Scales tipping as more boys born in HK

The number of boys born in Hong Kong is soaring compared with girls, spurred by an influx of mainland mothers who prefer sons. Many use sex-selection services that are illegal across the border.

Figures from the Census and Statistics Department show that the ratio rose from 109.8 boys for every 100 girls born in 2005, to 111.4 in 2006, 112 in 2007 and 113.6 in 2008.

At this rate it may soon approach the 120 to 130 found in some provinces on the mainland.
The trend is backed up by the first comprehensive study of its kind in Hong Kong. The researchers noted that many mothers came to Hong Kong specifically to learn the sex of their babies. Some would cancel their birth bookings on finding that they were expecting girls.

Since a landmark Court of Final Appeal ruling in 2001 gave permanent resident status to children born in Hong Kong to mainland parents, the city has become a “birth hub”.
These Hong Kong-born children may not be raised in the city during their early childhood, but they can come here at any time to enjoy their full rights to education and social services. In 2008, mainland mothers accounted for 42.6 per cent of all births in Hong Kong.
The overall male-to-female ratio in Hong Kong was only 1106.4 to 100 in the 1980s and 1990s, on a par with the international average of 105 to 107.

The study by three obstetricians and gynaecologists at hospitals in Kowloon West – Grace Wong Ying, Leung Wing-cheong and Robert chin kien-howe – was published recently in the Journal of Perinatal Medicine.

The team retrieved data on all the 194,602 babies born in public hospitals between 2003 and 2007. Of these, 140,962 (72.4 per cent) were born to Hong Kong Chinese and 52,741 (27.1 per cent) to mainland mothers. The overall sex ratio at birth during that five-year period was 108.8 to 100. But the ratio is lower for Hong Kong mothers, at 107.8, than for mainland mothers, 111.6.

Wong, the study’s chief author, said the rapid rise in the ratio was a result of and influx of mainlanders who practiced sex selection more than locals.

The researchers said as most mainland women giving birth in Hong Kong came from southern China, biological or environmental reasons alone probably could not explain such a “skewed” sex ratio.

“The most plausible explanation for this is the practice of sex selection. However, these findings do not provide direct evidence that such a high sex ratio is a result of selective abortion of females in women of higher birth order,” the report said.

“It is also possible that patients from mainland China tend to spend more resources on their sons, and are more willing to give birth in Hong Kong if their pregnancy is of a male baby.”
Wong, who formerly worked at the public Princess Margaret Hospital and switched to private practice a year ago, said almost 90 per cent of her patients were from the mainland.
“We have come across several cases in which the mainland mothers have defaulted or cancelled their booking for a delivery in Hong Kong after learning that they are carrying a girl. Some even disappeared without paying the medical fee after an ultrasound scan,' Wong said. The team also analysed the sex ratio of each birth order. They found that while mainland women did not have a clear preference for a son in their first pregnancy, they may have practised some form of sex selection from their second pregnancy.

For Hong Kong women, the sex ratios were 106 to 100 for the first baby, 107.3 for the second and 118.4 for the third child or above. The ratio increases much more steeply among mainland women - from 104.7 for a first baby, 114.9 for the second and 174.5 for the third child or above. The researchers warned that the 'abnormally skewed' sex ratio may have disastrous social consequences. 'High sex ratios at birth have deprived female fetuses of their birth rights. Mothers also suffer from tremendous psychological pressure and reproductive health risks while undergoing abortion.

'Discrimination against women is detrimental for both men and women, hindering the overall economic development. The phenomenon of missing girls will lead to a shortage of marriageable females,' the team said. There are now more women than men among the Hong Kong population aged 20 to 35. But University of Hong Kong demographer Dr Paul Yip Siu-fai said the changing sex ratio at birth would only have a limited effect on the overall sex ratio. 'This is because many Hong Kong men will marry mainland women and bring them to Hong Kong, and women's life expectancy is longer.' He called on the government to monitor demographic trends and prepare for an influx of Hong Kong-born children from the mainland.

Children born in Hong Kong enjoy full residency status In 2008, mainland mothers accounted for the following proportion of births in the city: 42.6%

Reference information:   SCMP
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above. 

Gene lab banned over test for sex (2)

'Although I told them I won't refer them to the laboratory, some of them found a way to get the test done and came back with a report. Some are reluctant to pay a deposit for a maternity package before they know the fetus is a boy or girl,' Wong said.

'The test's original purpose is for parents to check if the baby may suffer from severe sex-linked genetic diseases so they can have some prenatal counselling or an abortion, but doctors worry that the test is being used for gender selection including abortion,' she said.

Wong's earlier study, reported by the Post last year, found that the number of boys born in Hong Kong is soaring compared with girls, spurred by an influx of mainland mothers who prefer sons.

Wong said she would say it was unethical for doctors to refer patients for the test without knowing the real intentions behind it.

'Doctors won't know if the patient may use the result for the decision of abortion. Some parents may want to have better planning before the delivery, such as buying clothes for girls or boys,' she said.

