Association of Antenatal Gender Preference with Perceived Stress among Pregnant Women

Pregnancy Stress and Gender Preference



Gender Identity, Pregnancy, Prenatal Care, Psychological Factors


Background: Antenatal stress is the stress experienced by a pregnant mother as a result of stressful life circumstances. Gender preference for male children and dislike for female children prevails in many regions of the world. Therefore, this study aimed to determine how gender preferences during pregnancy, influenced by cultural and sociodemographic factors, contribute to perceived maternal stress.

Methods: A cross-sectional study was conducted to determine the association between stress and gender preference in pregnant women. A total of 363 healthy pregnant females recruited from tertiary care hospitals of Karachi and Lahore via purposive sampling technique were first interviewed for demographic information. The self-structured questionnaire comprises items based on preferences in pregnancies and antenatal or postnatal psychological health, was then asked to be filled to determine the association between antenatal gender preference and perceived stress among the participants.

Results: Male child preferences were significantly linked to antenatal stress (32.8%, p<0.05). Gender scans were performed in around 33.1% and 64.6% of mothers desired male children. The rationale behind it is that a male offspring will be able to support them in their later years.

Conclusion: It was concluded that a significant association was found between male child preferences and antenatal stress. Moreover, antenatal stress was also associated with younger mother age, low self-esteem, low socioeconomic position, and a strong familial desire for sons. Premature birth, low birth weight, and inadequate prenatal care are all possible outcomes of stress during pregnancy.


Author Biographies

Urooba Hasan, National Institute of Child Health

Department of Pediatrics

Ahad Hasan, Ziauddin University

College of Physical Therapy, Faculty of Allied Health Sciences

Hafsa Tahir, Dr. Ziauddin Hospital

Dr. Ziauddin Hospital


Bush NR, Savitz J, Coccia M, Jones-Mason K, Adler N, Boyce WT, Laraia B, Epel E. Maternal stress during pregnancy predicts infant infectious and noninfectious illness. The Journal of pediatrics. 2021 Jan 1;228:117-25.

Pai P. Becoming a mother: A role learning perspective on the use of online community resources to facilitate a life-role transition. Information & Management. 2023 Sep 11:103861.

Nagel EM, Howland MA, Pando C, Stang J, Mason SM, Fields DA, Demerath EW. Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clinical Therapeutics. 2022 Feb 1;44(2):215-27.

Goldner D, Lavine JE. Nonalcoholic fatty liver disease in children: unique considerations and challenges. Gastroenterology. 2020 May 1;158(7):1967-83.

Broadhurst K, Mason C. Child removal as the gateway to further adversity: Birth mother accounts of the immediate and enduring collateral consequences of child removal. Qualitative Social Work. 2020 Jan;19(1):15-37.

Liu J, Xing C, Zhang Q. House price, fertility rates and reproductive intentions. China Economic Review. 2020 Aug 1;62:101496.

Ghosh S. Factors responsible for childhood malnutrition: A review of the literature. Current Research in Nutrition and Food Science Journal. 2020 Aug 25;8(2):360-70.

IBEJI V. Gender Discrimination and Female Children's Education in Northern Nigeria: A case study of the Gbagyi of Abuja.

Cai Y, Feng W. The social and sociological consequences of China's one-child policy. Annual Review of Sociology. 2021 Jul 31;47:587-606.

Bano N, Beg A, Kumari A, Dahiya R. A critical review: problem of female feoticide and female infanticide in India. Pharma Innovation Journal. 2021;10(3):243-48.

Jungari S, Pardhi A, Bomble P. Violence Against Women During Pregnancy in India: A Literature Review. Violence Against Women. 2022 Jan;2(1):113-36.

Jarrett BA, Peitzmeier SM, Restar A, Adamson T, Howell S, Baral S, Beckham SW. Gender-affirming care, mental health, and economic stability in the time of COVID-19: a global cross-sectional study of transgender and non-binary people. MedRxiv. 2020 Nov 4.

Ritchie H, Roser M. Gender ratio. Our world in data. 2019 Jun 13.

Hu Y, Wang Y, Wen S, Guo X, Xu L, Chen B, Chen P, Xu X, Wang Y. Association between social and family support and antenatal depression: a hospital-based study in Chengdu, China. BMC pregnancy and childbirth. 2019 Dec;19:1-0.

Keddell E. Recognising the embedded child in child protection: Children’s participation, inequalities and cultural capital. Children and Youth Services Review. 2023 Apr 1;147:106815.

Daisy IJ, Diyaneshwaran G, Ravivarmaa K, Shobana S, Sneha M, Monessha NS. Review On Foetal Position Detection Using Different Techniques. In 2023 International Conference on Disruptive Technologies (ICDT) 2023 May 11 (pp. 24-29). IEEE.

Hartman S, Eilertsen EM, Ystrom E, Belsky J, Gjerde LC. Does prenatal stress amplify effects of postnatal maternal depressive and anxiety symptoms on child problem behavior?. Developmental psychology. 2020 Jan;56(1):128.

Harp AG. Perinatal patients with symptoms of anxiety. InWomen's Mood Disorders: A Clinician’s Guide to Perinatal Psychiatry 2021 May 26 (pp. 121-131). Cham: Springer International Publishing.

Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. Perinatal depression: Challenges and opportunities. Journal of Women's Health. 2021 Feb 1;30(2):154-9.

Sipasulta NG, Imamah IN, Tanihatu GE. Experiences and Expectations of Post-Partum Mothers Toward Psychosocial Nursing Services for Mothers Who Have Experienced Postpartum Blues in City of Balikpapan. Pharmacognosy Journal. 2023;15(3).

Abo S, Smith D, Stadt M, Layton A. Modelling female physiology from head to toe: Impact of sex hormones, menstrual cycle, and pregnancy. Journal of Theoretical Biology. 2022 May 7;540:111074.

Sipasulta NG, Imamah IN, Tanihatu GE. Experiences and Expectations of Post-Partum Mothers Toward Psychosocial Nursing Services for Mothers Who Have Experienced Postpartum Blues in City of Balikpapan. Pharmacognosy Journal. 2023;15(3).

Challacombe FL, Pietikäinen JT, Kiviruusu O, Saarenpää‐Heikkilä O, Paunio T, Paavonen EJ. Paternal perinatal stress is associated with children's emotional problems at 2 years. Journal of Child Psychology and Psychiatry. 2023 Feb;64(2):277-88.

Ghimire U, Papabathini SS, Kawuki J, Obore N, Musa TH. Depression during pregnancy and the risk of low birth weight, preterm birth and intrauterine growth restriction-an updated meta-analysis. Early Human Development. 2021 Jan 1;152:105243.

Hyde JS, Mezulis AH. Gender differences in depression: biological, affective, cognitive, and sociocultural factors. Harvard review of psychiatry. 2020 Jan 1;28(1):4-13.