P3B305: Paternal Postpartum Depression and Children’s Adverse Childhood Experiences at Age 5

Background: Paternal depression is associated with child behavior problems and problematic parenting, yet little is known about its association with subsequent child adverse childhood experiences (ACEs). We investigated associations between depression in fathers of infants and children’s ACEs at age 5, an important developmental stage.

Methods: We analyzed data on 1933 father/child dyads from the Future of Families and Child Wellbeing Study, a national U.S. urban birth cohort. By design, ~75% of the mothers were unmarried. Paternal depression was assessed using a validated instrument when the child was 1-year old and children’s ACEs were reported by their mothers 5 years later. ACEs included 5 measures of household chaos (father absence, maternal depression, substance use, incarceration, violence towards caregiver) and 4 types of child maltreatment (psychological, neglect, physical, sexual). We used measures of overall exposure to ACEs (>=1 ACE, >=2 ACEs, 3+ ACEs) as well as specific ACEs. We estimated unadjusted and adjusted logistic regression models of associations between paternal depression and ACEs. Adjusted models controlled for father, family, and child characteristics and maternal depression.

Results: Of the 1933 father/child dyads analyzed, about half of fathers were non-Hispanic Black (48%), 64% had a high school education or lower, and 50% of births were paid for by Medicaid. Nine percent of the fathers experienced depression during the year after their children were born and 70% of the children experienced at least one ACE at 5 years. Children whose fathers had depression at 1-year had higher odds of ACEs than those whose fathers did not have depression. In unadjusted logistic regression models, children whose fathers had depression at 1-year had almost 3 times higher odds of any ACEs (OR 2.94, CI 1.88-4.62) and over 2 times higher odds of 3+ ACEs (OR 2.40, CI 1.72-3.36). In adjusted models, associations remained robust with an OR of 2.35 (CI 1.45-3.81) for any ACEs and 2.04 (CI 1.42-2.93) for 3+ ACEs.

Conclusion: Children whose fathers experienced postpartum depression were significantly more likely to experience multiple ACEs at 5 years, above and beyond maternal postpartum depression and other potentially confounding factors. The preliminary findings show a robust association between fathers’ postpartum depression and subsequent adversity for their children. Expanding maternal and child health policy and practice to include fathers and early identification with robust intervention for paternal depression may stave off childhood adversity.