Investigating the Relationship Between Cortisol and Paternal Postpartum Depression: A Research Protocol

Abstract

Introduction: Postpartum depression (PPD) is a common mental health condition that affects new parents and is often associated with major depressive disorder (MDD). However, research focuses on maternal experiences, overlooking paternal PPD. Cortisol is a stress hormone that can cause dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, impacting the mental state, and serving as a biomarker of depression. This dysregulation could result in fathers experiencing PPD, as decreased levels of cortisol may hinder father-newborn bonding. PPD can develop over a year rather than within the first four weeks post-childbirth. 4% to 25% of new fathers experience PPD, with peak prevalence occurring within 3-6 months after childbirth. The Edinburgh Postnatal Depression Scale (EPDS) is a tool designed to screen for symptoms of PPD. This study examines the correlation between cortisol levels and PPD among fathers.

Methods: A total of 100 fathers aged 18-45 will be recruited from urban hospitals in the Greater Toronto Area within 1 month postpartum. Participants will be screened using the EPDS, and blood samples will be collected to measure cortisol levels using an enzyme-linked immunosorbent assay (ELISA). This data will be collected at 1, 3, 6, and 12 months postpartum. Fathers with pre-existing psychiatric conditions, cortisol-altering medications, or significant health conditions will be excluded. Statistical analyses of the data will investigate the association between cortisol levels and paternal PPD.

Results: The study expects a statistically significant negative difference in cortisol levels between fathers with PPD and those without, indicating a potential association between cortisol dysregulation and paternal PPD. The study may identify predictors (marital status, previous parenting experience, finances) influencing cortisol levels in fathers, providing insight into cortisol regulation and paternal well-being.

Discussion: Findings will indicate cortisol as a biomarker for paternal PPD and assist in early interventions. It can also help with the readiness of healthcare providers to begin mental health services to fathers after delivery.

Conclusion: This study investigates the link between low cortisol levels and paternal PPD, hypothesizing a positive correlation with EPDS. Findings may lead to early screening tools and targeted interventions aimed at improving paternal mental health.