could affect pregnancy and birth as well as early mother-(father)-child interaction. There are several studies investigating the effect of depressed or anxious parents on parent-child-interactions in early infancy, but data about the influence of parental ADHD is lacking although it is a common mental disorder in parents. Additionally, the prescription of stimulant and other ADHD medication for adult ADHD patients is rising due to improved diagnostic procedures and a greater awareness of this disorder in adulthood among psychiatrists and psychologists. However, this leads to increased numbers of treated ADHD women that wish to have children or experience unplanned pregnancies while taking stimulant medication. In our systematic review we aimed at analysing the current evidence for the association of maternal ADHD with pregnancy and birth outcomes, pregnancy risks and health behaviour in pregnancy, as well as the association of parental ADHD with early parent-child interaction and early child development in the first 3 years. Furthermore, we reviewed recent evidence on the risks of stimulant and non-stimulant treatment for ADHD in pregnancy and lactation.

Sperm DNA methylation epimutation biomarker for paternal offspring autism susceptibility

BACKGROUND

Autism spectrum disorder (ASD) has increased over tenfold over the past several decades and appears predominantly associated with paternal transmission. Although genetics is anticipated to be a component of ASD etiology, environmental epigenetics is now also thought to be an important factor. Epigenetic alterations, such as DNA methylation, have been correlated with ASD. The current study was designed to identify a DNA methylation signature in sperm as a potential biomarker to identify paternal offspring autism susceptibility.

METHODS AND RESULTS

Sperm samples were obtained from fathers that have children with or without autism, and the sperm then assessed for alterations in DNA methylation. A genome-wide analysis (> 90%) for differential DNA methylation regions (DMRs) was used to identify DMRs in the sperm of fathers (n = 13) with autistic children in comparison with those (n = 13) without ASD children. The 805 DMR genomic features such as chromosomal location, CpG density and length of the DMRs were characterized. Genes associated with the DMRs were identified and found to be linked to previously known ASD genes, as well as other neurobiology-related genes. The potential sperm DMR biomarkers/diagnostic was validated with blinded test sets (n = 8-10) of individuals with an approximately 90% accuracy.

CONCLUSIONS

Observations demonstrate a highly significant set of 805 DMRs in sperm that can potentially act as a biomarker for paternal offspring autism susceptibility. Ancestral or early-life paternal exposures that alter germline epigenetics are anticipated to be a molecular component of ASD etiology.

Association between family history, early growth and the risk of beta cell autoimmunity in children at risk for type 1 diabetes

AIMS/HYPOTHESIS

The aim of this work was to examine the relationship between family history of type 1 diabetes, birthweight, growth during the first 2 years and development of multiple beta cell autoantibodies in children with a first-degree relative with type 1 diabetes and HLA-conferred disease susceptibility.

METHODS

In a secondary analysis of the Trial to Reduce IDDM in the Genetically at Risk (TRIGR), clinical characteristics and development of beta cell autoantibodies were compared in relation to family history of type 1 diabetes (mother vs father vs sibling) in 2074 children from families with a single affected family member.

RESULTS

Multiple autoantibodies (≥2 of 5 measured) developed in 277 (13%) children: 107 (10%), 114 (16%) and 56 (18%) born with a mother, father or sibling with type 1 diabetes, respectively (p < 0.001). The HR for time to multiple autoimmunity was 0.54 (95% CI 0.39, 0.75) in offspring of affected mothers (n = 107/1046, p < 0.001) and 0.81 (95% CI 0.59, 1.11) (n = 114/722, p = 0.19) in offspring of affected fathers, compared with participants with a sibling with type 1 diabetes (comparator group n = 56/306). The time to the first autoantibody present (to insulin, GAD, tyrosine phosphatase-related insulinoma-associated 2 molecules, islet cell or zinc transporter 8) was similar in the three groups. Height velocity (z score/year) in the first 24 months was independently associated with developing multiple antibodies in the total cohort (HR 1.31 [95% CI 1.01, 1.70], p = 0.04). A higher birthweight in children born to an affected mother vs affected father or an affected sibling was not related to the risk of multiple autoimmunity.

CONCLUSIONS/INTERPRETATION

The risk of developing multiple autoantibodies was lower in children with maternal type 1 diabetes. For the whole group, this risk of developing multiple autoantibodies was independent of birthweight but was greater in those with increased height velocity during the first 2 years of life. However, the risk associated with paternal type 1 diabetes was not linked to differences in birthweight or early growth.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00179777 Graphical abstract.

Prevalence of perinatal depression among Japanese men: a meta-analysis

INTRODUCTION

Perinatal depression is a widely discussed mental illness that occurs not only in women, but also in men. A previous international meta-analysis of the prevalence of paternal perinatal depression suggested that cross-cultural variables or socioeconomic environment may influence paternal depression. However, it is not clear that these data are general enough to apply to Japanese men, and there are few review articles about perinatal depression among this demographic. The purpose of our study is to provide a reliable estimate of the prevalence of perinatal depression among Japanese men.

