MONDAY, Jan. 7 (HealthDay News) -- Plenty of research has linked a mother's mental health during and after pregnancy with her child's well-being. Now, a new study suggests that an expectant father's psychological distress might influence his toddler's emotional and behavioral development.
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"The results of this study point to the fact that the father's mental health represents a risk factor for child development, whereas the traditional view has been that this risk in large is represented by the mother," said study lead author Anne Lise Kvalevaag. "The father's mental health should therefore be addressed both in research and clinical practice."
For the study, published online Jan. 7 in the journal Pediatrics, the researchers looked at more than 31,000 children born in Norway and their parents.
Fathers were asked questions about their mental health, such as whether they felt blue or fearful, when the mothers were four to five months' pregnant.
Mothers provided information about their own mental health and about their children's social, emotional and behavioral development at age 3 years.
The researchers did not look at specific diagnoses in children, but instead gathered information on whether the youngsters got into a lot of fights, were anxious or if their mood shifted from day to day, said Kvalevaag, a doctoral candidate in psychology at the University of Bergen in Norway.
Three percent of the fathers reported high levels of psychological distress. In the end, the researchers identified an association between the father's mental health and a child's development. Children of the most distressed men struggled the most emotionally at age 3. However, the research was not able to establish a direct cause-and-effect relationship.
Any number of potential mechanisms may explain the association, stated the authors.
For instance, there may be a genetically transmitted risk to the child, said Kvalevaag.
Another expert said that depression in fathers could also affect the mental health of the mother-to-be and thus, indirectly, the developing fetus.
"If a father is highly distressed, that could affect the mom's secretion of hormones during pregnancy, it could affect her sleep, her own mental status," said Daniel Armstrong, professor of pediatrics and director of the Mailman Center for Child Development at the University of Miami Miller School of Medicine.
Kvalevaag added that "the prenatal mental state of the father is likely to predict the postnatal mental health of the father and this may also account for some of the associations found."
Although this was reportedly the largest prospective study to look at this issue, it did have some limitations.
For instance, information on mental health was obtained only from self-reports, which can be unreliable.
Previous research has shown that depressed mothers perceived their infants to be problematic more often than more objective observers did, said Michael Rice, associate clinical director of the Behavioral Health Education Center of Nebraska at the University of Nebraska Medical Center in Omaha.
A solution may be relatively straightforward, said Armstrong.
"When mom comes in for appointments, we should at least be raising the question of how dad's doing," he said. "That's probably a question that's never asked."
Rice welcomed the research. "This study gives a more complete picture," he said. "When we talk about preventative mental health and preventing these things in the kids, we really need resources there at the prenatal stage for both the mother and the father."
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SOURCES: Anne Lise Kvalevaag, Psy.D., specialist in clinical child and adolescent psychology, department of psychiatry, Haugesund Hospital, Helse Fonna HF, and Ph.D. candidate, faculty of psychology, University of Bergen, Norway; Michael Rice, Ph.D., psychiatric nurse practitioner and associate clinical director, Behavioral Health Education Center of Nebraska, University of Nebraska Medical Center, Omaha; Daniel Armstrong, Ph.D., professor, pediatrics, and director, Mailman Center for Child Development, University of Miami Miller School of Medicine; February 2013, Pediatrics