The variations of human sex ratio at birth during and after wars, and their potential explanations

Sex Ratio at Birth after Concurrent Events of Earthquakes and the COVID-19 Pandemic in Croatia

The sex ratio at birth (ratio of males to females) has been known to be affected by exogenous shocks such as wars, pollution, natural catastrophes, economic crises, and others. Among these stressful events, both earthquakes and the COVID-19 pandemic have been reported to lower the sex ratio at birth. In this article, a rather unusual situation of two episodes of simultaneous events of COVID-19 lockdown and earthquakes approximately nine months apart (March and December of 2020) is investigated to assess whether they were associated with a bias in sex ratio at birth 3-5 months later (in utero loss) and 9 months later (loss at conception) in Croatia. The monthly time series of sex ratio at birth, total number of births, and total number of both male and female births from January 2010 to December 2021 were analyzed. Seasonally adjusted autoregressive moving-average models were used to estimate the functional form of the time series from January 2010 to February 2020. These results were used to predict the future values of the series until December 2021 and to compare them with the actual values. For all series used, there was no indication of deviation from the values predicted by the models, neither for 3-5 months nor for 9 months after the COVID-19 lockdown and earthquake events. The possible mechanisms of the absence of bias, such as the threshold of the stressful events and its localized reach, as well as the statistical methods employed, are discussed.

The impact of catastrophic events on the sex ratio at birth: A systematic review

OBJECTIVE

The impact of maternal stress on birth outcomes is well established in the scientific research. The sex ratio at birth (SRB), namely the ratio of male to female live births, shows significant alteration when mothers experience acute stress conditions, as proposed by the Trivers-Willard Hypothesis. We aimed to synthetize the literature on the relationship between two exogenous and catastrophic stressful events (natural disasters and epidemics) and SRB.

METHODS

A systematic search was run in Scopus, PubMed, Web of Science, and Cochrane Library, until March 9, 2023. The search produced 1336 articles and 25 articles met the inclusion criteria. We found seven case-control studies and 18 observational studies. Most of studies investigated the impact of earthquakes and other natural disasters. Only seven studies examined the effect of epidemics or pandemics.

RESULTS

The results of the studies seem inconsistent, as 16 studies found a decline in SRB, three found a rise, four did not record any change and two studies gave contradictory results. The period and population analyzed, the source of information, the method of variance analysis in the SRB, and the failure to assess confounding variables may have influenced the incongruence of the results.

CONCLUSION

Our findings contribute to improve the knowledge about the relationship between socio-ecological factors and SRB. Future studies should investigate the mechanisms by which this relationship impacts public health, in particular the health of pregnant women and their newborn, through an accurate and consistent methodology that also includes confounding factors.

Sex differences in innate and adaptive immunity impact fetal, placental, and maternal health†

The differences between males and females begin shortly after birth, continue throughout prenatal development, and eventually extend into childhood and adult life. Male embryos and fetuses prioritize proliferation and growth, often at the expense of the fetoplacental energy reserves. This singular focus on growth over adaptability leaves male fetuses and neonates vulnerable to adverse outcomes during pregnancy and birth and can have lasting impacts throughout life. Beyond this prioritization of growth, male placentas and fetuses also respond to infection and inflammation differently than female counterparts. Pregnancies carrying female fetuses have a more regulatory immune response, whereas pregnancies carrying male fetuses have a stronger inflammatory response. These differences can be seen as early as the innate immune response with differences in cytokine and chemokine signaling. The sexual dimorphism in immunity then continues into the adaptive immune response with differences in T-cell biology and antibody production and transfer. As it appears that these sex-specific differences are amplified in pathologic pregnancies, it stands to reason that differences in the placental, fetal, and maternal immune responses in pregnancy contribute to increased male perinatal morbidity and mortality. In this review, we will describe the genetic and hormonal contributions to the sexual dimorphism of fetal and placental immunity. We will also discuss current research efforts to describe the sex-specific differences of the maternal-fetal interface and how it impacts fetal and maternal health.

Severe cyclones and sex-specific birth outcomes in Queensland, Australia: An interrupted time-series analysis

OBJECTIVES

A male is less adaptable to biological stressors than a female fetus with consequent higher morbidity and mortality. Adverse birth outcomes increase and male livebirths decrease after environmental disasters, economic crises, and terrorist events. We hypothesized the ratio of male to female livebirths would decrease in areas affected by severe tropical cyclones (TCs) in Queensland, Australia. Additionally, in male livebirths, there would be an increase in preterm and low birthweight births. Lastly, we hypothesized that the pregnancy stage at which exposure occurred would modify the association between TC exposure and observed outcomes.

METHODS

Interrupted time series analysis was used to analyze Queensland administrative birth records from July 2007 to June 2018 for significant changes in the sex ratio at birth, measured as the proportion of male livebirths. Adjusted generalized linear models were fitted to births in areas affected by two category five TCs: cyclones Yasi (February 2011) and Marcia (February 2015). To explore male mortality and morbidity risk, additional analysis was conducted on the proportion of male stillborn, low birthweight, and preterm births. The association between estimated pregnancy stage during the TC and the proportion of male births was also analyzed.

RESULTS

Contrary to our hypothesis, increases in the proportion of male livebirths were observed following early-pregnancy exposure to cyclone Yasi and mid-pregnancy exposure to Marcia, although the latter was not statistically significant. No significant changes were observed in proportions of male stillborn, low birthweight, and preterm births.

