Gebremedhin Amanuel Tesfay, Tessema Gizachew A, Srinivasjois Ravisha, Daire Judith A, Chai Kevin A, Duko Bereket, Mruts Kalayu Brhane, Pereira Gavin
School of Nursing and Midwifery, Edith Cowan University, Perth, Australia.
Curtin School of Population Health, Curtin University, Perth, Australia.
PLOS Glob Public Health. 2025 May 28;5(5):e0004672. doi: 10.1371/journal.pgph.0004672. eCollection 2025.
A skewed sex ratio at birth (SRB), commonly observed in countries with high son preference can be attributed to prenatal sex-selective abortion. However, the possibility of sex selection among migrants in high-income countries has received little attention. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. Our study aims to identify the indirect evidence of sex-selective abortion practices to the SRB imbalance in a large Australian cohort. In this population-based study, perinatal data were obtained from all registered births in Western Australia (WA) and New South Wales (NSW) for the period 1994 - 2015 (N = 2,175,252 births). We estimated the male-to-female sex ratio at birth (SRB) and 95% CI by mothers' country of birth stratified by sex of previous child and parity. The SRB exceeded expectations for children born to Indian, Chinese and Vietnamese mothers. For mothers from China, the SRB was 1.09 at second birth, slightly varying by sex of previous child (1.07 for male, 1.11 for a female) and markedly higher (1.34) at the third birth when the first two were female. A similar pattern was observed for Indian-born mothers. Indian and Chinese mothers had much higher induced abortion rates in early pregnancy than their Australian counterparts, which coincided with the introduction of non-invasive prenatal testing. Our study provides observational evidence that linked the male-biased SRB with prenatal sex determination followed by selective female-biased abortion practices. The findings of this study can inform public health policy decisions to address imbalanced SRB and sex-selective practices among migrants in high-income countries.
出生性别比失衡（SRB）在重男轻女观念严重的国家较为常见，这可能归因于产前性别选择性堕胎。然而，高收入国家移民中的性别选择可能性却很少受到关注。我们的研究旨在确定在澳大利亚一个大型队列中，性别选择性堕胎行为导致SRB失衡的间接证据。我们的研究旨在确定在澳大利亚一个大型队列中，性别选择性堕胎行为导致SRB失衡的间接证据。在这项基于人群的研究中，我们获取了1994年至2015年期间西澳大利亚州（WA）和新南威尔士州（NSW）所有登记出生的围产期数据（N = 2,175,252例出生）。我们根据母亲的出生国家、前一个孩子的性别和胎次，估计了出生时的男女比例（SRB）及95%置信区间。印度、中国和越南母亲所生孩子的SRB超出预期。对于中国母亲，第二胎的SRB为1.09，根据前一个孩子的性别略有不同（男孩为1.07，女孩为1.11），而当第一、二胎均为女孩时，第三胎的SRB明显更高（1.34）。印度出生的母亲也观察到类似模式。印度和中国母亲早期妊娠的人工流产率远高于澳大利亚母亲，这与无创产前检测的引入时间相吻合。我们的研究提供了观察性证据，将男性偏好的SRB与产前性别鉴定及随后的选择性女性堕胎行为联系起来。本研究结果可为公共卫生政策决策提供参考，以解决高收入国家移民中SRB失衡和性别选择行为问题。
