The terrorist attacks and the human live birth sex ratio: a systematic review and meta-analysis.

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dc.contributor.authorMasukume, Gwinyai
dc.contributor.authorO'Neill, Sinéad M.
dc.contributor.authorKhashan, Ali S.
dc.contributor.authorKenny, Louise C.
dc.contributor.authorGrech, Victor
dc.contributor.funderIrish Centre for Fetal and Neonatal Translational Research (INFANT)en
dc.date.accessioned2017-10-10T11:17:29Z
dc.date.available2017-10-10T11:17:29Z
dc.date.issued2017-10-05
dc.date.updated2017-10-10T11:11:41Z
dc.description.abstractThe 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.en
dc.description.sponsorshipIrish Centre for Fetal and Neonatal Translational Research (INFANT) (grant no. 12/RC/2272)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationMasukume, 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: 10.14712/18059694.2017.94en
dc.identifier.doi10.14712/18059694.2017.94
dc.identifier.endpage65en
dc.identifier.issn1211-4286
dc.identifier.issued2en
dc.identifier.journaltitleActa Medica (Hradec Kralove)en
dc.identifier.startpage59en
dc.identifier.urihttps://hdl.handle.net/10468/4852
dc.identifier.volume60en
dc.language.isoenen
dc.publisherCharles University, Karolinum Pressen
dc.rights© 2017 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en
dc.subjectPopulation stressen
dc.subjectSex ratioen
dc.subjectPregnancyen
dc.subjectStillbirthen
dc.subjectMiscarriageen
dc.titleThe terrorist attacks and the human live birth sex ratio: a systematic review and meta-analysis.en
dc.typeArticle (peer-reviewed)en
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