Editor—Sex differences in infant mortality have been the subject of previous international comparison and discussion, and the results presented by Khanna et al provide confirmation.1,2 I examined whether similar sex differences exist in England and Wales.
I used unpublished data on births and infant deaths by mother's country of birth from the Office for National Statistics. In the absence of national data by ethnic origin, the data for children born to first generation migrants provide the closest proxy to outcomes for minority populations in England and Wales.
For the 19 663 births registered between 1996 and 1998 to mothers born in India, infant mortality for both sexes was 5.49 per 1000 births, an odds ratio of 1.00, which is not significantly different from the overall England and Wales ratio of 0.80 (table).
Table 1.
Odds ratios (95% CI) of female to male birth ratio by mother's country of birth, England and Wales, 1996-8
|
Mother's country of birth
|
Odds ratio
|
|
|---|---|---|
| Female:male | 95% CI | |
| United Kingdom: | 0.78 | 0.75 to 0.81 |
| England and Wales | 0.78 | 0.75 to 0.81 |
| Scotland | 0.88 | 0.64 to 1.22 |
| Northern Ireland | 0.83 | 0.46 to 1.50 |
| Europe outside United Kingdom: | 0.90 | 0.82 to 0.99 |
| Irish Republic | 0.62 | 0.40 to 0.95 |
| Other European Union | 0.78 | 0.56 to 1.08 |
| Rest of Europe | 1.12 | 0.67 to 1.86 |
| Commonwealth: | ||
| Australia, Canada, New Zealand | 1.22 | 0.67 to 2.21 |
| New Commonwealth: | 0.91 | 0.81 to 1.02 |
| Bangladesh | 0.84 | 0.61 to 1.17 |
| India | 1.00 | 0.69 to 1.46 |
| Pakistan | 1.09 | 0.90 to 1.31 |
| East Africa | 0.83 | 0.53 to 1.29 |
| Southern Africa | 0.81 | 0.30 to 2.16 |
| Rest of Africa | 0.69 | 0.52 to 0.91 |
| Far East | 1.00 | 0.44 to 2.26 |
| Mediterranean | 0.79 | 0.40 to 1.57 |
| Caribbean | 0.85 | 0.54 to 1.33 |
| Rest of New Commonwealth | 0.73 | 0.28 to 1.91 |
| Rest of the world and not stated | 0.95 | 0.74 to 1.20 |
| All | 0.80 | 0.77 to 0.83 |
Source: Office for National Statistics (unpublished).
For the 37 947 births registered in the same period to mothers born in Pakistan, mortality among girls was higher than that for boys, with an odds ratio of 1.09, significantly higher (P < 0.05) than the overall ratio in England and Wales. For no other country of birth group was such an effect observed. Also noteworthy are the much higher infant mortality rates for this group when compared with births to other South Asian born mothers
Supplementary Material
Complete data are published on bmj.com
Competing interests: None declared.
References
- 1.United Nations Department of Economic and Social Affairs, Population Division. Too young to die: genes or gender. New York: UN, 1998.
- 2.Khanna R, Kumar A, Vaghela JF, Sreenivas V, Puliyel JM. Community based retrospective study of sex in infant mortality in India. BMJ 2003;327: 126-0. (19 July.) [DOI] [PMC free article] [PubMed] [Google Scholar]
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