CONCLUSIONS

This study found a significant association between severe TCs and sex ratio at birth. The stage of pregnancy at which maternal stressors were experienced modified this association. Among people exposed in early to mid-pregnancy, the proportion of male births was higher. This may be because of differential loss of females in utero. Studying sex differences in birth outcomes provides insight into in utero vulnerabilities associated with environmental stressors. Climate change is increasing the intensity and frequency of natural disasters. Understanding fetal vulnerability to environmental stressors will provide crucial information supporting early life health interventions that mitigate the immediate and long-term effects.

Windows of Vulnerability: Consequences of Exposure Timing during the Dutch Hunger Winter

Prior research on early-life exposures to famine has established in utero development as a critical period of vulnerability to malnutrition. Yet, previous research tends to focus narrowly on this stage, at the expense of a more comprehensive examination of childhood. As a result, the literature has yet to compare the severity of the consequences of exposure to malnutrition across developmentally salient periods. Such comparison is crucial not only in the magnitude of effects but also in the nature of outcomes. Using a restricted population registry-linked health survey, this study examines the Dutch Hunger Winter to provide a comprehensive examination of the long-term consequences of in utero, infant, childhood, and adolescent exposure to famine. The results show malnutrition leads to heterogeneous effects depending on when the exposure occurs. In utero exposure to malnutrition leads to deleterious conditions in physical health and lower socioeconomic attainment. For older cohorts, results suggest a resilience to the effects of malnutrition on physical health in late life, but a higher vulnerability to socioeconomic stunting. Furthermore, the results suggest important gender differences in the long-term impact of malnutrition. Males consistently show stronger negative consequences across a wider array of conditions.

Conflicts and son preference: Micro-level evidence from 58 countries

Research on the association between armed conflict and son preference has largely been based on single-country studies, often presenting descriptive patterns. This paper empirically analyzes the association between conflict and son preference using a sample of more than 1.1 million individuals from 58 countries over the period 2003-2018. We empirically show that both the incidence and intensity of conflict exposure are associated with greater son preference. Moreover, conflict-exposed individuals are likely to realise their preference for sons, as reflected in the systematically higher prevalence of sons over daughters among these individuals. To explore the aggregate effects of these findings, we conduct a cross-country analysis of sex ratios and show that history of conflict exposure plays an important role in explaining the cross-country differences in sex ratios.

Maternal stress and sex ratio at birth in Sweden over two and a half centuries: a retest of the Trivers-Willard hypothesis

STUDY QUESTION

Is there a negative relationship, as predicted in the Trivers–Willard hypothesis (TWH), between the intensity of maternal stress and sex ratio at birth (SRB)?

SUMMARY ANSWER

Using a comprehensive data set with multiple indicators of maternal stress, most measures of stress show no statistically significant association with SRB over a period spanning 243 years, indicating no support for the TWH.

WHAT IS KNOWN ALREADY

Evolutionary biologists have proposed a widely discussed hypothesis that women in poor and stressful conditions during pregnancy are more likely to give birth to girls, and exposure to stressful events may therefore lead to a reduction in sex (male-to-female) ratio at birth. The empirical evidence so far is mixed.

STUDY DESIGN, SIZE, DURATION

Annual time series data, spanning 243 years between 1749 and 1991 for Sweden at the national level, were drawn from multiple sources. The outcome is defined as the percentage of male births relative to all births in Sweden in a given year. The covariates include a set of economic and climatic variables as proxies for maternal stress.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We conduct a series of ARIMA (autoregressive integrated moving average) models to examine the relationship between maternal stress and SRB during three periods: 1749–1991, 1749–1861 and 1862–1991.

MAIN RESULTS AND THE ROLE OF CHANCE

In 1749–1991, economic proxies for maternal stress showed no statistically significant association with SRB. In 1749–1861, two indicators were significantly associated with SRB, but the coefficients were opposite in direction to the TWH. In 1862–1991, five out of six covariates showed no significant association with SRB. An additional analysis found no significant correlation between sex ratio of stillbirths and all covariates in 1862–1991. Our results are incompatible with the TWH and suggest that previous findings in support of the TWH are not robust.

LIMITATIONS, REASONS FOR CAUTION

This study provides population-level evidence that may not necessarily reflect the nature of all individuals due to the ecological fallacy. The time series analysed in this study are annual data, and we cannot examine the potential seasonality due to the lack of disaggregated monthly data. Our findings may not be generalised to the contexts of extreme maternal stress conditions such as famine and war.

WIDER IMPLICATIONS OF THE FINDINGS

The results from existing studies in this topic may be speculative, and additional research with more comprehensive design, data and covariates is needed to reconsider the robustness of previous findings.

STUDY FUNDING/COMPETING INTEREST(S)

The author receives no external funding and has no conflict of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Ovarian Hyperstimulation Syndrome Is Associated with a High Secondary Sex Ratio in Fresh IVF Cycles with Cleavage-Stage Embryo Transfer: Results for a Cohort Study

The sex ratio at birth is defined as the secondary sex ratio (SSR). Ovarian hyperstimulation syndrome (OHSS) is a serious and iatrogenic complication associated with controlled ovarian stimulation (COS) during assisted reproductive technology (ART) treatments. It has been hypothesized that the human SSR is partially controlled by parental hormone levels around the time of conception. Given the aberrant hormonal profiles observed in patients with OHSS, this retrospective study was designed to evaluate the impact of OHSS on the SSR. In this study, all included patients were divided into 3 groups: non-OHSS (n=2777), mild OHSS (n=644), and moderate OHSS (n=334). Our results showed that the overall SSR for the study population was 1.033. The SSR was significantly increased in patients with moderate OHSS (1.336) compared to non-OHSS patients (1.002) (p=0.048). Subgroup analyses showed that increases in the SSR in patients with moderate OHSS were observed in the IVF group (1.323 vs 1.052; p=0.043), but not in the ICSI groups (1.021 vs 0.866; p=0.732). In addition, the elevated serum estradiol (E2) and progesterone (P4) levels in OHSS patients were not associated with SSR. In this study, for the first time, we report that a high SSR is associated with OHSS in patients who received fresh IVF treatments. The increases in SSR in OHSS patients are not attributed to the high serum E2 and P4 levels. Our findings may make both ART clinicians and patients more aware of the influences of ART treatments on the SSR and allow clinicians to counsel patients more appropriately.

