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. 2021 Jan 6;12(1):6.
doi: 10.1186/s13293-020-00348-x.

Fetal sex and maternal postpartum depressive symptoms: findings from two prospective pregnancy cohorts

Whitney Cowell  1 , Elena Colicino  2 , Talia Askowitz  3 , Farida Nentin  4 , Rosalind J Wright  2   3
Affiliations

Fetal sex and maternal postpartum depressive symptoms: findings from two prospective pregnancy cohorts

Whitney Cowell et al. Biol Sex Differ. .

Abstract

Background: Fetal sex is known to modify the course and complications of pregnancy, with recent evidence of sex-differential fetal influences on the maternal immune and endocrine systems. In turn, heightened inflammation and surges in reproductive hormone levels associated with pregnancy and parturition have been linked with the development of perinatal depression. Here, we examined whether there is an association between fetal sex and maternal depression assessed during the prenatal and postnatal periods.

Methods: The study included two multi-ethnic, prospective pregnancy cohorts that enrolled women from prenatal clinics in the Northeastern United States between 2001 and 2018. Maternal depressive symptoms were measured during the prenatal and postnatal periods using the Edinburgh Postpartum Depression Scale (EPDS), and newborn sex was reported by the mother following delivery. We used logistic regression to examine associations between fetal sex and maternal depressive symptoms (EPDS > 10) during the prenatal period only, postnatal period only, or both periods versus no depressive symptoms during either period. We considered both unadjusted models and models adjusted for a core set of sociodemographic and lifestyle variables.

Results: In adjusted models using PRISM data (N = 528), women pregnant with a male versus female fetus had significantly greater odds of depressive symptoms during the postnatal period compared to women without depressive symptoms during either period (odds ratio [OR] = 5.24, 95% confidence interval [CI] = 1.93, 14.21). The direction of results was consistent in the ACCESS cohort, although the findings did not reach statistical significance (OR = 2.05, 95% CI = 0.86, 4.93). Significant associations were not observed in either cohort among women with prenatal symptoms only or women with prenatal and postnatal symptoms.

Conclusions: Male fetal sex was associated with the onset of depressive symptoms during the postnatal period.

Keywords: Depression; Fetus; Postnatal; Postpartum; Pregnancy; Sex.

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Conflict of interest statement

The authors have no competing conflicts of interest.

Figures

Fig. 1
Fig. 1
Diagram of analytic sample selection from the PRISM and ACCESS pregnancy cohorts. Abbreviations: ACCESS, Asthma Coalition on Community Environment and Social Stress; EPDS, Edinburgh Postnatal Depression Scale; PRISM, PRogramming of Intergenerational Stress Mechanisms
See this image and copyright information in PMC

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