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- Title
Adverse Pregnancy Outcomes and Subsequent First-Time Use of Psychiatric Treatment Among Fathers in Denmark.
- Authors
Christiansen, Frederik; Petersen, Janne; Thorius, Ida Holte; Ladelund, Agnes; Jimenez-Solem, Espen; Osler, Merete; Ankarfeldt, Mikkel Zöllner
- Abstract
Key Points: Question: Are adverse pregnancy outcomes associated with incident use of psychiatric treatment among first-time fathers? Findings: In this Danish register-based cohort study including 192 455 first-time fathers with no history of psychiatric treatment, stillbirth and induced abortion were associated with an increased risk of subsequent initiation of pharmacological or nonpharmacological psychiatric treatment. Meaning: These findings suggest a need for more awareness of the psychological state of first-time fathers who experience adverse pregnancy outcomes. This cohort study examines the potential associations of adverse pregnancy outcomes with first-time use of psychiatric treatment among first-time fathers in Denmark. Importance: Becoming a first-time parent is a major life-changing event and can be challenging regardless of the pregnancy outcome. However, little is known how different adverse pregnancy outcomes affect the father's risk of psychiatric treatment post partum. Objective: To examine the associations of adverse pregnancy outcomes with first-time psychiatric treatment in first-time fathers. Design, Setting, and Participants: This nationwide cohort study covered January 1, 2008, to December 31, 2017, with a 1-year follow-up completed December 31, 2018. Data were gathered from Danish, nationwide registers. Participants included first-time fathers with no history of psychiatric treatment. Data were analyzed from August 1, 2022, to February 20, 2024. Exposures: Adverse pregnancy outcomes including induced abortion, spontaneous abortion, stillbirth, small for gestational age (SGA) and not preterm, preterm with or without SGA, minor congenital malformation, major congenital malformation, and congenital malformation combined with SGA or preterm compared with a full-term healthy offspring. Main Outcomes and Measures: Prescription of psychotropic drugs, nonpharmacological psychiatric treatment, or having a psychiatric hospital contact up to 1 year after the end of the pregnancy. Results: Of the 192 455 fathers included (median age, 30.0 [IQR, 27.0-34.0] years), 31.1% experienced an adverse pregnancy outcome. Most of the fathers in the study had a vocational educational level (37.1%). Fathers experiencing a stillbirth had a significantly increased risk of initiating nonpharmacological psychiatric treatment (adjusted hazard ratio [AHR], 23.10 [95% CI, 18.30-29.20]) and treatment with hypnotics (AHR, 9.08 [95% CI, 5.52-14.90]). Moreover, fathers experiencing an early induced abortion (≤12 wk) had an increased risk of initiating treatment with hypnotics (AHR, 1.74 [95% CI, 1.33-2.29]) and anxiolytics (AHR, 1.79 [95% CI, 1.18-2.73]). Additionally, late induced abortion (>12 wk) (AHR, 4.46 [95% CI, 3.13-6.38]) and major congenital malformation (AHR, 1.36 [95% CI, 1.05-1.74]) were associated with increased risk of nonpharmacological treatment. In contrast, fathers having an offspring being born preterm, SGA, or with a minor congenital malformation did not have a significantly increased risk of any of the outcomes. Conclusions and Relevance: The findings of this Danish cohort study suggest that first-time fathers who experience stillbirths or induced abortions or having an offspring with major congenital malformation had an increased risk of initiating pharmacological or nonpharmacological psychiatric treatment. These findings further suggest a need for increased awareness around the psychological state of fathers following the experience of adverse pregnancy outcomes.
- Subjects
DENMARK; MISCARRIAGE; PSYCHOLOGY of fathers; FATHERHOOD; RESEARCH funding; PREGNANCY outcomes; PARENTING; TREATMENT effectiveness; DESCRIPTIVE statistics; LONGITUDINAL method; PSYCHOSES; CONFIDENCE intervals; DATA analysis software; ABORTION; PSYCHIATRIC drugs
- Publication
JAMA Network Open, 2024, Vol 7, Issue 4, pe249291
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.9291