The human sex ratio at birth and late fetal mortality: the Italian case

This study explores the short-term relationships between sex ratio at birth and late fetal mortality in Italy from 1910 to 2016. As the leading scholars' attention traditionally focused on long-term trends and variations in the sex ratios at birth among different populations, less interest regarded short-term fluctuations as they were mainly seen as an effect of random variability. We detrended the national series of males proportion among live births and stillbirths by their medium-term component to consider the annual deviations from a normal trend. After controlling for fertility tendencies and wars effects, regression models seem to show the effects of stillbirth on the proportion of male newborns. A sensitivity analysis was also carried out to assess the effects of the perinatal deaths on the proportion of males at birth, combining stillbirths and early neonatal losses to control the possible misspecification between stillborn infants and early neonatal deaths. The significance of late fetal mortality reflects the mortality excess among male fetuses during the intrauterine life, showing evidence for the in utero hypothesis selection.

Males can adjust offspring sex ratio in an adaptive fashion through different mechanisms

Sex allocation research has primarily focused on offspring sex-ratio adjustment by mothers. Yet, fathers also benefit from producing more of the sex with greater fitness returns. Here, we review the state-of-the art in the study of male-driven sex allocation and, counter to the current paradigm, we propose that males can adaptively influence offspring sex ratio through a wide variety of mechanisms. This includes differential production and motility of X- versus Y-bearing sperms in mammals, variation in seminal fluid composition in haplo-diploid invertebrates, and epigenetic mechanisms in some fish and lizards exhibiting environmental sex determination. Conflicts of interest between mothers and fathers over offspring sex ratios can emerge, although many more studies are needed in this area. While many studies of sex allocation have focused on adaptive explanations with little attention to mechanisms, and vice versa, the integration of these two topics is essential for understanding male-driven sex allocation.

Coupling between death spikes and birth troughs. Part 1: Evidence

In the wake of the influenza pandemic of 1889-1890 Jacques Bertillon, a pioneer of medical statistics, noticed that after the massive death spike there was a dip in birth numbers around 9 months later which was significantly larger than that which could be explained by the population change as a result of excess deaths. In addition it can be noticed that this dip was followed by a birth rebound a few months later. However having made this observation, Bertillon did not explore it further. Since that time the phenomenon was not revisited in spite of the fact that in the meanwhile there have been several new cases of massive death spikes. The aim here is to analyze these new cases to get a better understanding of this death-birth coupling phenomenon. The largest death spikes occurred in the wake of more recent influenza pandemics in 1918 and 1920, others were triggered by the 1923 earthquakes in Tokyo and the Twin Tower attack on September 11, 2001. We shall see that the first of these events indeed produced an extra dip in births whereas the 9/11 event did not. This disparity highlights the pivotal role of collateral sufferers. In the last section it is shown how the present coupling leads to predictions; it can explain in a unified way effects which so far have been studied separately, as for instance the impact on birth rates of heat waves. Thus, it appears that behind the apparent randomness of birth rate fluctuations there are in fact hidden explanatory factors.

Offspring sex ratio: Coital rates and other potential causal mechanisms

In recent years, scientists have begun to pay serious attention to the hypothesis that human parental coital rates around the time of conception causally influences the sexes of subsequent births. In this paper, the grounds of the argument are outlined. The point is important because, if the hypothesis were credible, it can potentially explain one of the best established (and otherwise unexplained) epidemiological features of sex ratio at birth - its rises during and just after World Wars 1 and 2 insofar as increased coital rates increase the ratio. Moreover, the greater the understanding of the variations of sex ratio at birth, the greater will be the understanding of the causes of those selected diseases associated with unusual sex ratios at birth (testicular cancer, hepatitis B, Toxoplasma gondii, and, perhaps, prostatic cancer).

A review of the established and suspected causes of variations in human sex ratio at birth

The human sex ratio (proportion male) at birth (SRB) varies with many variables. Some of this variation has an established proximate cause. For instance, low SRB (more females) at birth are associated with various forms of stressful events or circumstances during or prior to pregnancy. These low SRB are almost certainly mainly caused by maternal-stress-induced male foetal loss. Other types of SRB variation are thought to be caused by hormonal variation in either or both parents around the time of conception. One or other of these two types of proximate cause seems to be responsible for most of the established variation of SRB. This will be illustrated here in respect of some selected forms of SRB variation. It seems likely that a clarification of the hormonal causes of SRB variation will also help explain the striking (apparent) inconsistencies in the results of reported tests of the influential Trivers-Willard hypothesis. It is further proposed that an appreciation of the evidence that parental hormones influence SRB may enhance understanding of several important pathologies (hepatitis B, toxoplasmosis, testicular cancer, prostate cancer and autism).

