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

中文翻译：

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胎儿性别和母亲产后抑郁症状：两个前瞻性妊娠队列的发现


众所周知，胎儿性别会改变妊娠过程和并发症，最近的证据表明胎儿性别差异对母体免疫和内分泌系统有影响。反过来，与怀孕和分娩相关的炎症加剧和生殖激素水平激增与围产期抑郁症的发生有关。在这里，我们检查了胎儿性别与产前和产后期间评估的母亲抑郁症之间是否存在关联。该研究包括两个多种族、前瞻性妊娠队列，招募了 2001 年至 2018 年间美国东北部产前诊所的妇女。使用爱丁堡产后抑郁量表 (EPDS) 测量产前和产后期间的母亲抑郁症状，并使用爱丁堡产后抑郁量表 (EPDS) 测量母亲的抑郁症状。母亲在分娩后报告了性行为。我们使用逻辑回归来检查胎儿性别与仅在产前期、仅在产后期或两个时期的母亲抑郁症状 (EPDS > 10) 之间的关联，以及在任一时期都没有抑郁症状的情况。我们考虑了未经调整的模型和针对一组核心社​​会人口统计和生活方式变量进行调整的模型。在使用 PRISM 数据调整后的模型中 (N = 528)，怀有男性胎儿的女性与怀有女性胎儿的女性相比，怀有男性胎儿的女性在产后期间出现抑郁症状的几率明显高于在任一时期都没有抑郁症状的女性（比值比 [OR] = 5.24, 95 % 置信区间 [CI] = 1.93, 14.21)。 ACCESS 队列中的结果方向是一致的，尽管研究结果未达到统计学显着性（OR = 2.05，95% CI = 0.86，4.93）。 在仅具有产前症状的女性或具有产前和产后症状的女性的任一队列中均未观察到显着关联。男性胎儿性别与产后抑郁症状的发生有关。