Highlights
- Paternal perinatal mental distress is linked to poorer global, cognitive, language, social-emotional, and physical development in offspring.
- Associations are generally stronger for postnatal than antenatal paternal mental distress.
- No significant associations were found for adaptive or motor development outcomes.
- Paternal perinatal mental distress is a potentially modifiable risk factor, underscoring the need for preventive interventions targeting fathers.
Study Background and Disease Burden
Traditionally, maternal perinatal mental health has been the principal focus in research and clinical care regarding early child development. However, emerging evidence identifies paternal mental health during the perinatal period—defined as the time shortly before and after childbirth—as a critical yet often overlooked factor influencing offspring outcomes. Paternal perinatal depression, anxiety, and stress are relatively common, affecting an estimated 8–10% of new fathers globally. Untreated paternal mental distress not only impairs the father’s well-being but may also disrupt family dynamics, partner support, and, crucially, the developmental trajectory of the child. Understanding the magnitude and nature of this association is essential to inform public health strategies and clinical interventions.
Study Design
This systematic review and meta-analysis by Le Bas and colleagues, published in JAMA Pediatrics in 2025, provides the most comprehensive quantitative synthesis to date on the association between paternal perinatal depression, anxiety, and stress and child development outcomes.
The authors systematically searched MEDLINE Complete, Embase, PsycINFO, CINAHL Complete, and gray literature for studies published up to November 2024. Eligible studies were required to be in English, involve human participants, report quantitative data, have a longitudinal design, and include validated measures of paternal perinatal mental distress and subsequent offspring developmental outcomes. A total of 9572 studies were screened, with 48 cohorts (from 84 studies) and 674 effect sizes included in the final meta-analysis. Notably, 286 unpublished associations were incorporated through direct author contact and doctoral theses, enhancing the comprehensiveness and reducing publication bias.
The primary outcomes assessed in offspring up to 18 years included global, social-emotional, adaptive, cognitive, language, physical, and motor development. Study quality was systematically assessed using the US NIH quality assessment tool for observational, cohort, and cross-sectional studies.
Key Findings
The meta-analysis revealed significant associations between paternal perinatal mental distress (comprising depression, anxiety, and stress) and several domains of child development:
- Global Development: Paternal mental distress correlated with poorer global development in offspring (r = -0.12; 95% CI, -0.22 to -0.01), indicating a small but statistically significant effect.
- Social-Emotional Development: Increased paternal distress was associated with greater social-emotional difficulties in children (r = 0.09; 95% CI, 0.07–0.11).
- Cognitive Development: A negative association was observed (r = -0.07; 95% CI, -0.13 to -0.01), suggesting subtle, but meaningful, cognitive impairments in children exposed to paternal perinatal distress.
- Language Development: The strongest effect was seen here (r = -0.15; 95% CI, -0.25 to -0.05), highlighting language acquisition as particularly sensitive to paternal mental health.
- Physical Development: A modest association was found (r = 0.04; 95% CI, 0.00–0.08).
- Adaptive and Motor Development: No significant associations were detected for these domains, suggesting specificity in the areas most vulnerable to paternal influence.
Importantly, associations were generally stronger for postnatal paternal mental distress compared to antenatal distress. This temporal pattern implies that the direct interaction between father and child after birth may be a key pathway through which paternal mental health shapes developmental trajectories.
Expert Commentary
This landmark review underscores the importance of including fathers in perinatal mental health screening and support programs. While effect sizes were modest, they are consistent across multiple developmental domains and have meaningful implications at the population level. The findings align with emerging research on the role of paternal involvement, attachment, and co-parenting quality in fostering optimal child development.
The absence of association with adaptive and motor outcomes is notable and suggests specificity in the impact of paternal distress—likely mediated by factors such as father–child interactions, family stress, and the home environment, which disproportionately affect cognitive, language, and social-emotional growth. The stronger associations observed postnatally highlight the critical window for intervention after childbirth, when fathers are more directly engaged in caregiving and family functioning.
However, several limitations should be acknowledged. The heterogeneity of included studies, variability in assessment tools, and potential residual confounding (e.g., maternal mental health, socioeconomic status) may influence effect estimates. Further, while the synthesis included unpublished data, the generalizability to non-English-speaking populations remains uncertain.
Conclusion
This systematic review and meta-analysis provides compelling evidence that paternal perinatal depression, anxiety, and stress are associated with a range of adverse developmental outcomes in children from birth to adolescence, particularly in the cognitive, language, and social-emotional domains. Given the modifiable nature of paternal mental distress and the availability of effective interventions (e.g., psychotherapy, peer support, family-based approaches), integrating paternal mental health screening and support into perinatal care should be prioritized. Future research should seek to elucidate causal mechanisms, optimize intervention timing, and address cultural and contextual factors influencing paternal mental health and its impact on child development.
References
1. Le Bas G, Aarsman SR, Rogers A, et al. Paternal Perinatal Depression, Anxiety, and Stress and Child Development: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2025 Aug 1;179(8):903-917. doi: 10.1001/jamapediatrics.2025.0880. PMID: 40522669; PMCID: PMC12171964.
2. Paulson JF, Bazemore SD. Prenatal and Postpartum Depression in Fathers and Its Association with Maternal Depression: A Meta-analysis. JAMA. 2010;303(19):1961-1969.
3. Ramchandani PG, Stein A, Evans J, O’Connor TG. Paternal depression in the postnatal period and child development: a prospective population study. Lancet. 2005;365(9478):2201-2205.