Characterization of X-Chromosome Gene Expression in Bovine Blastocysts Derived by In vitro Fertilization and Somatic Cell Nuclear Transfer

To better understand X-chromosome reactivation (XCR) during early development, we analyzed transcriptomic data obtained from bovine male and female blastocysts derived by in-vitro fertilization (IVF) or somatic-cell nuclear transfer (SCNT). We found that X-linked genes were upregulated by almost two-fold in female compared with male IVF blastocysts. The upregulation of X-linked genes in female IVFs indicated a transcriptional dimorphism between the sexes, because the mean autosomal gene expression levels were relatively constant, regardless of sex. X-linked genes were expressed equivalently in the inner-cell mass and the trophectoderm parts of female blastocysts, indicating no imprinted inactivation of paternal X in the trophectoderm. All these features of X-linked gene expression observed in IVFs were also detected in SCNT blastocysts, although to a lesser extent. A heatmap of X-linked gene expression revealed that the initial resemblance of X-linked gene expression patterns between male and female donor cells turned sexually divergent in host SCNTs, ultimately resembling the patterns of male and female IVFs. Additionally, we found that sham SCNT blastocysts, which underwent the same nuclear-transfer procedures, but retained their embryonic genome, closely mimicked IVFs for X-linked gene expression, which indicated that the embryo manipulation procedure itself does not interfere with XCR in SCNT blastocysts. Our findings indicated that female SCNTs have less efficient XCR, suggesting that clonal reprogramming of X chromosomes is incomplete and occurs variably among blastocysts, and even among cells in a single blastocyst.

Maternal Blood Pressure Before Pregnancy and Sex of the Baby: A Prospective Preconception Cohort Study

BACKGROUND

Population-level sociologic studies have suggested that adverse societal conditions may affect fetal viability in a sex-specific manner and thereby modify the ratio of male vs. female babies. This concept suggests that there may exist certain physiologic features in a woman that relate to her likelihood of delivering a boy or girl. We thus established a preconception cohort to prospectively evaluate the relationship between maternal pregravid health and sex of the baby.

METHODS

In this analysis nested within an observational cohort study, 1,411 newly married women in Liuyang, China, underwent pregravid cardiometabolic characterization (including anthropometry and measurement of blood pressure, cholesterol, triglycerides, and glucose) at median 26.3 weeks before a singleton pregnancy, delivering at 39.0 ± 1.3 weeks gestation.

RESULTS

Systolic blood pressure before pregnancy was higher in women who delivered a boy than in those who had a girl (112.5 ± 11.9 vs. 109.6 ± 12.0 mm Hg, P < 0.0001). The prevalence of a male baby progressively increased across quintiles of pregravid systolic blood pressure (P < 0.0001). After covariate adjustment, mean adjusted pregravid systolic blood pressure was higher in mothers of boys vs. girls (106.0 vs. 103.3 mm Hg, P = 0.0015). On logistic regression analysis, pregravid systolic blood pressure emerged as the only significant predictor of having a male baby (adjusted odds ratio = 1.017 per mm Hg, 95% confidence interval = 1.007-1.028). The pregravid difference in blood pressure between mothers of boys and girls was not present during any trimester of pregnancy.

CONCLUSION

Maternal blood pressure before pregnancy is a previously unrecognized factor that may be associated with the likelihood of delivering a boy or girl.

Chances to Have A Boy after Gender Selection by Pre-Implantation Genetic Screening Are Reduced in Couples with only Girls and without A Boy Sired by The Male Partner

BACKGROUND

Gender selection and family planning have their roots in human history. Despite great interest in these fields, very few scientific propositions exist which could explain why some family do not attain the desired sex. Therefore, the aim of this study was to evaluate whether sex of previous child or children could affect the outcomes of pre-implantation genetic screening (PGS).

MATERIALS AND METHODS

This historical cohort study including 218 PGS cases referring to Isfahan Fertility and Infertility Center (IFIC). Couples were grouped as those who their male child passed away or her husbands' has a son(s) from their previous marriage (n=70) and couples who just have daughter (n=148). Male normal blastocysts were transferred for both groups. The outcomes of PGS including pregnancy, implantation and abortion rates, along with possible confounding factors were compared between the two groups.

RESULTS

Significant differences in pregnancy, implantation and abortion rates were observed between couples whose their male partner had/has one boy (n=70) compared to those who have just girl(s) (n=148) despite similar number and quality of male normal blastocyst transferred in the two groups. Confounding factors were also considered.

CONCLUSION

The Ybearing spermatozoa in male partners with no history of previous boy have lower ability to support a normal development to term, compared to male partners with previous history of boy requesting family balancing.

THE ENIGMA OF ETHIOPIAN SEX RATIOS AT BIRTH

This study analysed sex ratios at birth (defined as the number of male births per 100 female births) using data on children ever-born from three censuses conducted in Ethiopia in 1984, 1994 and 2007. The results showed very high values by any standard, with an average of 108.4 for a sample of some 8.2 million births, with somewhat lower values in urban areas. Analysis of socioeconomic correlates revealed that the sex ratio varied very much by household wealth, from about 110 for very poor women to about 102 for wealthier women. The high value of the sex ratio at birth in Ethiopia could be explained by poverty, used as a proxy for poor nutritional status. In multivariate analysis, the effects of living in urban areas and of maternal education were less important than household wealth. Among the many ethno-linguistic groups, the Nilotic family had higher sex ratios than other groups. The results were confirmed using data from DHS surveys conducted in the country, and by the analysis of children still living at time of census.

Sex ratios at birth after induced abortion

BACKGROUND

Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking.

METHODS

We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and spontaneous abortions were linked to Canadian immigration records. We determined associations of male:female infant ratios with maternal birthplace, sex of the previous living sibling(s) and prior spontaneous or induced abortions.

