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Fetal sex determination in infants in Punjab, India: correlations and implications
Insights
Prenatal fetal sex determination was common in India, particularly for families with existing daughters, driven by a preference for sons. This practice was less frequent for girls, suggesting selective abortion of female fetuses.
Area of Science:
- Medical ethics
- Public health
- Sociology
Background:
- Prenatal sex determination (PSD) is a sensitive issue in many societies.
- Cultural preferences for male offspring can influence reproductive choices.
- Understanding the prevalence and factors associated with PSD is crucial for public health interventions.
Purpose of the Study:
- To determine the proportion of children who underwent prenatal sex determination in an Indian hospital.
- To identify factors influencing the use of fetal sex determination.
Main Methods:
- A cross-sectional study was conducted.
- Interviews were performed with mothers of 596 children at a medical school hospital in Punjab, India.
- Data collected included fetal sex determination, child's sex, sibling information, care type, socioeconomic status, and maternal education.
Main Results:
- Prenatal sex determination was significantly more common for boys (14%) than girls (2%).
- Use of PSD increased with family income and was higher for boys with sisters compared to those with brothers.
- The hospital's birth sex ratio shifted towards more boys over time, from 107:100 in 1982 to 132:100 in 1993.
Conclusions:
- Fetal sex determination is prevalent, especially when families have daughters, indicating a strong desire for sons.
- Socioeconomic status and maternal education showed limited influence on PSD use.
- The low rate of PSD for girls likely reflects the practice of selective abortion after determining female fetuses.
Objectives:
To determine the proportion of children whose sex was determined prenatally among those attending one Indian hospital and to identify factors which affect use of fetal sex determination.
Design:
Cross sectional study using interviews with mothers.
Setting:
Medical school hospital in Punjab, India.
Subjects:
596 children delivered or seen for inpatient or outpatient care.
Main Outcome Measures:
Fetal sex determination, sex of child, number and sex of siblings, type of care received, socioeconomic status, and maternal education.
Results:
Sex had been determined prenatally for fewer girls (5/236, 2%) than boys (49/360, 14%). Fetal sex determination had been done for only 2% (3/154) of first born boys compared with 18% (12/66) with one older sister and no older brother and 63% (30/48) with more than one older sister and no older brother. Only four boys whose sex had been determined prenatally had older brothers. The five girls whose sex had been determined prenatally either had a male twin or were incorrectly identified as male. Prenatal sex determination had been done for 21% (26/122) of boys admitted for inpatient care compared with 11% (19/173) seen as outpatients. Use of fetal sex determination increased with increasing monthly income (chi2 for trend = 6.384, P = 0.0115). None of the mothers who had had no education had used fetal sex determination, but among mothers with some education the frequency of use did not change with increasing education. The sex ratio of children born at the hospital rose from 107 boys/100 girls in 1982 to 132 boys/100 girls in 1993.
Conclusions:
Fetal sex determination was common, especially if the family already had daughters. Sex determination seems to be driven by a desire to have sons, with socioeconomic status and education having little effect. The lower prevalence of fetal sex determinations for girls is likely to be due to abortion of fetuses found to be female.