Central South University, Changsha, China.
J Matern Fetal Neonatal Med. 2022 Jul;35(13):2581-2590. doi: 10.1080/14767058.2020.1786809. Epub 2020 Jul 7.
It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant.
Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates.
Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; = .03). However, substantial heterogeneity ( < .00001; = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed.
Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significance Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception. Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD. Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender.
目前尚无法确定婴儿的性别与母亲产后抑郁（PPD）风险之间的关联。此外，目前还缺乏全面的综述。本项荟萃分析对队列研究和病例对照研究进行了分析，以探讨与分娩男婴的女性相比，分娩女婴的女性是否有更高的患 PPD 风险。
对PubMed、Embase、Google Scholar、Cochrane 图书馆和中文数据库进行了无限制检索，检索日期截至 2018 年 1 月 31 日，以确定符合预先设定纳入标准的研究。还对检索到的文章的参考文献列表进行了审查。使用固定效应或随机效应模型计算总体合并风险估计值。
共纳入 23 项研究，涉及 119736 名女性。总体而言，与对照组相比，分娩女婴的母亲发生 PPD 的风险显著增加（OR=1.15，95%CI：1.01-1.31； = .03）。然而，研究之间存在显著的异质性（ < .00001； = 75%）。通过亚组分析确定了相关的异质性调节因素。敏感性分析得出了一致的结果。未观察到发表偏倚的证据。
尽管应仔细评估潜在偏倚的作用和异质性的证据，但本研究表明，与分娩男婴的女性相比，分娩女婴的女性发生 PPD 的风险更高。改善家庭和社会沟通以及减少性别偏好应该是任何干预措施的重要组成部分。
有趣的是，导致 PPD 的已知风险因素在不同地区和文化中基本相同，但婴儿的性别似乎是一个例外。一些在传统西方国家进行的研究表明，婴儿的性别与 PPD 风险之间存在微弱或不存在关联，而另一些研究则表明存在正相关。相比之下，在尼日利亚、印度、土耳其和中国进行的研究表明，分娩女婴的母亲发生 PPD 的风险更高。如今，婴儿的性别与产后抑郁（PPD）风险之间的关联仍然不确定；此外，目前还缺乏全面的综述。我们的研究代表了第一项关于婴儿性别与 PPD 风险关联的荟萃分析。
