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The stillbirth sex ratio as a marker of population health among live‐born males in Denmark, 1835‐1923
Ist Teil von
American journal of human biology, 2019-05, Vol.31 (3), p.e23241-n/a
Ort / Verlag
Hoboken, USA: John Wiley & Sons, Inc
Erscheinungsjahr
2019
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Objectives
We know little about whether an elevated stillbirth sex ratio (ratio of male to female stillbirths) gauges stronger selection in utero against frail male gestations and therefore predicts greater male infant survival. An alternative scenario could involve a “low endowment” case in which pregnancy cohorts show both excess male stillbirths and elevated mortality risk among male live births. We exploit the longest sex‐specific stillbirth series (Denmark, 1835‐1923) to explore whether annual deviations in age‐specific male mortality vary with the annual cohort's stillbirth sex ratio.
Methods
We applied autoregressive, integrated, moving average time series methods to annual counts of age‐specific male mortality in Denmark. We derived the independent variable, the stillbirth sex ratio, from only late stillbirths (ie, 28th week and thereafter) owing to data availability. Methods control for secular patterns as well as shared antecedents of male and female mortality.
Results
Cohort male infant mortality varies positively with the stillbirth sex ratio (coef = 0.0081, standard error [SE] = 0.0019, P < 0.001). This positive relation persists into childhood (ie, ages 1‐4.99 years) but attenuates with age.
Discussion
We infer support for the “low endowment” argument in that high stillbirth sex ratios predict a relatively greater risk of mortality among males which ultimately survive to birth. These findings provide evidence that the stillbirth sex ratio may serve as a marker of population health among male cohorts.