Sex-Selective Abortion in India: The Impact on Child Mortality B ...

The M:F sex ratio at birth, however, was less than one (0.968) for this study population of HIV-infected women, indicating an adverse in utero effect on males. Similarly, infant girls were twice as likely to be born with hepatitis C virus as boys in two recent studies (European Paediatric Hepatitis C Virus Network, 2005; Mast et al., 2005). Beasley (2005) noted the low sex ratio at birth in one of the studies, and suggested that excess male mortality in utero is more likely than a higher infection rate among female infants. The opposite effect has been posited as an explanation for the skewed sex ratio at birth in many countries where hepatitis B virus (HBV) infections are prevalent. Oster (2005) has estimated that as much as 75% of the “missing females” in China and 20% of those in India can be accounted for by differential in utero mortality of female offspring of HBV-infected women. Das Gupta (2005) countered that the data showing the variability of sex ratio at birth by parity and by the sex composition of older siblings do not support this viral hypothesis. Beasley (2005) points out that males of all ages have slightly higher HBV infection rates than females, poorer immune responses to HBV vaccination, and a higher incidence of sequelae of infection such as chronic hepatitis, cirrhosis, and hepatocellular carcinoma; thus, it is unlikely that females would have higher in utero mortality.

Sex Ratio of the Population in India

Although males are more vulnerable biologically in the perinatal and infant periods, in parts of South and East Asia and North Africa young females face mortality disadvantages based on social and behavioral factors (Arnold, 1992; Sen 1992; Waldron, 1987).