Male fetal loss in the U.S. following the terrorist attacks of September 11, 2001

Public Health & Planning, Policy and Design, University of California at Irvine, Irvine, CA, USA.
BMC Public Health (Impact Factor: 2.32). 05/2010; 10:273. DOI: 10.1186/1471-2458-10-273
Source: PubMed

ABSTRACT The secondary sex ratio (i.e., the odds of a male birth) reportedly declines following natural disasters, pollution events, and economic collapse. It remains unclear whether this decline results from an excess of male fetal loss or reduced male conceptions. The literature also does not converge as to whether the terrorist attacks of September 11, 2001 induced "communal bereavement", or the widespread feeling of distress among persons who never met those directly involved in the attacks. We test the communal bereavement hypothesis among gravid women by examining whether male fetal deaths rose above expected levels in the US following September 11, 2001.
We apply interrupted time-series methods to all fetal deaths at or greater than the 20th week of gestation in the US from 1996 to 2002. Time-series methods control for trends, seasonality, and other forms of autocorrelation that could induce spurious associations.
Results support the hypothesis in that the fetal death sex ratio (i.e., the odds of a male fetal death) increased above its expected value in September 2001. Additional analysis of the secondary sex ratio indirectly supports that the terrorist attacks may have threatened the gestation of male more than female fetuses.
Societal responses to events such as September 11, 2001 do not appear confined only to persons who have ever met the deceased. The fetal death sex ratio in the US population may serve as a sentinel indicator of the degree to which pregnant women react to population stressors.

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Available from: Tim Bruckner, Jul 29, 2015
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    • "Prenatal exposure to stress from conception onwards has been shown to alter birth outcomes including: increases in the percentage of infants born pre-term (defined as less that 37 weeks gestation) [1], an increase in the percentage of infants born at a low birth-weight (less than 2500 g) [1] and decreases to the secondary sex-ratio (an increase in the number of female infants born compared to male infants born). Although the biological and psychological drivers of these changes are not fully understood at present, stress-related changes to birth outcomes have been observed following exposure to: environmental disasters [2] [3] [4] [5] [6] [7] [8]; terrorist attacks [9] [10] [11]; wars [12] [13]; national economic decline [12] [14] [15]; severe life stress, such as the death of a partner or other child [16]; and racism [17]. Thus, as the intensity and frequency of environmental disasters continues to increase, reductions in gestational length and birthweight may present a significant challenge for public health and disaster policymakers. "
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    Emerging Health Threats Journal 04/2011; 4:7109. DOI:10.3402/ehtj.v4i0.7109
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