{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:59Z","timestamp":1792787279958,"version":"4.5.0"},"reference-count":40,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":83,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["21-416"],"award-info":[{"award-number":["21-416"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Zhejiang University Fundamental Research Fund for the Central Universities","award":["Grant no \u2013 NA"],"award-info":[{"award-number":["Grant no \u2013 NA"]}],"id":[{"id":"https:\/\/ror.org\/00a2xv884","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Key Medical Program of Jiangsu Health Commission","award":["ZD2021044"],"award-info":[{"award-number":["ZD2021044"]}]},{"name":"Huai\u2019an Science and Technology Program","award":["HAB2024039"],"award-info":[{"award-number":["HAB2024039"]}]},{"name":"Natural Science Foundation of China","award":["72474197"],"award-info":[{"award-number":["72474197"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,8,21]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Little is known about how differences in parental contributions to childcare impact maternal postpartum psychosocial well-being, particularly in the context of global fertility decline. This study aims to explore associations of parental childcare contributions with maternal postpartum psychosocial disorders among Chinese women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the Grandmothers, Mothers and Their Children\u2019s Health study in Huai\u2019an, China were used. Participants were 1991\u2009women who experienced childbirth between 2020 and 2021; follow-up survey was conducted in 2023. Parental childcare contributions were examined by care index. Maternal psychosocial disorders included mental health disorders and poor social health. Logistic regression models were conducted to assess the associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>93% mothers reported high-contribution childcare; in contrast, only 41% fathers had high-contributions. After mutual adjustment of parental childcare contributions, paternal low-contribution was associated with higher odds of maternal mental health disorders (OR=1.79, 95% CI 1.24 to 2.57) and poor social health (1.76, 1.37 to 2.24). However, these associations were not observed for maternal childcare contribution. For joint patterns of parental childcare contributions, those involving paternal low-contribution childcare were associated with higher odds of maternal psychosocial disorders, regardless of maternal contribution. The associations were consistent across different subpopulations with varied sociodemographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Parents\u2019 contributions in childcare were imbalanced in China. Paternal low-contribution childcare was independently associated with higher odds of maternal postpartum psychosocial disorders, highlighting the potential relevance of paternal childcare contribution to maternal postpartum psychosocial well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2026-005051","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:35:34Z","timestamp":1790102134000},"page":"e005051","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Differences in parental childcare contributions and maternal postpartum psychosocial well-being: a cross-sectional study"],"prefix":"10.1136","volume":"4","author":[{"given":"Yue","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9818-1174","authenticated-orcid":false,"given":"Marlee","family":"Bower","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijie","family":"Ding","sequence":"additional","affiliation":[{"name":"Healthcare Department, Huai'an Maternal and Child Health Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songtao","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunyi","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyue","family":"Dai","sequence":"additional","affiliation":[{"name":"Healthcare Department, Huai'an Maternal and Child Health Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaguan","family":"Zhou","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Cai","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yipei","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huafei","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuying","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Healthcare Department, Huai'an Maternal and Child Health Hospital Affiliated to Yangzhou University, Huai'an, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-9878","authenticated-orcid":false,"given":"Xiaolin","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China"},{"name":"School of Public Health, The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026092211352680000_4.3.e005051.1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.21037\/cdt-22-213","article-title":"Psychosocial well-being in postpartum women with congenital heart disease","volume":"12","author":"Freiberger","year":"2022","journal-title":"Cardiovasc Diagn Ther"},{"key":"2026092211352680000_4.3.e005051.2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s12916-025-03853-1","article-title":"Postpartum depression in relation to chronic diseases and multimorbidity in women\u2019s mid-late life: a prospective cohort study of UK Biobank","volume":"23","author":"Zhang","year":"2025","journal-title":"BMC