RESULTS

Male:female infant ratios did not appreciably depart from the normal range among Canadian-born women and most women born outside of Canada, irrespective of the sex of previous children or the characteristics of prior abortions. However, among infants of women who immigrated from India and had previously given birth to 2 girls, the overall male:female ratio was 1.96 (95% confidence interval [CI] 1.75-2.21) for the third live birth. The male:female infant ratio after 2 girls was 1.77 (95% CI 1.26-2.47) times higher if the current birth was preceded by 1 induced abortion, 2.38 (95% CI 1.44-3.94) times higher if preceded by 2 or more induced abortions and 3.88 (95% CI 2.02-7.50) times higher if the induced abortion was performed at 15 weeks or more gestation relative to no preceding abortion. Spontaneous abortions were not associated with male-biased sex ratios in subsequent births.

INTERPRETATION

High male:female ratios observed among infants born to women who immigrated from India are associated with induced abortions, especially in the second trimester of pregnancy.

Privation, stress, and human sex ratio at birth

This article reviews the growing interdisciplinary literature on the effect of privation and stress on human sex ratio at birth. Borrowing strength from the potential outcomes causal analysis framework, the discussion focuses on the issues of study design and identification strategy and how they have influenced the current state of the field. The review suggests that much of the inconsistency in the literature regarding the effect of privation and stress on human sex ratio at birth is due to the weak designs and over-simplistic identification strategies used in previous studies. Studies based on natural experimental designs and well-thought-out identification strategies, on the other hand, have produced rather compelling and consistent evidence suggesting that maternal privation and stress during pregnancy reduce male births.

Studies of human sex ratios at birth may lead to the understanding of several forms of pathology

This article deals with the problem of the causes of the variation of sex ratio (proportion male) at birth. This problem is common to a number of areas in biology and medicine, for example, obstetrics, neurology/psychiatry, parasitology, virology, oncology, and teratology. It is established that there are signifi cantly biased, but unexplained, sex ratios in each of these fields. Yet workers in them (with the possible exception of virology) have regarded the problem as a minor loose end, irrelevant to the field's major problems. However, as far as I know, no one has previously noted that unexplained biased sex ratios occur, and thus pose (perhaps similar) problems, in all these fields. Here it is suggested that similar sorts of solutions apply in each. Further research is proposed for testing each solution. If the argument here is substantially correct across this range of topics, it may lead to an improved understanding not only of sex ratio but also of some of the pathologies in these specialties.

Sex ratio of congenital abnormalities in the function of maternal age: a population-based study

Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis.

Economic stress or random variation? Revisiting German reunification as a natural experiment to investigate the effect of economic contraction on sex ratios at birth

BACKGROUND

The economic stress hypothesis (ESH) predicts decreases in the sex ratio at birth (SRB) following economic decline. However, as many factors influence the SRB, this hypothesis is difficult to test empirically. Thus, researchers make use of quasi-experiments such as German reunification: The economy in East, but not in West Germany, underwent a rapid decline in 1991. A co-occurrence of a decline in the East German SRB in 1991 has been interpreted by some as support for the ESH. However, another explanation might be that the low SRB in 1991 stems from increased random variation in the East German SRB due to a drastically reduced number of births during the crisis. We look into this alternative random variation hypothesis (RVH) by re-examining the German case with more detailed data.

METHODS

Our analysis has two parts. First, using aggregate-level birth register data for all births in the period between 1946 and 2011, we plot the quantum and variance of the SRB and the number of births and unemployment rates, separately for East and West Germany, and conduct a time series analysis on the East German SRB over time. Second, we model the odds for a male birth at the individual level in a multiple logistic regression (1991-2010, ~13.9 million births). Explanatory variables are related to the level of the individual birth, the mother of the child born, and the regional economic context.

RESULTS

The aggregate-level analysis reveals a higher degree of variation of the SRB in East Germany. Deviations from the time trend occur in several years, seemingly unrelated to economic development, and the deviation in 1991 is not statistically significant. The individual-level analysis confirms that the 1991-drop in the East German SRB cannot directly be attributed to economic development and that there is no statistically significant effect of economic development on sex determination in East or West Germany.

CONCLUSION

Outcomes support the RVH but not the ESH. Furthermore, our results speak against a statistically significant effect of the reunification event itself on the East German SRB. We discuss the relative importance of behavioral and physiological responses to macro-level stressors, a distinction that may help integrate previously mixed findings.

The battle of the sexes starts in the oviduct: modulation of oviductal transcriptome by X and Y-bearing spermatozoa

BACKGROUND

Sex allocation of offspring in mammals is usually considered as a matter of chance, being dependent on whether an X- or a Y-chromosome-bearing spermatozoon reaches the oocyte first. Here we investigated the alternative possibility, namely that the oviducts can recognise X- and Y- spermatozoa, and may thus be able to bias the offspring sex ratio.

RESULTS

By introducing X- or Y-sperm populations into the two separate oviducts of single female pigs using bilateral laparoscopic insemination we found that the spermatozoa did indeed elicit sex-specific transcriptomic responses. Microarray analysis revealed that 501 were consistently altered (P-value < 0.05) in the oviduct in the presence of Y-chromosome-bearing spermatozoa compared to the presence of X-chromosome-bearing spermatozoa. From these 501 transcripts, 271 transcripts (54.1%) were down-regulated and 230 transcripts (45.9%) were up-regulated when the Y- chromosome-bearing spermatozoa was present in the oviduct. Our data showed that local immune responses specific to each sperm type were elicited within the oviduct. In addition, either type of spermatozoa elicits sex-specific signal transduction signalling by oviductal cells.

