Sex ratios among Canadian liveborn infants of mothers from different countries

Background: There has been much discussion about whether female feticide occurs in certain immigrant groups in Canada. We examined data on live births in Ontario and compared sex ratios in different groups according to the mother's country or region of birth and parity. Methods: We completed a population-based study of 766 688 singleton live births between 2002 and 2007. We used birth records provided by Ontario Vital Statistics for live births in the province between 23 and 41 weeks' gestation. We categorized each newborn according to the mother's country or region of birth, namely Canada (n = 486 599), Europe (n = 58 505), South Korea (n = 3663), China (n = 23818), Philippines (n = 15367), rest of East Asia (n = 18971), Pakistan (n = 18018), India (n = 31 978), rest of South Asia (n = 20 695) and other countries (n = 89 074). We calculated male:female ratios and 95% confidence intervals (as) for all live births by these regions and stratified them by maternal parity at the time of delivery (0, 1, 2 or >= 3). Results: Among infants of nulliparous women, the male:female ratio was about 1.05 overall. As parity increased, the ratio remained unchanged among infants of Canadian-born women. In contrast, the male:female ratio was significantly higher among infants of primiparous women born in South Korea (1.20, 95% CI 1.09-1.34) and India (1.11, 95% CI 1.07-1.15) than among infants of Canadian-born primiparous women. Among multiparous women, those born in India were significantly more likely than Canadian-born women to have a male infant (parity 2, ratio 1.36, 95% CI 1.27-1.46; parity >= 3, ratio 1.25, 95% CI 1.09-1.43). Interpretation: Our study of male:female ratios in Ontario showed that multiparous women born in India were significantly more likely than multiparous women born in Canada to have a male infant.