Feb. 15, 2008 -- Women who give birth to a boy may be at increased risk of getting severe postpartum depression, according to a French study.
But a Canadian expert on women's mental health says the conclusion is premature.
And the study author himself warns that the results may not apply to U.S. women. "I believe that it would be dangerous to alarm all U.S. women about [the potential mental health hazards associated with] boys' delivery," writes Claude de Tychey, PhD, professor of clinical psychology at the Universite Nancy 2 in Nancy Cedex, France, in an email to WebMD.
Postpartum depression affects up to 15% of U.S. women in the month to year after childbirth, according to the National Institutes of Health. Women may refuse to eat, have sleep disturbances, frantic energy, or irrational thoughts, among other symptoms. Dramatic shifts in hormone levels during pregnancy and after birth are thought to lead to the problems.
Led by de Tychey, the research team evaluated 181 French women who had given birth within the past two months at one of three hospitals in eastern France, asking them about their adaptation to motherhood and their quality of life.
They assessed whether the women had depression and also evaluated their quality of life after the baby was born, using a questionnaire that asked about physical functioning, bodily pain, social functioning, and vitality, among other dimensions.
Postpartum Depression and Sex of Baby
Of the 181 women, 124 had no depression, 40 had mild depression, and 17 had severe depression.
When the researchers looked at the gender distribution in each group, they found that the 124 mothers without depression gave birth fairly equally to boys and girls (59 girls and 65 boys).
Of the 40 with mild depression, 24 had girls and 16 had boys.
Those with severe depression, however, were much more likely to give birth to boys. Of the 17 with severe depression, 13 had boys and four had girls.
Even if the women didn't have depression after the birth, giving birth to a boy was more likely to reduce the women's quality of life than giving birth to a girl, according to the women's answers on the questionnaire. It didn't matter if the woman was giving birth to her first born or her second baby.
The study is published in the February issue of the Journal of Clinical Nursing.
Previous studies in other countries, including China, India, and Turkey, have associated the birth of girls with a higher risk of postpartum depression, the researchers note in the paper, perhaps because in some cultures boys are preferred to girls.
De Tychey believes this is the first study to link postpartum depression to boys. "We were very surprised by the findings because France has no open gender preference," De Tychey writes in the email.
A Canadian-based expert on women's mental health took issue with the study. "They are talking about a total of 17 people with severe depression," says Gail Erlick Robinson, MD, director of the Women's Mental Health Program and professor of psychiatry and obstetrics-gynecology at the University of Toronto.
While the 17 women with severe postpartum depression were more likely to have boys, she points out that the 40 women with mild depression were more likely to have girls -- 24 of these women had girls, 16 had boys.
Regarding the finding that women who had boys reported lower quality of life, even if they weren't depressed, Robinson says: "There is a big difference between [lowered] quality of life and depression."
Taking care of a newborn boy may be more stressful, she acknowledges.
But she isn't convinced of a postpartum depression and gender link. "All we have is a statistical finding in their study based on 17 people," she says. "I think that's on pretty weak legs."