Association of Prenatal Depression With Second to Fourth Digit Ratio in Children Aged 4 and 6 Years

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Animal studies have indicated that prenatal depression may affect the reproductive development of offspring. The digit ratio has been proposed as a marker of in utero reproductive development. The aim of this study was to explore the association between prenatal depression and the digit ratio (2nd:4th digit ratio (2D:4D)) in children. This study involved 668 mother-child pairs enrolled in the Shanghai-Minhang birth cohort study (S-MBCS). Prenatal depressive symptoms among pregnant women were evaluated during recruitment and late pregnancy using the validated Chinese version of the Center for Epidemiological Studies Depression Scale (CES-D). Measurements of digit lengths of both hands were conducted during follow-up visits at 4 and 6 years. We observed that mothers with prenatal depressive symptoms tended to have offspring with higher digit ratios at 4 and 6 years of age. For children whose mothers experienced depressive symptoms in the second trimester, the digit ratio of the left hand (2D:4DL) at 4 years of age increased by 0.007 (95% CI: 0.000, 0.015) in the subthreshold group and 0.010 (95% CI: 0.001, 0.019) in the screen-positive group. For those with depressive symptoms in the third trimester, the 2D:4DL in the screen-positive group increased by 0.012 (95% CI: 0.001, 0.023) at 4 years of age and 0.014 (95% CI: 0.003, 0.024) at 6 years of age. A dose-response relationship was established for both the strength and duration of depressive symptoms. Our study suggests that prenatal depressive symptoms may perturb the reproductive development of offspring and predominantly exhibit a feminizing effect.