Perinatal Health Among 1 Million American-Born Chinese

Son preference is well documented in many Asian counties. Sex selection generates sex ratios (# of males/# of females) above the biologically normal ratio of around 1.05 at birth. For China, Chen, Li, and Meng [2013] argue that availability of prenatal sex determination through ultrasound lead to a 40-50% increase in the sex imbalance during the 1980s. Son preference manifests in sibling sex composition, where the sex ratio of firstborn children is relatively normal but rises at higher birth orders in the absence of a previous son [Yi et al., 1993]. Because official birth certificate and hospital discharge microdata are not publicly available for China, most studies analyze population census data. This tends to focus empirical work on the sex imbalance itself. A key unanswered question is the effect of gender preference on “survivors”. An exception is Li and Wu [2011], who use the China Health and Nutrition Survey to show that mother’s nutrition may deteriorate postpartum upon having a daughter relative to a son. Gender preference aside, perinatal health has a profound impact on population health. The WHO defines the perinatal period as running from 22 weeks gestation to 7 days after birth. Over half of infant deaths occur within first 7 days of life. The death rate for children under age one is more than 13 times higher than the death rate for children age 15 to 19, the group with the next highest rate. Moreover, the fetal origins hypothesis suggests that small gaps in perinatal health can map to large later-life gaps. In the absence of data for China, we explore the perinatal health of American-born Chinese (1.2% of US population)