Abbaszadeh F, Kafaei Atrian M, Masoudi Alavi N, Bagheri A, Sadat Z, Karimian Z Relationship between quality of life and depression in pregnant women. Nurs Midwifery Stud. 2013; 2:(2)193-7

Abujilban SK, Abuidhail J, Al-Modallal H, Hamaideh S, Mosemli O Predictors of antenatal depression among Jordanian pregnant women in their third trimester. Health Care Women Int. 2014; 35:(2)200-15

Ahmad Al-Akour N, Khassawneh M, Khader Y, Dahl E Sex preference and interest in preconception sex selection: a survey among pregnant women in the north of Jordan. Hum Reprod. 2009; 24:(7)1665-69

Al-Akour NA Knowing the fetal gender and its relationship to seeking prenatal care: results from Jordan. Matern Child Health J. 2008; 12:(6)787-92

Binh NT The rate of women having a third child and preference of son in present day Vietnamese families. Mediterranean Journal of Social Sciences. 2011; 3:(1)

Carroll JC, Reid AJ, Biringer A Effectiveness of the Antenatal Psychosocial Health Assessment (ALPHA) form in detecting psychosocial concerns: a randomized controlled trial. CMAJ. 2005; 173:(3)253-9

Chandra PS, Satyanarayana VA Gender disadvantage and common mental disorders in women. Int Rev Psychiatry. 2010; 22:(5):513-24

Dennis CLE, Janssen PA, Singer J Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatr Scand. 2004; 110:(5)338-46

Dhillon N, MacArthur C Antenatal depression and male gender preference in Asian women in the UK. Midwifery. 2010; 26:(3)286-93

Ekuklu G, Tokuc B, Eskiocak M, Berberoglu U, Saltik A Prevalence of postpartum depression in Edirne, Turkey, and related factors. J Reprod Med. 2004; 49:(11)908-14

Goldbort J Transcultural analysis of postpartum depression. MCN Am J Matern Child Nurs. 2006; 31:(2)121-6

Guilmoto CZ Son preference, sex selection, and kinship in Vietnam. Popul Dev Rev. 2012; 38:(1)31-54

Gul M, Bajwa S, Niaz S Postnatal depression and its comparison with the gender of newborn in fourth pregnancy. International Journal of Culture and Mental Health. 2013; 6:(1)16-28

Iseri E, zbas AA, Gürhan N, Sari BA Preferences for sex of firstborn child among primiparous Turkish women. Psychol Rep. 2012; 111:(1)165-72

Karaçam Z, Ançel G Depression, anxiety and influencing factors in pregnancy: a study in a Turkish population. Midwifery. 2009; 25:(4)344-56

Kheirabadi GR, Maracy MR Perinatal depression in a cohort study on Iranian women. J Res Med Sci. 2010; 15:(1)41-9

Kitamura T, Yoshida K, Okano T Multicentre prospective study of perinatal depression in Japan: incidence and correlates of antenatal and postnatal depression. Arch Women Ment Health. 2006; 9:(3)121-30

Klainin P, Arthur DG Postpartum depression in Asian cultures: A literature review. Int J Nurs Stud. 2009; 46:(10)1355-73

Lagerberg D, Magnusson M Infant gender and postpartum sadness in the light of region of birth and some other factors: a contribution to the knowledge of postpartum depression. Arch Women Ment Health. 2012; 15:(2)121-30

Lee DTS, Chung TKH Postnatal depression: an update. Best Pract Res Clin Obstet Gynaecol. 2007; 21:(2)183-91

Mao L, Ma L, Liu N Self-reported health problems related to traditional dietary practices in postpartum women from urban, suburban and rural areas of Hubei province, China: the zuò yuèzi. Asia Pac J Clin Nutr. 2016; 25:(1)158-64 Medline

Modabernia MJ, Shodjaei Tehrani H, Heydari Nezhad S Survey the Frequency of Depression in the Last Third Months of Pregnancy. Journal of Guilan University of Medical Sciences. 2009; 18:(71)19-25

Montazeri A, Torkan B, Omidvari S The Edinburgh Postnatal Depression Scale (EPDS): translation and validation study of the Iranian version. BMC Psychiatry. 2007; 7

Patel V, Rodrigues M, DeSouza N Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry. 2002; 159:(1)43-7

Pham A, Hardie T Does a first-born female child bring mood risks to new Asian American mothers?. J Obstet Gynecol Neonatal Nurs. 2013; 42:(4)471-6

Rouhi M, Usefi H, Hasan M, Vizheh M Ethnicity as a risk factor for postpartum depression. British Journal of Midwifery. 2012; 20:(6)419-26

Siu BWM, Leung SSL, Ip P, Hung SF, OHara MW Antenatal risk factors for postnatal depression: a prospective study of Chinese women at maternal and child health centres. BMC Psychiatry. 2012; 12:(1)

Sylvén SM, Papadopoulos FC, Mpazakidis V, Ekselius L, Sundström-Poromaa I, Skalkidou A Newborn gender as a predictor of postpartum mood disturbances in a sample of Swedish women. Arch Women Ment Health. 2011; 14:(3)195-201

Xie RH, He G, Liu A, Bradwejn J, Walker M, Wen SW Fetal gender and postpartum depression in a cohort of Chinese women. Soc Sci Med. 2007; 65:(4)680-4

Yasmin S, Mukherjee A, Manna N, Baur B, Datta M, Sau M, Roy M, Dasgupta S Gender preference and awareness regarding sex determination among antenatal mothers attending a medical college of eastern India. Scand J Public Health. 2013; 41:(4)344-50

Male child preference: Is it a risk factor for antenatal depression among Iranian women?

02 September 2017
Volume 25 · Issue 9



Male child preference is a phenomenon in decline in Asian women. However, it continues to exert hidden pressure on childbearing women in developing countries to dispose them to depression during pregnancy.


This study assessed the prevalence of antenatal depression and hypothesised that maternal perception of a family's male child preference was an independent risk factor for depression.


This was a cross-sectional study of 780 pregnant women who attended routine antenatal appointments and were assessed using the Iranian version of the Edinburgh Postnatal Depression Scale (EPDS). The questionnaire investigated sociodemographic characteristics and some possible risk factors, including maternal perception of male child preference in the family. Analysis was done using c2 tests to assess the relationship between variables.


The prevalence of antenatal depression was 20.1%. Maternal perception of male child preference was common and was associated with antenatal depression. Husbands and their families were found to prefer to have a male child.


Consideration of the male child preference as an independent risk factor is important for health care providers to prevent depression.

Depression is increasingly recognised as a serious, worldwide public health concern and a cause of disability (Klainin et al, 2009). It is well known that pregnancy and the postpartum period may be windows of elevated susceptibility to depression (Dhillon et al, 2010). Prevalence of depression is more common during pregnancy than after delivery but there is a trend for depression to decrease during the postpartum period (Dhillon et al, 2010).

Antenatal depression is generally defined as any symptoms of depression during pregnancy (Lee et al, 2007). The prevalence of antenatal depression in the world is 7–30%, depending on the timing and scale of data collection (Abujilban et al, 2014), while the prevalence of depression during pregnancy in Iranian women is estimated to be 20–30.6% (Modabernia et al, 2009). It has been demonstrated that antenatal depression has a fundamental effect on the mother's health, and the growth and development of the newborn (Klainin et al, 2009).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month