Attempts have been made to identify factors influencing the sex ratio at birth (number of males per 100 females). Statistical analyses have shown that comparisons between sex ratios demand large data sets. The secondary sex ratio has been believed to vary inversely with the frequency of prenatal losses. This hypothesis suggests that the ratio is highest among singletons, medium among twins and lowest among triplets. Birth data in Sweden for the period 1869–2004 showed that among live births the secondary sex ratio was on average 105.9 among singletons, 103.2 among twins and 99.1 among triplets. The secondary sex ratio among stillbirths for both singletons and twins started at a high level, around 130, in the 1860s, but approached live birth values in the 1990s. This trend is associated with the decrease and convergence of stillbirth rates among males and females. For detailed studies, we considered data for Sweden in 1869–1878 and in 1901–1967. Marital status or place of residence (urban or rural) had no marked influence on the secondary sex ratio among twins. For triplets, the sex ratio showed large random fluctuations and was on average low. During the period 1901–1967, 20 quadruplet, two quintuplet and one sextuplet set were registered. The sex ratio was low, around 92.0.