Fetal sex, social support, and postpartum depression.

OBJECTIVE

To examine the impact of prenatal and postnatal social support on the association between fetal sex and postpartum depression (PPD).

METHOD

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.

RESULTS

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.

CONCLUSION

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.