CONCLUSIONS

Our data suggest that the oviduct functions as a biological sensor that screens the spermatozoon, and then responds by modifying the oviductal environment. We hypothesize that there might exist a gender biasing mechanism controlled by the female.

Recurrent miscarriage and birth sex ratio

OBJECTIVE

To examine the relationship between birth sex ratio and unexplained recurrent miscarriage (RM).

STUDY DESIGN

Retrospective, observational study including a total of 138 women with primary recurrent miscarriage (PRM) and 170 women with secondary recurrent miscarriage (SRM) in a tertiary referral recurrent miscarriage clinic between 1992 and 2010. The sex ratio of the first birth and subsequent birth were the main outcome measures.

RESULTS

In women with SRM: (i) The male:female sex ratio of the first stillbirth was 10:2, significantly (OR=4.76) higher than the male:female sex ratio of 1.05 among all births in UK. (ii) When the first born was a male, the male:female sex ratio of the subsequent birth was 21:35, significantly (OR=0.57) lower than the sex ratio among the general population. (iii) A male firstborn did not affect the chance of a subsequent live-birth. The findings did not apply to sex ratio in primary RM.

CONCLUSION

There was a subtle relationship between the sex of the first and subsequent births and secondary recurrent miscarriage, but not primary recurrent miscarriage.

Evidence of adaptive intergenerational sex ratio adjustment in contemporary human populations

Using the abrupt decline in sex ratio at birth in China during and immediately after the 1959-1961 Great Leap Forward Famine in China as a natural experiment, this study conducts difference-in-differences analysis to test the hypothesis that changes in the sex ratio at birth of the maternal generation can produce adaptive changes in the sex ratio at birth of the offspring generation toward the opposite direction, which was derived from the developmental and evolutionary psychological literature on female reproductive strategy. The results show that, after controlling for sex-selective abortion, the decline in the sex ratio at birth in 1962-1964 caused a substantial increase in the sex ratio at birth among children whose mothers were born in 1963. Such finding suggests the presence of adaptive intergenerational sex ratio adjustment in humans.

Hormone-mediated adjustment of sex ratio in vertebrates

The ability to adjust sex ratios at the individual level exists among all vertebrate groups studied to date. In many cases, there is evidence for facultative adjustment of sex ratios in response to environmental and/or social cues. Because environmental and social information must be first transduced into a physiological signal to influence sex ratios, hormones likely play a role in the adjustment of sex ratio in vertebrates, because the endocrine system acts as a prime communicator that directs physiological activities in response to changing external conditions. This symposium was developed to bring together investigators whose work on adjustment of sex ratio represents a variety of vertebrate groups in an effort to draw comparisons between species in which the sex-determination process is well-established and those in which more work is needed to understand how adjustments in sex ratio are occurring. This review summarizes potential hormone targets that may underlie the mechanisms of adjustment of sex ratio in humans, non-human mammals, birds, reptiles, and fishes.

Excess female siblings and male fetal loss in families with systemic lupus erythematosus

OBJECTIVE

Systemic lupus erythematosus (SLE) occurs more frequently among women than men. We aimed to determine whether the male-female ratio in SLE families is different from what would be expected by chance, and whether excess male fetal loss is found.

METHODS

All patients with SLE met the revised American College of Rheumatology classification criteria, while unaffected subjects were shown not to satisfy these same criteria. Putative family relationships were confirmed by genetic testing. Pregnancy history was obtained from all subjects, including unrelated control women. Adjusted Wald binomial confidence intervals were calculated for ratio of boys to girls in families and compared to the expected ratio of 1.06.

RESULTS

There were 2579 subjects with SLE, with 6056 siblings. Considering all subjects, we found 3201 boys and 5434 girls (ratio 0.59, of 95% CI 0.576-0.602). Considering only the SLE-unaffected siblings, there were 2919 boys and 3137 girls (ratio 0.93, 95% CI 0.92-0.94). In both cases, the ratio of males to females was statistically different from the known birth rate. Among patients with SLE as well as among their sisters and mothers, there was an excess of male fetal loss compared to the controls.

CONCLUSION

Siblings of patients with SLE are more likely than expected to be girls. This finding may be in part explained by excess male fetal loss, which is found among patients with SLE and their first-degree relatives.

Geographic clustering of the secondary sex ratio in Japan: association with demographic attributes

The secondary sex ratio (SSR) has been suggested to decrease with adverse physical and psychological environments. Previous studies have focused on reduced SSR under adverse conditions, such as war, terrorism attack and earthquake, but few studies have investigated fluctuations in SSR in moderately adverse environments. This study analysed municipality-level vital statistics records in Japan collected between 1998 and 2002 to identify high-SSR clusters and low-SSR clusters with spatial-scan statistics. In 999 runs of simulation, high- and low-SSR clusters were detected but fewer than 950 times, indicating that SSR was not geographically clustered in Japan if type I error of 5% was adopted. Explorative analyses comparing demographic attributes between high-SSR clusters and low-SSR clusters that were detected more than 500 times in 999 runs of simulation, showed that rate of spontaneous abortion, rate of artificial abortion and divorce rate were higher in low-SSR clusters, while male life expectancy, female life expectancy and total fertility rate were higher in a high-SSR cluster.

