Impact of earthquakes on sex ratio at birth: Eastern Marmara earthquakes

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.

Birth Outcomes, Health, and Health Care Needs of Childbearing Women following Wildfire Disasters: An Integrative, State-of-the-Science Review

BACKGROUND

The frequency and severity of extreme weather events such as wildfires are expected to increase due to climate change. Childbearing women, that is, women who are pregnant, soon to be pregnant, or have recently given birth, may be particularly vulnerable to the effect of wildfire exposure.

OBJECTIVES

This review sought to systematically assess what is known about birth outcomes, health, and health care needs of childbearing women during and after exposure to wildfires.

METHODS

An integrative review methodology was utilized to enable article selection, data extraction, and synthesis across qualitative and quantitative studies. Comprehensive searches of SCOPUS (including MEDLINE and Embase), CINAHL, PubMed, and Google Scholar identified studies for inclusion with no date restriction. Included studies were independently appraised by two reviewers using the Crowe Critical Appraisal Tool. The findings are summarized and illustrated in tables.

RESULTS

Database searches identified 480 records. Following title, abstract, and full text screening, sixteen studies published between 2012 and 2022 were identified for this review. Eleven studies considered an association between in utero exposure to wildfire and impacts on birth weight and length of gestation. One study reported increased rates of maternal gestational diabetes mellitus and gestational hypertension following exposure; whereas one study reported differences in the secondary sex ratio. Two studies reported higher incidence of birth defects following in utero exposure to wildfire smoke. Three studies reported increased mental health morbidity, and one study associated a reduction in breastfeeding among women who evacuated from a wildfire disaster.

DISCUSSION

Evidence indicates that wildfire exposure may be associated with changes to birth outcomes and increased morbidity for childbearing women and their babies. These effects may be profound and have long-term and wide-ranging public health implications. This research can inform the development of effective clinical and public health strategies to address the needs of childbearing women exposed to wildfire disaster. https://doi.org/10.1289/EHP10544.

Could maternal stress be a causal factor for nonsyndromic cleft lip and/or palate: A retrospective study

BACKGROUND

The etiology of the nonsyndromic cleft lip and palate is multifactorial and not clearly defined.

OBJECTIVE

To determine whether maternal stress could be a causal factor for the occurrence of nonsyndromic cleft lip and palate.

MATERIALS AND METHODS

We conducted a retrospective observational study in which data from 50 mothers of children born with nonsyndromic cleft lip and palate and 50 mothers of noncleft children were analyzed. The outcomes defined were to study the association between the increased stress scores and the occurrence of nonsyndromic cleft lip and/or palate. Statistical analysis was performed using the Chi-square test.

RESULTS

The association between the high maternal stress scores and the occurrence of nonsyndromic cleft lip and/or palate was not found to be significant (P = 0.3220). A significant association was noted between increased maternal age and increased stress levels in the cleft group (P = 0.0001).

CONCLUSION

No significant association was found between the increased stress scores and the occurrence of nonsyndromic cleft lip and/or palate. However, mothers of cleft children whose age was 35 years and above at the time of conception were noted to have higher stress levels.

Effects of earthquakes and other natural catastrophic events on the sex ratio of newborn infants

Stress due to earthquakes and other natural catastrophic events may result in a decline in the male to female ratio of newborn infants. One reason may be an increased death of male fetuses 3-5 months earlier. Another reason may relate to reduced conception of males and/or early male embryo demise 8-10 months earlier. Almost all of the earthquakes and natural catastrophic events have caused declines in sex ratios at birth except the Hurricane Katrina which showed a rise in the birth sex ratio. We describe hypothetical immunological cause for the decline in the sex ratio at birth following periods of augmented stress levels.

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).