Fetal sex determination in infants in Punjab, India: correlations and implications

Abstract

Objectives: To determine the proportion of children whose sex was determined prenatally among those attending one Indian hospital and to identify factors which affect use of fetal sex determination. Design - Cross sectional study using interviews with mothers. Setting - Medical school hospital in Punjab, India. Subjects - 596 children delivered or seen for inpatient or outpatient care. Main outcome measures: Fetal sex determination, sex of child, number and sex of siblings, type of care received, socioeconomic status, and maternal education. Results: Sex had been determined prenatally for fewer girls (5/236, 2%) than boys (49/360, 14%). Fetal sex determination had been done for only 2% (3/154) of first born boys compared with 18% (12/66) with one older sister and no older brother and 63% (30/48) with more than one older sister and no older brother. Only four boys whose sex had been determined prenatally had older brothers. The five girls whose sex had been determined prenatally either had a male twin or were incorrectly identified as male. Prenatal sex determination had been done for 21% (26/122) of boys admitted for inpatient care compared with 11% (19/173) seen as outpatients. Use of fetal sex determination increased with increasing monthly income (X² for trend=6.384, P=0.0115). None of the mothers who had had no education had used fetal sex determination, but among mothers with some education the frequency of use did not change with increasing education. The sex ratio of children born at the hospital rose from 107 boys/100 girls in 1982 to 132 boys/100 girls in 1993. Conclusions: Fetal sex determination was common, especially if the family already had daughters. Sex determination seems to be driven by a desire to have sons, with socioeconomic status and education having little effect. The lower prevalence of fetal sex determinations for girls is likely to be due to abortion of fetuses found to be female.