A Systematic Review and Meta-analysis: Paternal Anxiety and the Emotional and Behavioral Outcomes in Their Offspring

Abstract

Anxiety disorders are highly prevalent worldwide; however, the literature lacks a meta-analytic quantification of the risk posed by fathers' anxiety for offspring development. Here, we aimed to provide a comprehensive estimate of the magnitude of the association between paternal anxiety and offspring emotional and behavioral problems. In this systematic review and meta-analysis, to identify all the quantitative studies that measured anxiety in fathers and emotional and/or behavioral outcomes in offspring, we searched Web of Science, Ovid (Embase, MEDLINE, PsycINFO), the Trip Database and ProQuest in February 2022. We set no limits for offspring age, publication language or year. We extracted summary estimates from the primary studies. We used meta-analytic random-effects three-level models to calculate correlation coefficients. Quality was assessed using the Newcastle-Ottawa Scale. Our study protocol was pre-registered with PROSPERO (CRD42022311501) and adhered to the PRISMA reporting guidelines. We identified 11,746 records, 98 of which were included in our meta-analysis. We found small but significant associations between paternal anxiety and offspring emotional and behavioral problems overall (r=.16, 95%CI[.13,.19]), behavioral (r=.19, 95%CI[.13,.24]), emotional (r=.15, 95%CI[.12,.18]), anxiety (r=.13, 95%CI[.11,.16]), and depression problems (r=.13, 95%CI[.03,.23]). We identified some significant moderators. Paternal mental health is associated with offspring development and the offspring of fathers with anxiety symptoms or disorders are at increased risk of negative emotional and behavioral outcomes, in line with the principles of multifinality and pleiotropy. The substantial heterogeneity among studies and the over-representation of White European American groups in this literature highlight the need for further research.