# Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors

## TL;DR

This study tracks depression and anxiety symptoms in mothers and fathers from pregnancy to two years postpartum, identifying risk and protective factors for emotional health.

## Contribution

The study identifies modifiable risk and protective factors for internalizing symptoms in both mothers and fathers during the perinatal period.

## Key findings

- 21.2% of mothers had persistent clinical elevations in internalizing symptoms up to two years postpartum.
- 7.8% of fathers showed clinical elevations, and 29.0% had subthreshold symptoms during the perinatal period.
- Psychological flexibility and emotional intimacy were protective factors for fathers' mental health.

## Abstract

There is an increased risk for depression and anxiety across the perinatal period (i.e., spanning pregnancy and the first year postpartum); however, limited research has examined elevations in core negative affectivity underlying internalizing disorders more broadly. The current study sought to characterize trajectories of core internalizing problems among both mothers and fathers across the perinatal period and explored whether modifiable risk and protective factors buffered risk for elevated symptoms during this key developmental transition. A community sample of mixed-sex couples (N = 159) completed assessments during pregnancy and at four postpartum timepoints. Using growth mixture modeling, we found that 21.2% of mothers demonstrated clinical elevations in core internalizing symptoms that persisted up to 2 years postpartum. In contrast, 7.8% of fathers demonstrated clinical elevations in core internalizing symptoms across this period, with an additional 29.0% of fathers demonstrating subthreshold symptom elevations. Concerns related to pregnancy and childbirth and paternal (partner) internalizing problems during pregnancy conferred risk for elevated symptoms in mothers, whereas psychological flexibility, emotional intimacy, and the quality of received support were identified as protective factors for fathers. Results highlight the importance of repeated screening for internalizing problems and suggest that promoting a strong interparental relationship is critical for emotional health and well-being across the perinatal period.