Revisiting a sample of U.S. billionaires: how sample selection and timing of maternal condition influence findings on the Trivers-Willard effect

Based on evolutionary theory, Trivers & Willard (TW) predicted the existence of mechanisms that lead parents with high levels of resources to bias offspring sex composition to favor sons and parents with low levels of resources to favor daughters. This hypothesis has been tested in samples of wealthy individuals but with mixed results. Here, I argue that both sample selection due to a high number of missing cases and a lacking specification of the timing of wealth accumulation contribute to this equivocal pattern. This study improves on both issues: First, analyses are based on a data set of U.S. billionaires with near-complete information on the sex of offspring. Second, subgroups of billionaires are distinguished according to the timing when they acquired their wealth. Informed by recent insights on the timing of a potential TW effect in animal studies, I state two hypotheses. First, billionaires have a higher share of male offspring than the general population. Second, this effect is larger for heirs and heiresses who are wealthy at the time of conception of all of their children than for self-made billionaires who acquired their wealth during their adult lives, that is, after some or all of their children have already been conceived. Results do not support the first hypothesis for all subgroups of billionaires. But for males, results are weakly consistent with the second hypothesis: Heirs but not self-made billionaires have a higher share of male offspring than the U.S. population. Heiresses, on the other hand, have a much lower share of male offspring than the U.S. average. This hints to a possible interplay of at least two mechanisms affecting sex composition. Implications for future research that would allow disentangling the distinct mechanisms are discussed.

Parental status and gender preferences for children: is differential fertility stopping consistent with the trivers-willard hypothesis?

Based on evolutionary reasoning, Trivers & Willard (1973) predicted status-biased sex composition and parental investment with son-preferencing effects in higher, and daughter-preferencing effects in lower status groups. Previous research shows mixed results. This study uses event-history methods and Swedish register data to study one possible mechanism in isolation: do parents in different status groups vary in their proclivities to continue fertility based on the sex composition of previous offspring? The results show no support for the Trivers-Willard hypothesis on a wide range of different status indicators. Future research on the stated hypothesis should focus on physiological rather than behavioural mechanisms.

Community psychological stressor-induced secondary sex ratio decline after a seismic sequence in the Greek island of Zakynthos

The secondary sex ratio (the ratio of boys to girls at birth) may demonstrate a decline following community stress-inducing major destructive events. This study aims to investigate whether or not moderate adverse life events, in conjunction with endogenous psychological characteristics, can induce sufficient community stress to affect the sex ratio. From April 3rd to May 8th 2006 a moderate sized earthquake sequence occurred offshore the Greek island of Zakynthos, which had been hit by a destructive earthquake half a century earlier. The monthly sex ratio after the earthquake sequence was estimated and compared with that of previous and following years. Eleven months after the onset of the earthquakes the sex ratio fell to 1.000, and during the next two months (March and April) it declined further to 0.612. The sex ratio one year before its decline was 1.158 and over a total 6-year period, 3 years before and 3 years after the sequence, it was 1.063; the March-April decline in male births is significant (OR=0.53, 95% CI=0.32-0.86, p=0.013, and OR=0.57, 95% CI=0.36-0.91, p=0.023, respectively). Also, the number of boys relative to girls in March-April 2007 was significantly lower than during the same months 3 years before and after the sequence (OR=0.50, 95% CI=0.31-0.82, p=0.007). The findings suggest that basic biological characteristics, such as the sex ratio, can be affected by psychological stressors interwoven with the pertaining psychology of the population.

The association between living through a prolonged economic depression and the male:female birth ratio--a longitudinal study from Cuba, 1960-2008

The Trivers-Willard hypothesis suggests that populations respond to scarcity by decreasing the ratio of males to females at livebirth. Cuba experienced an extreme economic depression in the 1990s called the "special period." Using time-series analysis, the authors studied the impact of this event on the male:female sex ratio at birth in Cuba from 1960 to 2008. From 1990 to 1993, the per capita gross domestic product in Cuba decreased by 36%. By use of a definition of the special period from 1991 to 1998, there was a prolonged increase in the male:female ratio of livebirths during this period of economic depression (P < 0.001), from 1.06 at baseline to a peak of 1.18. This association persisted when using alternative definitions of the duration of economic depression in sensitivity analyses. Once the period of economic depression was over, the male:female ratio returned to the baseline value. These data suggest that, in Cuba, contrary to the Trivers-Willard hypothesis, the human population responded to conditions of scarcity by increasing the ratio of males to females at livebirth. These data may be relevant in the modeling of demographic projections in countries that experience prolonged economic depression and in understanding adaptive human reproductive responses to environmental change.

Whatever the weather: ambient temperature does not influence the proportion of males born in New Zealand

Background

The proportion of male births has been shown to be over 50% in temperate climates around the world. Given that fluctuations in ambient temperature have previously been shown to affect sex allocation in humans, we examined the hypothesis that ambient temperature predicts fluctuations in the proportion of male births in New Zealand.

Methodology/Principal Findings

We tested three main hypotheses using time series analyses. Firstly, we used historical annual data in New Zealand spanning 1876–2009 to test for a positive effect of ambient temperature on the proportion of male births. The proportion of males born ranged by 3.17%, from 0.504 to 0.520, but no significant relationship was observed between male birth rates and mean annual temperature in the concurrent or previous years. Secondly, we examined whether changes in annual ambient temperature were negatively related to the proportion of male stillbirths from 1929–2009 and whether the proportion of male stillbirths negatively affected the proportion of male live births. We found no evidence that fewer male stillbirths occurred during warmer concurrent or previous years, though a declining trend in the proportion of male stillbirths was observed throughout the data. Thirdly, we tested whether seasonal ambient temperatures, or deviations from those seasonal patterns, were positively related to the proportion of male births using monthly data from 1980–2009. Patterns of male and female births are seasonal, but very similar throughout the year, resulting in a non-seasonal proportion of male births. However, no cross correlations between proportion of male births and lags of temperature were significant.

