Worsening sex ratio in India--some evidence from Mumbai.

We recruited 1217 middle and lower-class pregnant women in Mumbai over June-November 2002, to study the effect of smokeless tobacco use on reproductive outcomes. These women were recruited on a house-to-house basis from eight health administrative areas in Mumbai. Detailed interviews and abstraction of medical records were undertaken at recruitment and at follow up after delivery (November 2002-May 2003). Dates of ultrasound examinations and results of such examination including gestational age were abstracted by trained social workers. Ethical guidelines laid down by the Indian Council of Medical Research were adhered to in carrying out the research. Details of the methodology are published elsewhere. Overall, 1064 singleton live births occurred in this cohort of which information on sex of baby was missing for 10; 1054 births were analyzed for sex ratios at birth, by educational status, socio-economic status, birth-order, number of antenatal visits and number and timing of ultrasound examinations. We hypothesized that if the ultrasound was carried out closer to the first antenatal visit, the possibility of an intention of sex selection would have been greater (timing of first ultrasound visit was known for 440 women).