Fetal Sex Differences in Intrapartum Electronic Fetal Monitoring

Porter, Anne; Triebwasser, Jourdan E.; Tuuli, Methodius G.; Caughey, Aaron B.; Macones, George A.; Cahill, Alison G.

doi:10.1055/s-0036-1572531

Cited by 8 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Male fetuses were also found to be at increased risk for both repetitive variable decelerations (aOR: 1.24, 95% CI: 1.05–1.47) and prolonged decelerations (aOR: 1.21, 95% CI: 1.03–1.42). This study suggests that there may be significant sex differences in EFM patterns at term among pregnancies without evidence of academia (37). One explanation of these differences is that brain anatomy and the chemistry of neuronal transmission is affected by the protocadherin gene expression in the brain.…”

Section: Methodsmentioning

confidence: 77%

Effect of Fetal Sex on Maternal and Obstetric Outcomes

2017

View full text Add to dashboard Cite

Fetal sex plays an important role in modifying the course and complications related to pregnancy and may also have an impact on maternal health and well-being both during and after pregnancy. The goal of this article is to review and summarize the findings from published research on physiologic and pathologic changes that may be affected by fetal sex and the effect of these changes on the maternal and obstetrical outcomes. This will help create awareness that fetal sex is not just a random chance event but an interactive process between the mother, the placenta, and the fetus. The reported effects of male sex on the course of pregnancy and delivery include higher incidence of preterm labor in singletons and twins, failure of progression in labor, true umbilical cord knots, cord prolapse, nuchal cord, higher cesarean section rate, higher heart rate variability with increased frequency, and duration of decelerations without acidemia and increased risk of gestational diabetes mellitus through the poor beta cells function. Similarly, female fetal sex has been reported to modify pregnancy and delivery outcomes including altered fetal cardiac hemodynamics, increased hypertensive diseases of pregnancy, higher vulnerability of developing type 2 DM after pregnancy possibly because of influences on increased maternal insulin resistance. Placental function is also influenced by fetal sex. Vitamin D metabolism in the placenta varies by fetal sex; and the placenta of a female fetus is more responsive to the relaxing action of magnesium sulfate. Male and female feto-placental units also vary in their responses to environmental toxin exposure. The association of fetal sex with stillbirths is controversial with many studies reporting higher risk of stillbirth in male fetuses; although some smaller and limited studies have reported more stillbirths with female fetus pregnancies. Maternal status such as BMI may in turn also affect the fetus and the placenta in a sex-specific manner. There is probably a sex-specific maternal–placental–fetal interaction that has significant biological implications of which the mechanisms may be genetic, epigenetic, or hormonal. Determination of fetal sex may therefore be an important consideration in management of pregnancy and childbirth.

show abstract

Section: Methodsmentioning

confidence: 77%

Effect of Fetal Sex on Maternal and Obstetric Outcomes

2017

View full text Add to dashboard Cite

show abstract

“…While some studies found no significant differences between male and female FHR during the first and second trimester (Neiger et al, 2004; McKenna et al, 2005), different intrapartum FHR patterns have been reported for two genders (Porter et al, 2016). Another study on term fetuses just before the labor, reported significantly lower values of most linear HRV measures for female fetuses compared to male fetuses, in both IUGR and control groups, as well as higher entropy indices in the control group (Gonçalves et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Fetal Development Using Cardiac Valve Intervals

