Abstract TP507: Sex-Related Differences in Neonatal Stroke: International Maternal Newborn Stroke Registry

Abstract

Background: There is evidence that male neonates have higher incidences of ischemic stroke and associated limitations in brain repair compared to female neonates. We used data from the International Maternal Newborn Stroke Registry (IMNSR) to further explore neonatal sex differences in demographics, birth characteristics, stroke onset, and maternal factors. Methods: Eleven international sites participated; 8 entered data for this analysis. Eligible participants with newborn (28 weeks gestation to 28 postnatal days) ischemic or hemorrhagic stroke or cerebral venous thrombosis were identified prospectively and retrospectively and enrolled. Preterm infants born before 28 weeks and neonates with germinal matrix intraventricular hemorrhage were excluded. We collected APGAR scores at 1 and 5 minutes, resuscitation status, demographics, stroke type, maternal and gestational age at birth, and mother’s health conditions at birth. Descriptive statistics were performed to identify differences in female versus male neonate cases related to demographics, pregnancy-related factors, and birth-related factors. Results: We analyzed 68 cases, 38 males and 30 females. Median maternal age for all cases was 31 y (IQR 29-34). Compared to females, males were more likely to have a lower APGAR 1 score and receive resuscitation, and more likely to have a stroke onset within the first week of life. This data set did not show significant gender-related differences in stroke type, or maternal health concerns during pregnancy (Table). Conclusions: We found that males with newborn strokes had more complications at birth and were more likely to have strokes present in the first week of life than females. Further research on the reasons for these sex differences is needed.

Changes in arginase isoforms in a murine model of neonatal brain hypoxia–ischemia

“…28 It is possible that ARG-1 + microglia play role in neurodevelopment and/or sex-specific response to injury. 29 ARG-1 + microglia have been widely reported after HI injury 30 and are thought to mediate neuroprotective effects. While we detected similarly high numbers of ARG-1 + microglia at the injury site, not all microglia at the injury site were ARG-1 + .…”

“…A unique population of ARG-1 + microglia has been shown to represent only 0.5 % of microglia formed at E14.5/P4/5 with higher specificity for females ( 28 ). It is possible that ARG-1 + microglia play role in neurodevelopment and/or sex-specific response to injury ( 29 ). ARG-1 + microglia have been widely reported after HI injury ( 30 ) and are thought to mediate neuroprotective effects.…”