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Introduction: Multiple risk factors are associated with depression during pregnancy, but so far the effect of fetal sex on depression in pregnancy has not been investigated in Iran. Objective: Frequency survey and depression – related factors with emphasis on relationship between depression and fetal sex in pregnant women referred to Al-Zahra Rasht. Materials and Methods: This analytical cross-sectional study was done within a period of two months (June and July 2013) on 500 pregnant women referred (more than 20 weeks of pregnancy) to prenatal care of Al-Zahra hospital. The questionnaire consistingof two demographic data and midwifery sections and Beck standard depression inventory were completed by patients who had the inclusion criteria. Results: The prevalence of depression in 500 pregnant women was found to be 27.4%. Factors associated with depression in pregnancy using multiple Logistic regression models, maternal employment status, number of children, same sex of fetus with previous children, duration of notice from fetus sex, family history of depression, stressful event and satisfaction from spouse, and were identified as the most powerful variables affecting theincidence of depression in pregnancy. There was no significant relationship between depression and fetal gender. Conclusion: The high prevalence of depression among pregnant women in this study, compared with global studies suggests the need for more reviews and principal interventionalstudies in this field. The same gender of fetus with previous child and duration of knowledge of fetal sex had a significant relationship with depression during pregnancy. According to the results of this study, screening of the groups at risk of depression is recommended. [ABSTRACT FROM AUTHOR]