Paternal anxiety during pregnancy and infancy linked to children’s mental health risks

Children whose fathers experience anxiety during the perinatal period may be at increased risk for mental health difficulties later in life, according to a new study published in the journal Development and Psychopathology. The researchers found that anxiety in fathers either before or after the child’s birth was associated with emotional and behavioral problems in early childhood.

This research responds to a long-standing gap in developmental psychology. While maternal mental health has been extensively studied in relation to child development, the potential impact of paternal anxiety—especially around the time of a child’s birth—has received comparatively little attention.

Yet anxiety is a common experience for new fathers, who often face social, financial, and emotional pressures during this period. Estimates suggest that between 6 to 13 percent of new fathers experience anxiety disorders, a rate notably higher than that observed in men more generally. The transition to fatherhood may be a sensitive time, both for the parent and the child.

“The main motivation behind my research is the urgent need to address the rising rates of mental health difficulties among children and young people. Around the world, we are seeing a worrying increase in these issues – a trend that has been recognized as a major international health priority,” said study author Francesca Zecchinato (@fzecchinato), a researcher within the NIHR ARC Wessex Mental Health Hub at the University of Southampton.

“While there is no single or simple solution, prevention is seen as one of the most promising ways to ease this burden. But to prevent mental health problems effectively, we first need to understand the risk factors that contribute to them. One of the clearest, and potentially modifiable, risk factors for child mental ill-health is parental mental health. Among all mental health conditions, anxiety is the most common worldwide, and it is particularly prevalent in parents. That is why we chose to focus our research on the potential impact of parental anxiety on children’s mental health.”

“Much of the existing research in this area has focused on mothers, especially during pregnancy,” Zecchinato explained. “But fathers also play a crucial role in a child’s early development, and their mental health has received far less attention. I was especially interested in whether a father’s anxiety during the perinatal period, a time of major life change and adjustment, could have lasting effects on their child’s mental health outcomes.”

“To explore this, we used data from one of the largest and most well-established longitudinal studies in the UK, which follows children and their families over many years. With this study, we hoped to shed light on an often-overlooked area and contribute to a more complete understanding of how we might better support families from the very beginning.”

The study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large cohort study tracking thousands of families in the United Kingdom since the early 1990s. The researchers examined anxiety symptoms in fathers at two key timepoints: 18 weeks into their partner’s pregnancy (prenatal) and 8 weeks after birth (postnatal). They then tracked the mental health of the children at ages 3.5 and 7.5 years.

Fathers were categorized into four groups based on their anxiety status: those with no anxiety, those with anxiety only during pregnancy, those with anxiety only after birth, and those with anxiety at both timepoints. Anxiety was measured using a self-reported symptom questionnaire. The study then looked at how each group related to emotional and behavioral outcomes in the children, while also accounting for factors such as the child’s temperament, maternal mental health, and family socioeconomic background.

At 3.5 years old, children whose fathers had experienced anxiety during pregnancy (but not after birth) showed higher rates of emotional and behavioral problems than those whose fathers had not been anxious at either time. This prenatal-only group appeared to be at particular risk for emotional difficulties. Children whose fathers experienced anxiety only after birth did not show significantly higher mental health risks at this age.

By the time children reached 7.5 years old, a different pattern emerged. At this later stage, it was the children who had been exposed to paternal anxiety both before and after birth who showed the greatest vulnerability. These children were more likely to receive a psychiatric diagnosis, particularly for behavioral disorders such as attention-deficit hyperactivity disorder or conduct problems. In contrast, children exposed to paternal anxiety at only one timepoint—either prenatal or postnatal—did not show significantly elevated risk at age seven.

“What stood out was how the timing of paternal anxiety seemed to matter,” Zecchinato told PsyPost. “We looked at whether anxiety in fathers during pregnancy (prenatal), after birth (postnatal), or both, was linked to children’s mental health later on, both in early childhood (around 3.5 years) and later in primary school (around 7.5 years).”

“Interestingly, we found that paternal prenatal anxiety on its own was already associated with emotional and behavioral difficulties in early childhood, even in the absence of paternal postnatal anxiety. But when we looked at mental health outcomes later in childhood, difficulties were more likely to appear only when children had been exposed to paternal anxiety both before and after birth.”

“While there could be several factors behind this pattern, it suggests that when a child is exposed to parental anxiety might influence how it affects their development, and that different stages of early life may involve different processes of risk.”

These findings held even after controlling for a wide range of other influences, including the mother’s mental health, child temperament, and family social characteristics. The researchers also examined whether the child’s sex mattered. Boys appeared to be more strongly affected by prolonged paternal anxiety than girls, particularly when it came to behavioral problems. This may reflect differences in how fathers interact with sons versus daughters, or biological sensitivities that vary by sex.

“Our findings suggest that when fathers experience anxiety during their partner’s pregnancy or in the early months after birth, it can increase the risk of emotional and behavioral difficulties in their children, even when we take into account the mother’s mental health and other sociodemographic factors,” Zecchinato said. “This highlights an important message: fathers’ mental health matters, not just for their own wellbeing, but for their children’s development too.”

“By supporting both parents during the perinatal period, including helping fathers recognise and manage stress or anxiety, and their mental health in general, we may be able to make a real difference to the mental health of future generations.”

The authors stress that their findings do not mean paternal anxiety directly causes mental health problems in children. The mechanisms remain unclear. Prenatal paternal anxiety could influence children indirectly, for instance by affecting the mother’s stress levels during pregnancy or by contributing to conflict in the family. Postnatal anxiety may interfere more directly with father-child interactions, such as through increased withdrawal, overcontrol, or difficulty responding sensitively to the child’s emotional needs.

“We weren’t able to pinpoint exactly how or why paternal anxiety might affect children’s development,” Zecchinato said. “Understanding these mechanisms is an important next step. It would help us design more effective prevention and intervention strategies that target modifiable risk factors to support children’s mental health from the earliest stages of life.”

Despite these caveats, the study carries important implications. It suggests that paternal mental health in the perinatal period deserves more attention in both research and clinical settings. While mothers have historically been the focus of interventions aimed at supporting child development, these findings highlight that fathers’ mental wellbeing can also shape the family system in ways that affect children’s long-term outcomes.

“For a long time, research on child development has focused almost exclusively on mothers, who were traditionally seen as the primary caregivers,” Zecchinato explained. “Fathers were often viewed as having a more secondary role, which meant their experiences and contributions were frequently overlooked. This imbalance not only led to a limited understanding of parental influence, but also, at times, placed unfair blame on mothers for the challenges their children faced.”

“Our study adds to a growing body of evidence showing that fathers’ mental health matters, too. When we exclude fathers from research and clinical conversations, we risk missing a key piece of the puzzle when it comes to understanding and supporting child and family wellbeing. This is especially important today, as fathers are increasingly taking on more active caregiving roles.”

The study, “The impact of perinatal exposure to paternal anxiety on offspring: A prospective study using the Avon Longitudinal Study of Parents and Children cohort,” was authored by Francesca Zecchinato, Jana M. Kreppner, and Peter J. Lawrence.