Deputy medical director of the Union Hospital Dr Ares Leung Kwok-ling said the hospital's resident obstetricians 'have reached a consensus' not to use the test because the worry of it 'being abused for gender selection'.

'The test is different from ultrasound scans because it can tell the fetal sex in the first trimester [of pregnancy] while the ultrasound can only detect it in the second trimester. At the later stage of pregnancy, it is always easier for doctors to warn against an abortion because it would be more painful and risky to the mother,' said Leung, who is also senior vice-president of the college.

Dr Fung Tak-yuen, head of obstetrics at Baptist Hospital, said doctors in his department received requests from mainland mothers for fetal sexing, but the hospital denied them.

Head of obstetrics at the Hong Kong Sanatorium and Hospital Dr Joseph Chan Woon-tong said fetal sexing test was unnecessary. 'Why do we have to provide it?' he asked.

St Paul's Hospital administration discussed the test after requests from some mothers, but decided to ban it after DiagCor failed to provide scientific proof of its accuracy rate.

A sales and marketing manager at Diagcor, who gave her name only as Ms Ma, said the laboratory test was the first part of a paternity test. Ma said the test, which examines fetal genes contained in the mother's blood, can reveal whether the baby's Y-chromosome matches the father's.

If the baby is a girl, the doctor then takes a sample of amniotic fluid for testing for further matching with the father's genes. Fluid in the amniotic sac surrounding the fetus also contains fetal DNA.

Ma, who declined to provide the total number of requests for the test, would say only that demand is 'growing fast' among mainland mothers giving birth in Hong Kong.

She said how the test results were used was an issue of medical practice and a patient's choice.

'We have never promoted the test for fetal sexing, but some mothers need the paternity test results for immigration applications and other purposes ... other tests such as ultrasounds and samples of the amniotic fluid can also tell the sex of a fetus,' she said.

Two pregnant women from the mainland have appeared in Kowloon City Court accused of using false doctor's certificates to book obstetrics services in Hong Kong.

The women, who are both due to give birth in November, were arrested after they tried to make appointments at the Princess Margaret Hospital last month.

They were refused bail, and the case was adjourned until August 12.

130

The number of boys born for every 100 girls in China, from Henan in the north to Hainan in the south. Without selection it would be 105

Private obstetrician Dr Grace Wong Ying

Reference information:  Sunday Morning Post
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above.

Gene lab banned over test for sex (1)

A Hong Kong biotechnology laboratory has been banned by private hospitals amid fears that mainland mums-to-be are using its services for unethical sex selection.

Doctors believe that some women are abusing a genetic test offered by DiagCor Bioscience which can identify the sex of a baby and its chances of developing a severe sex-linked genetic disorder. Parents who have a family history of a severe genetic disorder use this test to determine the chances of the fetus developing a severe genetic disease.

DiagCor in Kowloon Bay is the only laboratory to offer the test, which isolates fetal genes in the mother's blood.

The abortion of female fetuses is notorious in the mainland under the one-child policy. Hong Kong has become a destination for fetal sexing because mainland doctors may not disclose such information.

This issue has come to light days after Hong Kong set quotas for deliveries for mainland mothers next year - capped at 34,400, of which 31,000 will be at private hospitals and 3,400 at public hospitals. The government announced the quotas to ease pressure on services and allay fears among Hong Kong mothers-to-be that they will not get a bed.

DiagCor's test can be done as early as in the eighth week of pregnancy, compared with about 15 to 16 weeks for an ultrasound scan, doctors say.

If the test detects the presence of an XY chromosome pair, this confirms that the baby is a boy. An XX chromosome pair means it is a girl.

Although the test can determine the sex of a fetus, DiagCor says it has never been promoted as a tool for selection.

The College of Obstetricians and Gynaecologists has discussed the ethical issues related to the test but failed to reach a decision on what it should do. Expressing concerns on gender selection, the college held a special seminar for doctors last month on issues related to the test.

In Hong Kong, it is illegal to choose the sex of a child for non-medical reasons in assisted human reproduction treatment. But there is no law prohibiting fetal sexing.

At least four major private hospitals - Baptist Hospital, Union Hospital, St Paul's Hospital and the Hong Kong Sanatorium and Hospital - have banned the test, which is still available at a cost of a few thousand dollars through private practitioners.

Doctors said the laboratory reports had recently been made available in Chinese, making them more popular with mainland parents.

Private obstetrician Dr Grace Wong Ying said she encountered at least one to two mainland mothers each month who specifically requested the test.

Reference information:  Sunday Morning Post
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above.

