P2.B036: Implementing Routine Postpartum Depression Screening in Fathers with Infants with a Prenatal Diagnosis of Congenital Heart Defects

Background: The role of the father in the parent-child dyad is an emerging area of research with evolving societal expectations. The American Academy of Pediatrics (AAP) advocates for paternal involvement in pediatric care. Pediatric providers play a vital role in changing this landscape.

Fathers have been overlooked in post-partum depression (PPD). The recognized standard for maternal PPD has not translated to paternal screening. Studies suggest that about 25% of fathers suffer from PPD symptoms and the risk increases with combined maternal PPD.

Paternal PPD increases childhood emotional instability and leads to poorer outcomes in development. Fathers of infants with chronic illness have been found to experience intense emotional reactions and deeper involvement with their child’s care compared to average. Our center recently implemented a maternal PPD screening pathway for mothers of congenital heart disease (CHD) infants. Alarmingly, nearly half of mothers screened positive for PPD, but we currently have no process for screening fathers. Consequently, it is imperative to better determine the need for paternal PPD screening in CHD.

Project Description: The aim of this study was to assess the need for paternal PPD screening in fathers of children with prenatally diagnosed CHD.

Inclusion criteria: primary paternal guardian of a child with prenatal diagnosis of CHD (2022-23) admitted to the ICU during the postpartum period. Fathers with fetal or infant demise or who were not involved with the child were excluded.

The survey (Figure 1), created at a < 8th grade reading level, included five yes/no and subjective response questions regarding mental health screening and support provided during their infant’s admission. The survey was conducted by the cardiology team via phone. We utilized this data to identify key stakeholders/partners in paternal PPD identification and develop a process map for paternal PPD screening.

Discussion: 29 fathers were identified meeting all inclusion criteria, 17 completed the survey. 17.6% reported their mental health was not supported by our cardiology team, 0% reported they were screened for PPD during their child’s admission. 29% were interested in mental health support, 100% of which reported not receiving support. 60% of those who were interested in mental health support had partners with positive maternal PPD screens. Qualitative responses for questions are shown in figure 1. A screening process was derived for improved paternal support (Figure 2).

Conclusion: Despite the changing societal realities with fathers playing increasingly involved roles, pediatric care remains centered around mothers. This focus often leaves fathers unsupported, which can add to long-term morbidity. Pediatric health care providers should play an active role in screening for paternal PPD. Identifying paternal PPD and connecting fathers to mental health resources has potential to improve both infant and paternal health outcomes.