title: Infant's sex, birth control policy and postpartum well-being: a prospective cohort study in Shanghai, China.
abstract: The majority of Chinese families were under either one-child or two-child birth control policy status from 2001 to 2015. We explore the association between an infant's sex and the mother's postpartum well-being, which may be moderated by birth control policy status in China.
  
  
  
  We conducted a prospective cohort study in Shanghai City, one of the largest cities in China. A total number of 1730 childbearing women from eight obstetric hospitals across Shanghai were included in the study at baseline, with 1503 women completing the survey 7 days postpartum in 2013.
  
  
  
  The General Well-Being Schedule (GWBS) was used to assess maternal well-being at baseline and follow-up investigation in the study. The women's demographic, clinical characteristics, and well-being were measured at baseline. Maternal satisfaction and postpartum well-being were assessed in the follow-up survey.
  
  
  
  Multivariable linear regression analyses showed that women who gave birth to male infants were positively associated with the total score of maternal well-being, when the participating hospitals, maternal well-being at baseline, sociodemographic characteristics, and maternal and infant health outcomes were added to the adjustments (β=1.462, p<0.05). The association disappeared when the two-child policy status was added to the adjustments (p>0.05). The results of a multiple logistic regression model showed that having a male infant was a risk factor of 'severe distress' (OR=1.607, p<0.05), which was moderated by the two-child policy status (p>0.05).
  
  
  
  Our results emphasise the importance of conducting interventions to increase maternal general well-being, especially for those with a female infant in a society such as China where preference is for a son, and enhance the necessity of sustainability of a newly relaxed two-child policy which allows more couples to have a second child in China.
authors.affiliation: Department of Shanghai First Maternity and Infant Hospital, The Women and Children's Health Care, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Hua
authors.affiliation: The Research Office of Shanghai Maternity and Child Health Care Center, Shanghai, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Psychology Division, Nottingham Trent University, Nottingham, UK.
authors.forename: Wenchong
authors.initials: W
authors.lastname: Du
authors.affiliation: The Research Office of Shanghai Maternity and Child Health Care Center, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Du
authors.affiliation: Department of Public health School, Health Statistics and Social Medicine, Fudan University, Shanghai, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Luo
authors.affiliation: Department of Public health School, Health Statistics and Social Medicine, Fudan University, Shanghai, China.
authors.forename: Zhuochun
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003268:Contraception Behavior / Q000523:psychology*; D003466:Cultural Characteristics; D019052:Depression, Postpartum / Q000523:psychology; D005191:Family Characteristics; D016656:Family Planning Policy / Q000331:legislation & jurisprudence; D005193:Family Planning Services; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011446:Prospective Studies; D012744:Sex Ratio; D055815:Young Adult
keywords: Birth control policy; China; Infant’s sex; Postpartum well-being