ENP科學 贏在出世前

新一代競爭激烈，學習要早、興趣要多，父母都希望孩子贏在起跑線，不過要贏人最緊要先贏自己，有健康的身體才可以勝任一大堆的學習，裝備自己應付未來的挑 戰。但在香港每七個小孩便有一個患有哮喘，每五個小孩子便有一個過重或癡肥，每三個小孩便有一個患有敏感症例如濕疹等，這些疾病不但令孩子受苦，父母在照 顧這些非傳染性疾病也消耗了不少金錢及精力。最近流行的ENP科學理論，若母親能掌握懷孕前、懷孕期及孩子嬰兒期的飲食營養，可為下一代健康帶來希望。

究 竟什麼是ENP科學？ENP科學(Early-life Nutritional Programming早期營養編程) 就是根據表觀遺傳學(Epigenetics) 的最新研究成果為母親提出的培養孩子的指引。最新ENP科學研究發現，基因的確不會改變，但基因表現可以基於寶寶的早期生命經驗及環境因素，而在一代之間 產生轉變。母親在懷孕前，懷孕期以致寶寶幼兒期的飲食營養，情緒管理及生活模式等，會對寶寶的終生健康產生深遠的影響。

綜合多份科學報告，寶寶的終身健康最多有兩成在受孕時由遺傳基因決定，而至少八成則可在生命早期階段受到不同環境因素影響，均衡及充足的營養能減低患上非傳染性疾病的風險。
 
抓緊「前六後六」

「ENP」科學發現，DNA在表層的表觀基因組(Epigenome) 的微觀標記對外在環境因素反應活躍，這些反應會影響基因的活躍度，啟動或關閉以適應環境變化，即是代表母親可透過外在環境因素的調控，影響寶寶健康基因的 表現，以抵抗日後的疾病。而兒童在「前六後六」最受影響，所以把握懷孕前六個月至幼兒六歲成長關鍵期相當重要，如果孕婦攝取足夠營養素，有助減低孩子將來 患上非傳染性疾病，例如皮膚敏感、濕疹、糖尿病及哮喘等機會。

註冊營養師張智良指出，基因排列在正常情況下不會改變，但基因會因為一些環 境因素而影響基因表現，如食物中的營養素、藥物及污染物。孕婦在懷孕前或期間應注意均衡飲食，而營養素葉酸則在懷孕前六至八星期攝取效果最佳，但因她們往 往不知自己已受精懷孕，所以往往會錯過這時機。

他建議計劃懷孕前可以增加攝取量，但如果婦女本身體重超標，生育前便應留意，好好控制體重。他認為，由於懷孕期間母親對嬰兒的健康影響較大，吸煙飲酒這些不良嗜好應戒掉，而且日常的飲食也要注意，少吃大魚避免水銀等有害物質，也不應燒烤。

孕婦飲食誤解

婦產科醫生關詠恩經常接觸準媽咪，看到不少婦女懷孕時有很多誤解。「中國人傳統社會相信食物一 人一份，母親一份、嬰兒一份，所以懷孕母親要吃雙份，其實是錯誤的。主要要看孕婦的體質，如果母親懷孕時過重，若再鼓勵孕婦多吃，便會增加孕婦患上妊娠糖 尿病、妊娠毒血症、嬰兒過重及日後患上癡肥等風險。」

她表示孕婦的飲食和營養必須均衡，切忌營養過度。此外亦不宜節食，因為過度節食便容易造成營養不足。當胎兒已適應某個食量時，出生後食量一旦超過以往的標準，便會把過多的熱量儲存而變成癡肥，降低了抵禦慢性非傳染性疾病的機能，對胎兒未來健康反而造成終生的壞影響。

對 於嬰兒來說，不能進食其他食物，只能靠母乳作為主要食糧，而最理想的營養食品就是母乳，它能滿足嬰兒最全面的生長需求，並提供最充分的各項營養所需。它是 最全面的營養組合和均衡營養，而且最容易消化，以便嬰兒未完全發育的消化系統吸收。事實上媽媽可提升嬰兒的認知能力發展，而且其乳汁內含有抗體、微生態製 劑、生長因子和酶，可增強嬰兒的免疫系統，其低敏感的物質有助降低濕疹和哮喘的發生率，同時減低嬰兒猝死綜合症、癲癇發作及患上慢性疾病的風險。
 
母乳最佳食品

母乳除了給嬰兒全面的營養元素外，在餵哺母乳時對嬰兒及媽媽都有好處。當媽媽餵哺時，身體會釋出催乳素和催產 素，這些荷爾蒙有鎮靜的作用，可以加深媽媽及嬰兒的連繫。而媽媽看著嬰兒一天一天的成長，也會產生滿足感，這種滿足感給她們的心情有著正面的作用，能減輕 初為人母的壓力，令心境更開朗。此外，餵哺母乳對產後的媽媽也有修身的作用，身體製造母乳有助燃燒卡路里，可令肚子快些回復原來的大小。

雖 然社會公認母乳餵哺對於確保母嬰的生理和心理健康與福祉具有優越性，而嬰兒的早期營養對其長遠影響有重大影響。但一些母親因為身體或是其他的因素未能餵哺 而選用嬰兒配方產品，政府為了加強配方產品及嬰兒食物營養及健康聲稱的規管，於早前就供36個月以下嬰幼兒食用的配方產品及預先包裝嬰幼兒食物營養及健康 聲稱諮詢公眾，盼望能在規管下，正確無訛的食物標籤和聲稱可為消費者提供有用的資訊，協助他們作出有依據的選擇。公眾諮詢期至4月17日，為期逾三個月。




參考資料：  信報
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