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Secular trends in sex ratios at birth in North America and Europe over the second half of the 20th century
  1. V Grech1,
  2. P Vassallo-Agius2,
  3. C Savona-Ventura3
  1. 1Paediatric Department, St Luke’s Hospital, Malta
  2. 2Medical School, University of Malta
  3. 3Department of Obstetrics and Gynaecology, St Luke’s Hospital, Malta
  1. Correspondence to:
 Dr V Grech, Paediatric Department, St Luke’s Hospital, Guardamangia, Malta; 


Context: A previous study showed that significantly more boys were born in southern latitudes in Europe than in northern latitudes and the converse pattern was observed in North America.

Objective: This study analyses secular trends in gender ratios for live births over the second half of the 20th century.

Design, setting, participants: Analysis was carried out from a World Health Organisation dataset comprising live births over the above period. This included 127 034 732 North American and 157 947 117 European live births.

Main outcome measures: Analysis of trends in gender ratios for countries in both continents.

Results: The findings show a highly significant overall decline in male births in both Europe and North America (p<0.0001), particularly in Mexico (p<0.0001). Interestingly, in Europe, male births declined in North European countries (latitude>40°, p<0.0001) while rising in Mediterranean countries (latitude ≅35–40°, p<0.0001). These trends produced an overall European male live birth deficit 238 693 and a North American deficit of 954 714 (total male live birth deficit 1 193 407).

Conclusions: No reasonable explanation/s for the observed trends have been identified and the causes for these trends may well be multifactorial.

  • sex ratio
  • birth rate
  • climate

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