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The empirical evidence so far is mixed.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title><jats:p>Annual time series data, spanning 243\u2009years between 1749 and 1991 for Sweden at the national level, were drawn from multiple sources. The outcome is defined as the percentage of male births relative to all births in Sweden in a given year. The covariates include a set of economic and climatic variables as proxies for maternal stress.<\/jats:p><\/jats:sec><jats:sec><jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title><jats:p>We conduct a series of ARIMA (autoregressive integrated moving average) models to examine the relationship between maternal stress and SRB during three periods: 1749\u20131991, 1749\u20131861 and 1862\u20131991.<\/jats:p><\/jats:sec><jats:sec><jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title><jats:p>In 1749\u20131991, economic proxies for maternal stress showed no statistically significant association with SRB. In 1749\u20131861, two indicators were significantly associated with SRB, but the coefficients were opposite in direction to the TWH. In 1862\u20131991, five out of six covariates showed no significant association with SRB. An additional analysis found no significant correlation between sex ratio of stillbirths and all covariates in 1862\u20131991. Our results are incompatible with the TWH and suggest that previous findings in support of the TWH are not robust.<\/jats:p><\/jats:sec><jats:sec><jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title><jats:p>This study provides population-level evidence that may not necessarily reflect the nature of all individuals due to the ecological fallacy. The time series analysed in this study are annual data, and we cannot examine the potential seasonality due to the lack of disaggregated monthly data. Our findings may not be generalised to the contexts of extreme maternal stress conditions such as famine and war.<\/jats:p><\/jats:sec><jats:sec><jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title><jats:p>The results from existing studies in this topic may be speculative, and additional research with more comprehensive design, data and covariates is needed to reconsider the robustness of previous findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title><jats:p>The author receives no external funding and has no conflict of interest to declare.<\/jats:p><\/jats:sec><jats:sec><jats:title>TRIAL REGISTRATION NUMBER<\/jats:title><jats:p>N\/A.<\/jats:p><\/jats:sec>","DOI":"10.1093\/humrep\/deab158","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T12:35:35Z","timestamp":1622723735000},"page":"2782-2792","source":"Crossref","is-referenced-by-count":13,"title":["Maternal stress and sex ratio at birth in 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