Depression associated with decreased odds of having children
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Depression was associated with a lower likelihood of having children and of having fewer children for adults in Finland, according to data published in the American Journal of Obstetrics & Gynecology.
“It is possible that depression is associated with lower fertility, but previous findings were mixed, and there were also only few population-based studies on this topic,” Kateryna Golovina, PhD, a postdoctoral researcher at the University of Helsinki, told Healio. “Therefore, we decided to use Finnish high-quality register data to study whether depression is related to the likelihood of having children among men and women.”
Golovina and colleagues included 1,408,951 men and women born in Finland between 1960 and 1980 in their analyses. They identified 106,725 people who had depression using the Care Register for Health Care, which listed inpatient hospital episodes between 1969 and 2017 and specialist outpatient visits between 1996 and 2017.
The researchers analyzed the relationship between depression and the odds of having children, as well as identified differences in these associations between socioeconomic strata.
Findings
Compared with no depression, having depression decreased the odds of having children for both men (OR = 0.66; 95% CI, 0.64-0.67) and women (OR = 0.84; 95% CI, 0.82-0.85). Having depression was also associated with having fewer children (men incidence rate ratio [IRR] = 0.86; 95% CI, 0.86-0.87; women IRR = 0.96; 95% CI, 0.96-0.96) and younger parental age at first birth (men, 33.1 years vs. 34 years; women, 31.3 vs. 32.1 years; both P < .001) compared with having no depression.
Additionally, the likelihood of having children and the number of children decreased with increasing severity of depression. For women, only severe depression and severe depression with psychosis were linked to a lower likelihood of having children and fewer children compared with no depression. For men, having any severity of depression was associated with lower odds of having children and fewer children.
Younger age at onset of depression was also linked to lower likelihood of having children and having fewer children compared with older age at onset.
Role of socioeconomic status
Among women who attained less than a high school degree, those with depression had greater odds of being a parent (OR = 1.44; 95% CI, 1.36-1.52) and having more children (IRR = 1.13; 95% CI, 1.11-1.15) compared with women with no depression. For men who attained less than a high school degree, researchers observed no associations between depression and the odds of having children or number of children.
Among both men and women with at least a secondary education, having depression was associated with lower odds of having children and having fewer children.
“Our findings suggest that depression is one of the factors contributing to the likelihood of having children, which is why early prevention and on-time treatment of depression are crucial,” Golovina said. “For example, screening for depression can be done by obstetrician-gynecologists and women’s health providers or by increasing the availability of mental health providers. Also, the severity of depression should be taken into account, given that milder depression is likely to have more negative health and behavioral effects among men compared to women.”
Future research should examine how impactful depression is on having children in comparison to other mental disorders, Golovina said.