| Objective On the foundation of analyzing the data of the third, the forth, thefifth census, making the sampling survey in hospital and typical survey in the area with high sex ratio at birth, we described the level, the features and the trends of the sex ratio at birth in Henan. By analyzing these data we identified the influences factors and the reasons of the abnormal sex ratio at birth in Henan. We also use these data to forecast the consequence of the continual abnormal sex ratio at birth and apply the relevant knowledge to approach the suggestions to decline the high sex ratio at birth in Henan.Methods1.Through analyzing the domestic and international data, we understand the present condition of the sex ratio at birth in the world.2. Analysis is focused on the fifth census in Henan and compared to the third, the forth, through which we realized the sex ratio at birth's level, the trends in the future, region difference, characteristics of crowd distributes and primarily influence factors.3. Analysis on the data of sex ratio at birth in Henan hospital delivery room: by means of sampling survey, we gain the hospital delivery room infants' data. Samplingmethod: based on the consideration of all levels hospitals in foundation and geography distribute condition, the hospitals were divided into, province, ground city and county class, of three classes. Then by cluster, stratified sampling we take 1 province class hospital, 6 city class hospitals, 9 county class hospitals as research units. Survey method: On-site inspection was taken. From March to August 2004, the investigators collected the infants' data of during 1990 to 2003, recording the mothers' age, education, race, habitation and the orders of childbirth.4. Typical survey: the investigation were carried out in the region with high sex ratio at birth, including influence factors and the sex ratio of induced abortion investigations. According to the method of sampling study, the numbers of samples are estimated. During September to December 2004 data collection was made in the high sex ratio region of Henan. The qualified investigators get closely into the inhabitants, they investigate 3398 childbirth women, 3432 infants, 2001 male infants and 1431 female infants of 2003. They recorded the mothers' age, inhabitation, education, race and the children's sex, order of the previous lived. The investigation also includes induced abortion in the pregnancy period.5. To import the related census data and sampling data into the computer, then establish the database, and analyze by use of the SPSS 10.0 statistic analysis system to analyze. Describe study: Using the forms, diagrams to describe the level and the trends of the sex ratio at birth from 1981 to 2000 in Henan. The region and crowd distribution characteristics were also described. Analysis research: making use of the simple and multiple Logistic regression model to analyze the data, on the foundation of which, we identified the main influence factors and the reasons for the abnormal sex ratio at birth in Henan. Research variable: (1) independent variable: the mothers' age, ethnic group, education, habitation and the sex, number of children they previously had. (2) dependent variable: 1 means the male, 0 means female. Using the number of male baby opposite to each 100 female baby means the sex ratio at birth.Results1. Distribution characteristic of the sex ratio at birth in Henan. (1) The value ofthe sex ratio at birth in Henan has been higher than normal since 1982, and has the trends of gradually rising. The sex ratio at birth were 110.30 in 1982, 115.60 in 1990, 130.30 in 2000. (2) According to the 2000 census in Henan, all the cities' sex ratio at birth were higher than normal. Zhengzhou is the lowest and it was the only one lower than average level. Jiyuan's sex ratio at birth was the highest in Henan with the value of 149.00. Town and rural's sex ratio at birth is higher than city's. The values of the sex ratio at birth in city, town, rural get all higher than the forth census. (3) The sex ratio at birth rise along with the mothers' age then descend gradually. But the proportion of the second and the above parity births increase along with mothers' age. Sex ratio at birth in each parity births has no relation to the mothers' age. The first, the second, the third, the forth, the fifth and above parities' sex ratio at birth were 104.43, 194.00, 214.58, 264.84, 235.14, respectively. The sex ratio at birth and the parity births has positive correlation, the rank correlation coefficient was 0.900, P= 0.037; The first parity births has no relation to the mothers' education. Regardless to the mothers' education, the second and the above parity births' sex ratio at birth all grow up obviously.2. The sex ratio at birth in Henan hospital. The sex ratio at birth in Henan hospital had the tendency of increasing gradually from 1990 to 2003.The values of the second and the third parity births' sex ratio at birth are higher than the first in every hospital. The ratio at birth in county's hospital is higher than in province's and city's hospital.3. The typical survey of the sex ratio at birth. The sex ratio at birth in 2003 in one of counties in Henan was 142.35, and the first parity births' was 107.70, and the second was 193.07, and the third and the above was 195.45, and the second parity births which had one girl was 284.65, and the induced abortion's sex ratio was 85.64. The sex ratio at birth is only determined by the number and the sex of the previous lived children, and has no relation to the mothers' age, ethnic group, education and habitation.4. The birth statistics in Henan. According to the fifth census in Henan, the underreporting rate of male births was 8.85%, and the female births was 17.14%. The underreporting sex ratio was 59.14. Expelling the underreporting factor, the sex ratioat birth will descend to 113.54. The male infants' death rate was 20.23‰, 21.28‰, 16.88‰, and the female was 20.89‰, 26.06‰, 29.29‰, and the infants' death rate sex ratio was 0.97, 0.82, 0.58 in 1982,1990, 2000 respectively.Conclusion1. The sex ratio at birth was high in Henan since 1980s and had the tendency to grow up gradually. The sex ratio at birth is only determined by the number and the sex of the previous lived children, and has no relations to the mothers' age, ethnic group, education and habitation.2. The causes of the high sex ratio at birth in Henan were identified as follows: (1) Reporting and tabulation errors in birth statistics is one of the reasons for the abnormal sex ratio at birth. Expelling the deceive, leak and report error, the sex ratio at birth will descend a lot, but still higher the top limit of the normal. This proved that abnormal sex ratio at birth in Henan was existing for sure. (2) Sex-selective abortion and the use of ultrasound equipment in fetal sex identification were proved to be one significant effect on the abnormal sex ratio at birth in Henan, which is probably the main cause of these increasing sex ratios (3) An unusual higher female death rate due to parental neglect and lack of caring for sick female infants was another reasons for the abnormal sex ratio at birth. (4) The root reason for abnormal sex ratio at birth is the strong son preference. The existing inequality between man and woman lead to the strong son preference.3. The countermeasures and suggestions to control the abnormal sex ratio at birth in Henan: Firstly, the government should pay more attention to the consequences of the continual high sex ratio at birth, and adjust the population policy. Secondly, thegovernment should manage to weaken the sex preference, to increase the women's status, to increase old-age pensions and social security. Finally, legislations were passed to prohibit the sex-selective abortion and the use of ultrasound equipment in fetal sex identification.
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