Abstract
Background: The existence of female feticide in India is well known. However, limited data are available on the association of socioeconomic status (SES) on sex ratio at live birth in disadvantaged populations, despite the fact that 33% of the population of India live on less than $1.25 per day.

Objective: To study the association of SES with sex ratio at live birth in individuals living in the slums of Sholapur city, India.

Materials and Methods: We used the data collected as a part of a social work intervention in the slums of Sholapur city, Maharashtra, from January 2007 to August 2011. Two measures of SES were used, location of birth (government hospital compared to private hospital) and eligibility for means-tested financial support after delivery.

Results: Data were available for 1391 infants. The infants born in government hospitals were more likely to be male compared to those born in private hospitals (sex ratio of 1.45 compared to 1.14, respectively, p = 0.03). Similarly, infants whose parents were eligible for post-delivery financial support had a trend to a higher sex ratio (1.47 compared to 1.18, p = 0.057). Maternal age was independently and inversely associated with sex ratio at live birth with a linear relation (OR per year increase in maternal age 0.96, 95% CI 0.93–1.00, p = 0.03).

Conclusion: In this particular population, two measures of less affluent SES were associated with higher sex ratio at live birth. However, care should be taken while generalizing these observations to other disadvantaged groups living in India, but this represents an area of research where more epidemiological work is required, as these differences perpetuated over generations may have substantial demographic consequences.

Key words: Socioeconomic status, sex ratio, female feticide, India