Citation

Masukume G, O'Neill SM, Khashan AS, Kenny LC, Grech V. Acta Med. (Hradec Kralove) 2017; 60(2): 59-65.

Affiliation

Academic Department of Paediatrics, Medical School, Mater Dei Hospital, Malta. victor.e.grech@gov.mt.

Copyright

(Copyright © 2017, Charles University, Faculty of Medicine in Hradec Králové, Publisher Karolinum Press)

DOI

10.14712/18059694.2017.94

PMID

28976871

Abstract

AIM: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

Language: en

Keywords

miscarriage; population stress; pregnancy; sex ratio; stillbirth