METHOD

We searched two databases, PubMed and ICHUSHI, to identify studies with data on the prevalence of prenatal or postpartum depression among Japanese men. Data were extracted from reports published from January 1994 to June 2018. The period prevalence of paternal perinatal depression among Japanese men was investigated. A subgroup analysis of gender differences in perinatal depression was also performed.

RESULTS

We reviewed 1,379 abstracts, retrieved 33 articles and ultimately included 15 studies. The period prevalence of paternal prenatal depression in men was 8.5% (95% CI 3.3-20.3%). Moreover, the period prevalence of postpartum depression in men was 9.7% (95% CI 7.4-12.8%) within the first month, 8.6% (95% CI 5.5-13.3%) in postpartum months 1-3, 13.2% (95% CI 11.6-15.0%) in postpartum months 3-6 and 8.2% (95% CI 1.3-38.0%) in postpartum months 6-12. We also found that the prevalence of prenatal depression was significantly lower in men than in women. However, the prevalence of postpartum depression was not significantly different between men and women.

CONCLUSIONS

The prevalence of perinatal depression among Japanese men peaked at 3-6 months after birth, and its overall prevalence was approximately 10%. These results were similar to those of an international meta-analysis on perinatal depression. Notably, we found that the prevalence of postpartum depression was as high in men as it was in women. Therefore, it is suggested that healthcare workers should be more watchful for paternal perinatal depression in the postpartum period than in the prenatal period.

[Parental anxiety and associated factors in pediatric hospital emergencies, a cross-sectional descriptive study.]

OBJECTIVE

Pediatric hospital emergencies have increased hardly in the recent years, product of the irrational use and the over-massification. The objective of this study was to evaluate the relationship between anxiety and sociodemographic factors of the parents and mothers.

METHODS

Descriptive cross-sectional study on parental anxiety and associated factors in a pediatric hospital emergency service with sample n=200 fathers and mothers who demand care in a level 3 hospital in Valencia. (Spain), during march, april and may of 2019. It was estimated the reliability of the Anxiety Scale E-7 (STAI-E7). The data was obtained with a self-administrated and desired document for the purpose. Data related to the level of anxiety and possible predictive variables were collected. The analysis of the data obtained was performed with the Statistical Package for the Social Sciences program (SPSS, version 20.0 for Windows) and ordinal regression with the R commander program.

RESULTS

The results show that 75.5% of the people who went to the hospital with their children were mothers and 24.5% were fathers. The mean score obtained regarding the level of anxiety in the sample is moderate (9.18±4.92). Mothers present higher levels of anxiety than fathers (9.7±4.8 and 7.5±5.1, respectively). The probability of experiencing a higher level of anxiety in mothers is multiplied by two (OR=2.286; 95% CI: 1.212-4.353; P=0.01) compared to parents. The STAI-E7 scale presents a good internal consistency (Cronbach's α=0.847).

CONCLUSIONS

Mothers have higher levels of anxiety. It will be appreciated doing more studies to quantify the levels of parental anxiety, with the purpose of creating tools and programs to decrease it.

Evaluation of the effect of narrative writing on the stress sources of the fathers of preterm neonates admitted to the NICU

OBJECTIVE

Identification of the nurses and fathers' understanding of the stress sources facilitates nursing interventions and increases parental satisfaction.

MATERIALS AND METHODS

The quasi experimental study with pretest and posttest was administered to a sample size of 70 fathers with preterm neonates hospitalized in the NICUs of Gorgan University of Medical Sciences in 6 months. The Parental Stressor Scale (PSS) was used. The data were analyzed using descriptive and analytical statistical methods.

RESULTS

Evaluation of the differences in the domains showed that narrative writing had significant effects on all three domains. The results showed that the highest stress reduction was observed in parents' relationship followed by infant behavior and appearance while the lowest stress reduction was observed in the sights and sounds in the intervention group.

CONCLUSION

Narrative writing may be considered an efficient supportive intervention to reduce the fathers' stress, infant behavior and appearance in the NICUs.

Coparenting in the feeding context: perspectives of fathers and mothers of preschoolers

PURPOSE

This study examined how fathers and mothers coparent around child feeding.

METHODS

Father-mother pairs (N = 30) of preschool-aged children (M child age = 4.1 years old) participated in joint or group interview sessions.

RESULTS

Three themes emerged from the qualitative analysis: (1) couples' division of labor regarding feeding tasks seemed to align with stereotypical gender roles; (2) couples noted that they attempted healthier family eating habits in comparison to families of origin and recognized the influence of extended family on their attempts at healthier feeding; (3) couples agreed on the importance of family mealtime, routines, and healthy meals, yet disagreed on strategies to limit unhealthy foods and achieve harmonious family meals.

CONCLUSIONS

This study identified processes of coparenting and child feeding areas that were particularly challenging to manage among parents, which could be important targets for childhood obesity interventions.

LEVEL OF EVIDENCE

V, descriptive study.