Med"},{"key":"2026092211352680000_4.3.e005051.3","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1038\/s41398-021-01663-6","article-title":"Mapping global prevalence of depression among postpartum women","volume":"11","author":"Wang","year":"2021","journal-title":"Transl Psychiatry"},{"key":"2026092211352680000_4.3.e005051.4","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-022-02065-5","article-title":"Loneliness in pregnant and postpartum people and parents of children aged 5 years or younger: a scoping review","volume":"11","author":"Kent-Marvick","year":"2022","journal-title":"Syst Rev"},{"key":"2026092211352680000_4.3.e005051.5","doi-asserted-by":"crossref","unstructured":"The Lancet Public Health . Social health-the neglected third pillar. Lancet Public Health 2025. doi:10.1016\/S2468-2667(25)00175-6","DOI":"10.1016\/S2468-2667(25)00175-6"},{"key":"2026092211352680000_4.3.e005051.6","unstructured":"Fostering social connection for global health: the essential role of social connection in combating loneliness, social isolation and inequities in health. 2025. Available: https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA78\/A78_ACONF2-en.pdf [Accessed 5 Sep 2025]."},{"key":"2026092211352680000_4.3.e005051.7","article-title":"The ministry of loneliness","volume":"64","author":"Pimlott","year":"2018","journal-title":"Can Fam Physician"},{"key":"2026092211352680000_4.3.e005051.8","unstructured":"Preparatory meeting of the collaborative platform for loneliness and isolation measures. Available: https:\/\/japan.kantei.go.jp\/99_suga\/actions\/202109\/_00033.html [Accessed 5 Sep 2025]."},{"key":"2026092211352680000_4.3.e005051.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00550-6"},{"key":"2026092211352680000_4.3.e005051.10","unstructured":"d\u2019Addio AC . Childcare policies and fertility considerations. In: Daly M , Pfau-Effinger B , Gilbert N , et al , eds. The Oxford Handbook of Family Policy Over The Life Course. Oxford University Press, 2023."},{"key":"2026092211352680000_4.3.e005051.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2015.11.001"},{"key":"2026092211352680000_4.3.e005051.12","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2018-3556","article-title":"Parenting behaviour and child language: A meta-analysis","volume":"144","author":"Madigan","year":"2019","journal-title":"Pediatrics"},{"key":"2026092211352680000_4.3.e005051.13","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S446490"},{"key":"2026092211352680000_4.3.e005051.14","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/cdev.13858","article-title":"Child care and family processes: Bi-directional relations between child care quality, home environments, and maternal depression","volume":"94","author":"Hart","year":"2023","journal-title":"Child Dev"},{"key":"2026092211352680000_4.3.e005051.15","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4054\/DemRes.2024.51.3","article-title":"Lessons from the pandemic: Gender inequality in childcare and the emergence of a gender mental health gap among parents in Germany","volume":"51","author":"Hiekel","year":"2024","journal-title":"DemRes"},{"key":"2026092211352680000_4.3.e005051.16","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.acap.2018.05.006","article-title":"Childcare instability and maternal depressive symptoms: Exploring new avenues for supporting maternal mental health","volume":"19","author":"Johnson","year":"2019","journal-title":"Acad Pediatr"},{"key":"2026092211352680000_4.3.e005051.17","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajog.2012.12.020","article-title":"A prospective study of perinatal depression and trauma history in pregnant minority adolescents","volume":"208","author":"Meltzer-Brody","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"2026092211352680000_4.3.e005051.18","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jogn.2020.05.007","article-title":"Effect of fathers\u2019 presence and involvement in newborn care in the NICU on mothers\u2019 symptoms of postpartum depression","volume":"49","author":"Kim","year":"2020","journal-title":"Journal of Obstetric, Gynecologic & Neonatal Nursing"},{"key":"2026092211352680000_4.3.e005051.19","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1080\/02646838.2012.693155","article-title":"The impact of paternity leave and paternal involvement in child care on maternal postpartum depression","volume":"30","author":"S\u00e9journ\u00e9","year":"2012","journal-title":"J Reprod Infant Psychol"},{"key":"2026092211352680000_4.3.e005051.20","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s00737-022-01256-2","article-title":"The association between paternal childcare involvement and postpartum depression and anxiety among Chinese women\u2014a path model analysis","volume":"26","author":"Zhang","year":"2023","journal-title":"Arch Womens Ment Health"},{"key":"2026092211352680000_4.3.e005051.21","doi-asserted-by":"crossref","first-page":"102865","DOI":"10.1016\/j.wsif.2024.102865","article-title":"Shaping gender disparity in childcare between dual-earner parents in urban China: An exploratory study of influencing factors","volume":"102","author":"Zhang","year":"2024","journal-title":"Womens Stud Int Forum"},{"key":"2026092211352680000_4.3.e005051.22","doi-asserted-by":"crossref","first-page":"108039","DOI":"10.1016\/j.amepre.2025.108039","article-title":"Prepregnancy stressful life events and perinatal