| Summary: | 碩士 === 臺北醫學大學 === 公共衛生學系暨研究所 === 102 === Background: Significant changes during prenatal and postpartum periods may affect maternal physical, mental and psychosocial health. Postnatal emotional difficulties, including depression and anxiety, are frequently observed. In Taiwan, no matter women are employed or not, childcare duties are mainly taken by mothers. Recently, more and more studies have emphasized the importance of paternal involvement (i.e., fathers are encouraged to engage in child caring work and offer instrumental support to the mothers) during perinatal periods. Paternal involvement may be positive to children’s growth and development and to the marital relationship as well. Although low paternal involvement was identified as a potentially detrimental factor, more studies are in need to further estimate the effects of paternal involvement on maternal postpartum depression and anxiety, together with the role of maternal job status in this association.
Objectives: This study was aimed at investigating (1) the current picture of paternal involvement at 6 months postpartum in Taipei and New Taipei City; (2) the prevalence of maternal depression and anxiety at 6 months postpartum in Taipei and New Taipei City; (3) the association between paternal involvement and maternal postnatal depression and anxiety at 6 months postpartum; and (4) the potential modifying effects of maternal job status in the association between paternal involvement and maternal postnatal depression and anxiety.
Method: Women prior to 16 gestational weeks and their partners attending the prenatal visits from July 2011 to June 2013 in four selected hospitals in Taipei City and New Taipei City were invited for participation. A total of 425 pairs of parents completed the first interview and responded the follow-up questionnaire at 6 months postpartum. Self-reported data were collected by instruments of the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory scale (STAI-S) and the paternal involvement scale. Binary and multinomial logistic regression models were performed for analyses.
Result: We found that fathers spent an average of 34.28 hours a week with their child. When mothers were away, an average of 12.95 hours a week was reported. The frequencies of paternal engagement in childcare work ranged from once a day to several times a week, while those of father-child interaction ranged from several times a week to several times a month. The prevalences of maternal postnatal depression and anxiety were estimated as 21.24％ and 40.77％, respectively. In binary and multinomial logistic regression analyses, compared to higher level of paternal involvement, lower level of involvement was independently associated with increased risks of maternal postpartum depression (adjusted OR=2.33, 95％CI=1.23-4.42). If both depression and anxiety were considered, lower level of paternal involvement significantly increased the risks of maternal comorbid depression and anxiety (adjusted OR=2.35, 95％CI=1.09-5.05). For mothers without jobs, the impact of lower paternal involvement on maternal emotional difficulties was even more salient, while for employed mothers, findings did not reach the statistically significant level.
Conclusion: High prevalences of maternal postpartum emotional difficulties deserve continued consideration. We suggest the need of screening perinatal depression and anxiety during routine obstetric examination to help gynecologists promptly evaluate maternal emotional status. For public health and psychological professionals, continued physical and mental care together with appropriate health education should be provided. Especially for unemployed mothers, the considerable effects of higher paternal involvement on childcare arrangements to help ameliorate maternal emotional difficulties should be emphasized. Future longitudinal studies with larger sample size are in need to further clarify the relationships between paternal involvement and maternal emotional status. Findings could also be extended to longer-term impact on children’s preschool years.
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