Abstract
Objectives: The transition to parenthood is regarded as a potentially life changing event. The surrounding literature tends to dwell upon the negative aspects. Much emphasis is placed upon the mother’s mental health status, particularly screening for potential psychopathology, the aim being to diagnosis the presence of postnatal depression and provide suitable treatment. Whilst the value of screening for and being vigilant of potential problems for mothers and fathers in the postnatal period cannot be devalued, this approach provides little knowledge of what it is that makes mothers and fathers happy at this time. The aim of the study was to evaluate both the positive and negative health outcomes for mothers and their partners.
Study Design: Longitudinal Cohort Study
Methods: Women who delivered a live infant(s) at the Jessop Hospital, Sheffield between March 2008 and October 2009 were recruited to the study. Mothers were not eligible for participation if they required admission to Intensive Care or High Dependency Unit or if their infant required admission to the Neonatal Intensive Care Unit.
The health status of mothers and their partners was measured using self-reported outcome measures at five time points (1, 3, 6, 9 and 12 months postpartum). These questionnaires were a selection of generic and parent specific instruments, which measured positive and/or negative outcomes. These were; Positive Affect Negative Affect Schedule (PANAS), Edinburgh Postnatal Depression Scale (EPDS), Short Form 12 (SF-12) and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and the Sheffield Postnatal Health Instrument (S-PHI). The primary statistical analysis was conducted on parents who had completed questionnaires at all five time points. The baseline (one month postpartum) scores were compared to the average of the four follow up scores using paired samples t-test. Pearson Correlation coefficients were calculated using scores from ‘households’ to ascertain if there was any correlation between the parents.
Results: 710 participants (398 mothers and 312 fathers) were recruited at baseline and questionnaires were returned by 186 participants (112 mothers and 74 fathers) at twelve months postpartum. The mean age for mothers taking part in the study was 29 years of age (range 16 to 48 years) and 32 years of age for fathers (range 18 to 59 years).
There was a statistically significant increase in the PANAS Positive Affect for mothers from a mean score of 35.1 (SD 7.2) at baseline to an average follow-up score of 39.2 (SD 5.8), mean difference 4.1 (95% CI: 2.8 TO 5.5, P<0.001). For fathers, there was no change with a mean score of 38.8 (SD 7.2) at baseline and a mean average follow-up score of 38.8 (SD 6.3), mean difference 0.0 (95% CI: 1.6 to 1.7, P =0.947). There was a weak positive but not statistically significant correlation between mothers and fathers at twelve months (0.27, (95% CI:-0.15 to 0.61, P =0.202).
The results for the mothers’ domains of the S-PHI showed that there was a statistically significant difference between the mean baseline score and the average follow up score in 9 out of 11 domains. Of those nine domains eight showed a statistically significant decrease and one a statistically significant increase between the mean baseline score and the average follow up score. Only the ‘relationship with extended family’ domain results showed a statistically significance increase, suggesting a worsening over time with a mean score of 20.7 (SD 19.5) at baseline and a mean average follow up of 26.3 (SD 18.1) mean difference 5.5 (95% CI 2.7 to 8.4, P =<0.001). The results for the fathers’ domains showed that there was a statistically significant difference in three of the six domains. Two domains, ‘relationship with partner’ and ‘support from partner’ there was an increase between the mean baseline score and the average follow up score suggesting a worsening over time. Whereas the results for ‘role of father’ showed a statistically significant decrease suggesting an improvement over time.
Conclusion: Whilst overall, the health of parents appeared to improve with time; the results of the S-PHI do suggest that there may be concerns about parents’ perceived levels of support during the first year after the birth of their infant