mental health disorders from pregnancy to 3 years after childbirth: An observational study","volume":"69","author":"Wu","year":"2025","journal-title":"Am J Prev Med"},{"key":"2026092211352680000_4.3.e005051.23","article-title":"Intergenerational association of adverse childhood experiences and perinatal mental health in adult female offspring: evidence from the longitudinal grandmothers, mothers, and their children\u2019s health study in China","volume":"59","author":"Wang","year":"2025","journal-title":"Lancet Reg Health West Pac"},{"key":"2026092211352680000_4.3.e005051.24","first-page":"359","article-title":"Employed carers in mid-life: Findings from the Australian Longitudinal Study on Women\u2019s Health","volume":"29","author":"Lucke","year":"2006","journal-title":"Midwifery"},{"key":"2026092211352680000_4.3.e005051.25","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"2026092211352680000_4.3.e005051.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(18)30622-6"},{"key":"2026092211352680000_4.3.e005051.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-041921","article-title":"Adapting the UCLA 3-item loneliness scale for community-based depressive symptoms screening interview among older Chinese: a cross-sectional study","volume":"10","author":"Liu","year":"2020","journal-title":"BMJ Open"},{"key":"2026092211352680000_4.3.e005051.28","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/46.4.503"},{"key":"2026092211352680000_4.3.e005051.29","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"2026092211352680000_4.3.e005051.30","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199209000-00012"},{"key":"2026092211352680000_4.3.e005051.31","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1177\/0363199017746449","article-title":"Changes in parental time with children in China, 2004\u20132011","volume":"43","author":"Zhao","year":"2018","journal-title":"J Fam Hist"},{"key":"2026092211352680000_4.3.e005051.32","doi-asserted-by":"crossref","first-page":"108481","DOI":"10.1016\/j.childyouth.2025.108481","article-title":"The influence of parental involvement on the development of rural children: A comparative study of left-behind children and non-left-behind children","volume":"177","author":"Chen","year":"2025","journal-title":"Child Youth Serv Rev"},{"key":"2026092211352680000_4.3.e005051.33","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1111\/jomf.12305","article-title":"Educational gradients in parents\u2019 child-care time across countries, 1965\u20132012","volume":"78","author":"Dotti Sani","year":"2016","journal-title":"J of Marriage and Family"},{"key":"2026092211352680000_4.3.e005051.34","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jad.2017.05.010","article-title":"Postnatal paternal involvement and maternal emotional disturbances: The effect of maternal employment status","volume":"219","author":"Lin","year":"2017","journal-title":"J Affect Disord"},{"key":"2026092211352680000_4.3.e005051.35","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/S2468-2667(22)00311-5","article-title":"The effect of parental leave on parents\u2019 mental health: a systematic review","volume":"8","author":"Heshmati","year":"2023","journal-title":"Lancet Public Health"},{"key":"2026092211352680000_4.3.e005051.36","doi-asserted-by":"crossref","first-page":"100318","DOI":"10.1016\/j.ssmmh.2024.100318","article-title":"Father involvement is a protective factor for maternal mental health in Western Kenya","volume":"5","author":"McCann","year":"2024","journal-title":"SSM - Mental Health"},{"key":"2026092211352680000_4.3.e005051.37","doi-asserted-by":"crossref","first-page":"112421","DOI":"10.1016\/j.socscimed.2019.112421","article-title":"Father involvement in the first year of life: Associations with maternal mental health and child development outcomes in rural Pakistan","volume":"237","author":"Maselko","year":"2019","journal-title":"Social Science & Medicine"},{"key":"2026092211352680000_4.3.e005051.38","doi-asserted-by":"crossref","DOI":"10.1192\/j.eurpsy.2021.2213","article-title":"Paternal childcare at 6 months and risk of maternal psychological distress at 1 year after delivery: The Japan Environment and Children\u2019s Study (JECS)","volume":"64","author":"Kasamatsu","year":"2021","journal-title":"Eur Psychiatr"},{"key":"2026092211352680000_4.3.e005051.39","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/1471-2393-13-70","article-title":"Fathers\u2019 engagement in pregnancy and childbirth: evidence from a national survey","volume":"13","author":"Redshaw","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026092211352680000_4.3.e005051.40","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pdig.0000326","article-title":"Investigating perspectives on e-health interventions to enhance maternal mental well-being: Results of a stakeholder interview","volume":"2","author":"Schmidt-Hantke","year":"2023","journal-title":"PLOS Digit Health"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2026-005051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:35:40Z","timestamp":1790102140000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2026-005051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,22]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjph-2026-005051"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2026-005051","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}