Paternity leave uptake and parental post-partum depression: findings from the ELFE cohort study.

BACKGROUND

Several countries are expanding their paternity leave policies, which can have positive effects on parental mental health. We examined whether 2 weeks of paid paternity leave are associated with post-partum depression in mothers and fathers at 2 months after the birth of their child.

METHODS

We used data from the Etude Longitudinale Française depuis l'Enfance (ELFE) cohort study. Participating mothers gave birth in 2011 in a representative sample of 320 maternity hospitals in mainland France. Inclusion criteria were single or twin livebirths born after at least 33 weeks' gestation; mother's age at least 18 years; no plans to leave metropolitan France within 3 years. Mothers were interviewed face-to-face shortly after the child's birth. Fathers and mothers were both interviewed by telephone 2 months after the child's birth, reporting whether the father had the right to paternity leave and if yes, if he had taken or intended to take it. We used the Edinburgh Postnatal Depression Scale to assess post-partum depression among fathers and mothers at 2 months. Logistic regression models, using survey-weighted data and adjusted for confounders using inverse probability weights, yielded odds ratios (ORs).

FINDINGS

We included 10 975 fathers and 13 075 mothers with reported information on paternity leave and post-partum depression at 2 months in the statistical analyses. Fathers had a median age of 32·6 years (IQR 36·9-22·6) and mothers had a median age of 30·5 years (34·0-27·1) at the time of the ELFE child's birth. The prevalence of depression in fathers according to paternity leave status was 4·5% among those who used paternity leave, 4·8% among those who intended to use paternity leave, and 5·7% among those who did not use paternity leave. For mothers, the prevalence of post-partum depression was 16·1% among those whose partner used paternity leave, 15·1% among those whose partner intended to use paternity leave, and 15·3% among those whose partner did not use paternity leave. Fathers who took paternity leave had reduced odds of post-partum depression (OR 0·74 [95% CI 0·70-0·78]) as did fathers who intended to take paternity leave (0·76 [0·70-0·82]) compared with fathers who did not take paternity leave. However, we did not find such beneficial effects for mothers whose partners took (1·13 [1·05-1·20]) or intended to take paternity leave (1·02 [0·96-1·08]).

INTERPRETATION

Taking and intending to take 2-weeks' paid paternity leave was associated with a reduced likelihood of reporting post-partum depression in fathers. However, offering 2-weeks' paternity leave might place mothers at a greater risk of post-partum depression, suggesting that optimal length and timing of the leave, among other factors, need further investigation.

FUNDING

The French National Research Agency.