Hum. Reprod. Advance Access published online on September 3, 2007
Human Reproduction, doi:10.1093/humrep/dem274
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Psychological distress during early gestation and offspring sex ratio
1 Department of General Practice, Institute of Public Health, University of Aarhus, 8000 Aarhus C, Denmark 2 Department of Paediatrics, Aarhus University Hospital, Skejby, 8200 Aarhus N, Denmark 3 Department of Obstetrics and Gynecology, Hvidovre University Hospital, 2650 Hvidovre, Denmark 4 School of Public Health University of California, Berkeley, CA 94720, USA 5 Department of Obstetrics and Gynecology, Rigshospitalet, 2100 Copenhagen, Denmark
6 Correspondence address. Tel: +45 89426059; Fax: +45 86124788; E-mail: co{at}alm.au.dk
BACKGROUND: Exposure to severe stress in early pregnancy is associated with a lower male to female ratio (sex ratio), but whether more moderate levels of psychological discomfort have the same kind of effect is unknown. In a population based follow-up study, we aimed to test whether psychological distress was associated with the sex ratio in the offspring.
METHODS: From 1989 to 1992, a cohort of 8719 Danish-speaking pregnant women were followed until delivery. Questionnaires were administered to the women in early pregnancy and 6629 (76%) completed the 30-item version of the General Health Questionnaire (GHQ).
RESULTS: We found an overall male to female ratio (sex ratio) of 1.03. There was an inverse dose response association (test for trend P < 0.01) between GHQ score and sex ratio. Each 5-point increase in the GHQ score was associated with a decreasing odds of having a boy [Odds ratio (OR) = 0.93, 95% CI 0.89–0.98]. Mothers scoring in the upper quartile of the GHQ had 47% boys as compared with 52% in the undistressed groups (Risk difference =4.8%, 95% CI 1.9–7.7%) resulting in a significantly lower sex ratio of 0.85 compared with 1.07 (OR 0.82, 95% CI 0.72–0.94).
CONCLUSIONS: Our results suggest that not only severe stress, but also more moderate and common levels of psychological distress, may decrease the sex ratio in the offspring. Stress during pregnancy is a likely candidate involved in the decreasing sex ratio observed in many countries.
Key words: psychological distress/stress/pregnancy/sex ratio/GHQ
Submitted on April 2, 2007; resubmitted on June 11, 2007; accepted on July 17, 2007.
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