{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T22:18:07Z","timestamp":1766528287374,"version":"3.48.0"},"reference-count":28,"publisher":"BMJ","issue":"7093","license":[{"start":{"date-parts":[[1997,5,24]],"date-time":"1997-05-24T00:00:00Z","timestamp":864432000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1997,3,11]]},"published-print":{"date-parts":[[1997,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    To study reproductive pattern and perinatal mortality in rural Tamil Nadu, South India.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Community based, cross sectional questionnaire study of 30 randomly selected areas served by health subcentres.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Rural parts of Salem District, Tamil Nadu, South India.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects:<\/jats:bold>\n                    1321 women and their offspring delivered in the 6 months before the interview.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures:<\/jats:bold>\n                    Number of pregnancies, pregnancy outcome, spacing of pregnancies, sex of offspring, perinatal and neonatal mortality rates.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    41% of the women (535) were primiparous; 7 women (0.5%) were grand multiparous (&gt;6 births). The women had a mean age of 22 years and a mean of 2.3 pregnancies and 1.8 live children. The sex ratio at birth of the index children was 107 boys per 100 girls. The stillbirth rate was 13.5\/1000 births, the neonatal mortality rate was 35.3\/1000, and the perinatal mortality rate was 42.0\/1000. Girls had an excess neonatal mortality (rate ratio 3.42; 95% confidence interval 1.68 to 6.98; this was most pronounced among girls born to multiparous women with no living sons (rate ratio 15.48 (2.04 to 177.73)\n                    <jats:italic>v<\/jats:italic>\n                    1.87 (0.63 to 5.58) in multiparous women with at least one son alive).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    In this rural part of Tamil Nadu, women had a controlled reproductive pattern. The excess neonatal mortality among girls constitutes about one third of the perinatal mortality rate. It seems to be linked to a preference for sons and should therefore be addressed through a holistic societal approach rather than through specific healthcare measures.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text position=\"float\">\n                      <jats:sec>\n                        <jats:title>Key messages<\/jats:title>\n                        <jats:list list-type=\"bullet\">\n                          <jats:list-item>\n                            <jats:p>In this area of Tamil Nadu, women have a controlled reproductive pattern, with an average of 2.3 pregnancies and 1.8 living children; the average age at the birth of the first child is 20<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>The sex ratio at birth is 107 boys to 100 girls<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Girls have a substantial excess neonatal mortality, which is most pronounced among girls born to multiparous women with no living sons<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>This excess neonatal mortality among girls seems to be linked to a preference for sons and must be addressed through a holistic societal approach<\/jats:p>\n                          <\/jats:list-item>\n                        <\/jats:list>\n                      <\/jats:sec>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1136\/bmj.314.7093.1521","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:46:41Z","timestamp":1319744801000},"page":"1521","source":"Crossref","is-referenced-by-count":45,"title":["Reproductive pattern, perinatal mortality, and sex preference in rural Tamil Nadu, South India: community based, cross sectional study"],"prefix":"10.1136","volume":"314","author":[{"given":"Birgitte Bruun","family":"Nielsen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerker","family":"Liljestrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Hedegaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakuntala Haraksingh","family":"Thilsted","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,5,24]]},"reference":[{"unstructured":"Unicef. 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