Conclusions

Results showed, across all hypotheses under examination, that ambient temperatures were not related to the proportion of male births or the proportion of male stillbirths in New Zealand. While there is evidence that temperature may influence human sex allocation elsewhere, such effects of temperature are not universal.

Variation of human sex ratios at birth by the sex combinations of the existing sibs, and by reproductive stopping rules: comments on Garenne (2009)

Garenne (2009) presented data on the sex ratio of a present birth by the numbers of previous brothers and sisters. In unisexual sibships, the probability of a further girl increases with the number of previous girls; and the probability of a further boy increases with the number of previous boys. Garenne noted that there is an asymmetry in that the effect is stronger with regard to girls than boys. He was uncertain of the cause of this. Here I suggest a potential solution to this problem. Garenne also seems to imply that parental reproductive stopping rules cause heterogeneity of sex ratios. I suggest that they may reveal it - but do not cause it. Moreover, I suggest that the effects of such stopping rules may be counter-intuitive.

THE CATEGORIES OF EVIDENCE RELATING TO THE HYPOTHESIS THAT MAMMALIAN SEX RATIOS AT BIRTH ARE CAUSALLY RELATED TO THE HORMONE CONCENTRATIONS OF BOTH PARENTS AROUND THE TIME OF CONCEPTION

This note categorizes the evidence for the hypothesis that mammalian offspring sex ratios (proportions male) are causally related to the hormone levels of both parents around the time of conception. Most of the evidence may be acknowledged to be correlational and observational. As such it might be suspected of having been selected; or of having been subject to other forms of bias or confounding; or, at any rate, of being inadequate as a firm basis for causal inference. However, there are other types of evidence that are not vulnerable to these types of criticism. These are from the following sources: (1) previously neglected data from Nazi Germany and Soviet Russia; (2) fulfilled predictions; (3) genetics; and (4) a network of logically (mathematically) related propositions, for some of which there is overwhelming empirical evidence. It is suggested that this variety of evidence confers greater overall credibility on the hypothesis than would be the case if all the evidence were of the same observational/correlational status. This observational/correlational evidence is tabulated to illustrate its consistency.

The changing sex ratios at birth during the civil war in Tajikistan: 1992-1997

Sex ratios at birth are known to change during wars or shortly after. This study investigated changes in sex ratios during the civil war that occurred in Tajikistan after the dismantling of the Soviet Union. This civil war was particularly bloody and long lasting, and had many demographic consequences. According to vital registration data, some 27,000 persons died in excess of previous trends during the civil war period (1992-1997), and total mortality was sometimes estimated to be three times higher by independent observers. Birth rates dropped markedly during the war, and sex ratios at birth increased significantly from 104.6 before the war to 106.9 during the war, to return to baseline values afterwards. The change in sex ratio is investigated according to demographic evidence (migration, delayed marriage, spouse separation), substantiated with qualitative evidence (difficulties with food supply), and compared with patterns found in Europe during World War II, as well as with recent wars in the Middle East.

An exploration of secondary sex ratios among women diagnosed with anxiety disorders

BACKGROUND

Theory suggests that natural selection conserved reactivity in part because highly reactive women spontaneously abort less fit conceptuses, particularly small males. Other literature argues that high reactivity manifests clinically as anxiety disorders. If true, births to women diagnosed with anxiety disorders should exhibit a low secondary sex ratio (i.e. ratio of male to female births). We explored whether births to women diagnosed with anxiety disorders exhibit a lower sex ratio than births to women diagnosed with other psychiatric disorders, or to women without mental health diagnoses.

METHODS

We performed a case-control comparison of the secondary sex ratios among groups of women categorized by mental health diagnosis using birth records linked to data from California County Mental Health system records. We compared sex ratios among 5994 deliveries to mothers diagnosed with anxiety disorders, 23 443 deliveries to mothers diagnosed with other psychiatric disorders and 1 099 198 'comparison' births.

RESULTS

Although comparison births exhibited a higher sex ratio than births to women diagnosed with anxiety disorders or with other diagnoses, differences were not statistically significant. Births to African American women diagnosed with anxiety disorders, however, exhibited sex ratios significantly lower than comparison births among African Americans (OR = 0.89, P = 0.038) or births to African American women with other mental health diagnoses (OR = 0.88, P = 0.042).

CONCLUSIONS

We found that infants born to African American women diagnosed with anxiety disorders exhibited a significantly lower secondary sex ratio than reference groups. We urge confirmatory tests of our findings and discuss implications of the reactivity/anxiety hypothesis for psychiatry, obstetrics and public health.

Retention of gene products in syncytial spermatids promotes non-Mendelian inheritance as revealed by the t complex responder

The t complex responder (Tcr) encoded by the mouse t haplotype is able to cause phenotypic differences between t and + sperm derived from t/+ males, leading to non-Mendelian inheritance. This capability of Tcr contradicts the concept of phenotypic equivalence proposed for sperm cells, which develop in a syncytium and actively share gene products. By analyzing a Tcr minigene in hemizygous transgenic mice, we show that Tcr gene products are post-meiotically expressed and are retained in the haploid sperm cells. The wild-type allele of Tcr, sperm motility kinase-1 (Smok1), behaves in the same manner, suggesting that Tcr/Smok reveal a common mechanism prone to evolve non-Mendelian inheritance in mammals.