Obstetrics, Maternal, and Neonatal Investigations (OMNI) Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.
Can J Psychiatry. 2009 Nov;54(11):750-6. doi: 10.1177/070674370905401105.
To examine the impact of prenatal and postnatal social support on the association between fetal sex and postpartum depression (PPD).
We conducted a prospective cohort study in Changsha, China, between February and September 2007. We first compared the sociodemographic and obstetric characteristics, and the prenatal and postnatal social support between women who gave birth to a female infant and those who gave birth to a male infant. We then examined the association between fetal sex and PPD by following logistic regression models: fetal sex as the independent variable; with adjustment for sociodemographic and obstetric factors; with adjustment for sociodemographic, obstetric factors, and prenatal social support; and with adjustment for sociodemographic, obstetric factors, and postnatal social support.
Postnatal social support scores were much lower in women who gave birth to a female infant than in those who gave birth to a male infant. The odds ratio of PPD for women who gave birth to a female infant, as compared with those who gave birth to a male infant, was 3.67 (95% CI 2.31 to 5.84). The increased risk of PPD for women who gave birth to a female infant remained after adjustment for sociodemographic and obstetric factors and prenatal social support, but disappeared after adjustment for postnatal social support score.
We conclude that increased risk of PPD in Chinese women who give birth to a female infant is caused by lack of social support after childbirth.
探讨产前和产后社会支持对胎儿性别与产后抑郁（PPD）之间关系的影响。
我们在中国长沙进行了一项前瞻性队列研究，时间为 2007 年 2 月至 9 月。我们首先比较了分娩女婴和分娩男婴的妇女在社会人口统计学和产科特征以及产前和产后社会支持方面的差异。然后，我们通过以下逻辑回归模型来检查胎儿性别与 PPD 之间的关联：胎儿性别为自变量；调整社会人口统计学和产科因素；调整社会人口统计学、产科因素和产前社会支持；以及调整社会人口统计学、产科因素和产后社会支持。
分娩女婴的妇女的产后社会支持评分明显低于分娩男婴的妇女。与分娩男婴的妇女相比，分娩女婴的妇女患 PPD 的比值比为 3.67（95%CI 2.31 至 5.84）。调整社会人口统计学和产科因素以及产前社会支持后，分娩女婴的妇女患 PPD 的风险增加，但调整产后社会支持评分后，这种风险消失。
我们的结论是，中国分娩女婴的妇女患 PPD 的风险增加是由于产后社会支持不足所致。
