title: Impact of earthquakes on sex ratio at birth: Eastern Marmara earthquakes.
abstract: OBJECTIVE
  Previous reports suggest that maternal exposure to acute stress related to earthquakes affects the sex ratio at birth. Our aim was to examine the change in sex ratio at birth after Eastern Marmara earthquake disasters.
  
  
  METHODS
  This study was performed using the official birth statistics from January 1997 to December 2002 - before and after 17 August 1999, the date of the Golcuk Earthquake - supplied from the Turkey Statistics Institute. The secondary sex ratio was expressed as the male proportion at birth, and the ratio of both affected and unaffected areas were calculated and compared on a monthly basis using data from gender with using the Chi-square test.
  
  
  RESULTS
  We observed significant decreases in the secondary sex ratio in the 4th and 8th months following an earthquake in the affected region compared to the unaffected region (p= 0.001 and p= 0.024). In the earthquake region, the decrease observed in the secondary sex ratio during the 8th month after an earthquake was specific to the period after the earthquake.
  
  
  CONCLUSIONS
  Our study indicated a significant reduction in the secondary sex ratio after an earthquake. With these findings, events that cause sudden intense stress such as earthquakes can have an effect on the sex ratio at birth.
authors.affiliation: Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Emek
authors.initials: E
authors.lastname: Doğer
authors.affiliation: Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Cakıroğlu
authors.affiliation: Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Sule Yıldırım
authors.initials: SY
authors.lastname: Köpük
authors.affiliation: Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Ceylan
authors.affiliation: Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Hayal Uzelli
authors.initials: HU
authors.lastname: Simşek
authors.affiliation: Department of Gynecology and Obstetrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Calışkan
keywords: Earthquakes; sex ratio at birth