The terrorist attacks and the human live birth sex ratio: a systematic review and meta-analysis.
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Published version
Date
2017-10-05
Authors
Masukume, Gwinyai
O'Neill, Sinéad M.
Khashan, Ali S.
Kenny, Louise C.
Grech, Victor
Journal Title
Journal ISSN
Volume Title
Publisher
Charles University, Karolinum Press
Published Version
Abstract
The live birth sex ratio is defined as male/total births (M/F). Terrorist attacks have been associated with a transient decline in M/F 3-5 months later with an excess of male losses in ongoing pregnancies. The early 21st century is replete with religious/politically instigated attacks. This study estimated the pooled effect size between exposure to attacks and M/F. Registration number CRD42016041220.
PubMed and Scopus were searched for ecological studies that evaluated the relationship between terrorist attacks from 1/1/2000 to 16/6/2016 and M/F. An overall pooled odds ratio (OR) for the main outcome was generated using the generic inverse variance method.
Five studies were included: 2011 Norway attacks; 2012 Sandy Hook Elementary School shooting; 2001 September 11 attacks; 2004 Madrid and 2005 London bombings. OR at 0.97 95% CI (0.94-1.00) (I2 = 63%) showed a small statistically significant 3% decline in the odds (p = 0.03) of having a male live birth 3-5 months later. For lone wolf attacks there was a 10% reduction, OR 0.90 95% CI (0.86-0.95) (p = 0.0001).
Terrorist (especially lone wolf) attacks were significantly associated with reduced odds of having a live male birth. Pregnancy loss remains an important Public Health challenge. Systematic reviews and meta-analyses considering other calamities are warranted.
Description
Keywords
Population stress , Sex ratio , Pregnancy , Stillbirth , Miscarriage
Citation
Masukume, G., O'Neill, S. M., Khashan, A. S., Kenny, L. C. and Grech, V. (2017) 'The terrorist attacks and the human live birth sex ratio: a systematic review and meta-analysis'. Acta Medica (Hradec Kralove), 60 (2), pp. 59-65. doi: 10.14712/18059694.2017.94