The Effectiveness of Interventions for the Prevention or Treatment of Paternal Perinatal Anxiety: A Systematic Review

Michelle L Fisher; Paul Sutcliffe; Charlotte Southern; Amy L Grove; Bee K Tan

doi:10.3390/jcm11226617

The Effectiveness of Interventions for the Prevention or Treatment of Paternal Perinatal Anxiety: A Systematic Review

J Clin Med. 2022 Nov 8;11(22):6617. doi: 10.3390/jcm11226617.

Authors

Michelle L Fisher¹, Paul Sutcliffe¹, Charlotte Southern¹, Amy L Grove¹, Bee K Tan²

Affiliations

¹ Division of Health Sciences, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, UK.
² Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK.

Abstract

Background: The worldwide prevalence of paternal perinatal anxiety (PPA) ranges between 3.4% and 25.0% antenatally, and 2.4% and 51.0% postnatally. Experiencing PPA can adversely impact the individual, partners, and infants. Research concerning PPA is lagging and fragmented compared to research for new mothers. Objectives: To establish the effectiveness of prevention or treatment interventions for PPA in adults identifying as male. Data sources: We completed searches of Medline, EMBASE, PsycINFO and Web of Science from inception to 2 December 2021, as well as hand searches of references from relevant papers. Search selection and data extraction: Randomised controlled trials delivering prevention or treatment interventions and reporting anxiety outcomes for new/expectant fathers in the perinatal mental health period were included. Our review follows the PRISMA reporting guidelines. One reviewer independently screened 5170 titles/abstracts; second reviewers screened 50%. Two reviewers independently screened full text, extracted data, and conducted risk of bias assessments. Synthesis: Cochrane's collaboration tool 2 was used to assess quality. Primarily results are synthesised narratively, a post-hoc sub-group analysis was completed on four studies using the same outcome measure. Main results: Twelve of the 5170 studies fulfilled the inclusion criteria. Studies used psychoeducational or practical skills interventions. Interventions mostly involved couple-dyads and three studies assessed PPA as a primary outcome. Included interventions were prevention-based; no treatment interventions were found. Father-only interventions consistently reported a significant reduction of PPA. Conclusions: Systematic searching yielded no treatment interventions, highlighting a substantial gap in the evidence base. Within a limited and heterogenous sample, no studies targeted diagnosed PPA. Evidence suggested father-focused interventions may be effective in preventing PPA, regardless of the intervention delivery mode or intervention content. However, consistency between study design and options within the field are lacking compared to interventions available for mothers.

Keywords: anxiety; father; intervention; paternal; perinatal; systematic review.

Publication types

Review

Grants and funding

This study was supported by doctoral research funding from Warwick Medical School, awarded as part of the Warwick Medical School postgraduate research scholarship to Michelle Fisher. Prof. Amy Grove is supported by the National Institute for Health Research (NIHR) Advanced Fellowship Programme Reference (AF-300060) and the NIHR Applied Research Collaboration West Midlands. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The content of this manuscript is solely the responsibility of the authors.