et al. 2017

View full text Add to dashboard Cite

An automated method to assess the fetal physiological development is introduced which uses the component intervals between fetal cardiac valve timings and the Q-wave of fetal electrocardiogram (fECG). These intervals were estimated automatically from one-dimensional Doppler Ultrasound and noninvasive fECG. We hypothesize that the fetal growth can be estimated by the cardiac valve intervals. This hypothesis was evaluated by modeling the fetal development using the cardiac intervals and validating against the gold standard gestational age identified by Crown-Rump Length (CRL). Among the intervals, electromechanical delay time, isovolumic contraction time, ventricular filling time and their interactions were selected in a stepwise regression process that used gestational age as the target in a cohort of 57 fetuses. Compared with the gold standard age, the newly proposed regression model resulted in a mean absolute error of 3.8 weeks for all recordings and 2.7 weeks after excluding the low quality recordings. Since Fetal Heart Rate Variability (FHRV) has been proposed in the literature for assessing the fetal development, we compared the performance of gestational age estimation by our new valve-interval based method, vs. FHRV, while assuming the CRL as the gold standard. The valve interval-based method outperformed both the model based on FHRV. Results of evaluation for 30 abnormal cases showed that the new method is less affected by arrhythmias such as tachycardia and bradycardia compared to FHRV, however certain types of heart anomalies cause large errors (more than 10 weeks) with respect to the CRL-based gold standard age. Therefore, discrepancies between the regression based estimation and CRL age estimation could indicate the abnormalities. The cardiac valve intervals have been known to reflect the autonomic function. Therefore the new method potentially provides a novel approach for assessing the development of fetal autonomic nervous system, which may be growth curve independent.

show abstract

“…Male fetal sex is an independent risk factor for preterm birth (PTB) (Brettell et al, 2008; Challis et al, 2013; Ingemarsson, 2003; Zeitlin et al, 2004), gestational diabetes (GDM), and macrosomia and cord complications (cord prolapse, nuchal cord, true umbilical cord knots) (Sheiner et al, 2004; Verburg et al, 2016). Males also have a higher risk of complications during labor and delivery, such as failure to progress during the first and second stages of labor (Sheiner et al, 2004), nonreassuring fetal heart patterns (Dawes et al, 1999; Porter et al, 2016), cesarean section (CS) delivery (Eogan, 2003; Lurie et al, 2004), and neonatal morbidity and mortality (Mondal et al, 2014; Stevenson, 2000).…”

mentioning

confidence: 99%

A 10-Year Observational Study on Twin Pregnancy: Role of Fetal Sex Pairing on Obstetric Outcome

Vannuccini,

Bolzonella,

Colucci

et al. 2023

Twin Res Hum Genet

View full text Add to dashboard Cite

Fetal sex contributes to the determination of obstetric outcome, as pregnancies carrying male babies seem to have an increased risk of maternal-fetal complications. Most studies have been conducted on singleton pregnancies, whereas less evidence is available for twins. A 10-year retrospective observational study was conducted on a cohort of 1180 women with twin pregnancy delivered at a single tertiary hospital. Clinical data on maternal characteristics, and obstetric and neonatal outcomes were collected, and the analysis was performed on monochorionic (MC) and dichorionic (DC) diamniotic twins separately. The group of DC twins included 837 cases, and those conceived by assisted reproductive technologies (ART) were more likely to have one or both female fetuses rather than males. The incidence of hypertensive disorders of pregnancy (HDP) was higher in same-sex pairs than in opposite-sex pairs. No differences were found regarding other obstetric and neonatal outcomes among the three sex-pairing groups. The MC twins group included 228 cases, and in female-carrying pregnancies a higher incidence of gestational diabetes (GDM) was observed compared to the male group. Furthermore, male pairs had significantly lower Apgar scores than females. Fetal sex seems to have a mild effect in twins compared to singleton pregnancies, suggesting a more complex set of factors contributing to pregnancy outcome in multiple pregnancies. However, we observed a higher incidence of HDP among same-sex DC pairs, a higher rate of GDM among MC female-female pairs, and a worse adaptation to extrauterine life among male-male pairs in MC twins.

show abstract

Fetal Sex Differences in Intrapartum Electronic Fetal Monitoring

Cited by 8 publications

References 9 publications

Effect of Fetal Sex on Maternal and Obstetric Outcomes

Effect of Fetal Sex on Maternal and Obstetric Outcomes

Assessment of Fetal Development Using Cardiac Valve Intervals

A 10-Year Observational Study on Twin Pregnancy: Role of Fetal Sex Pairing on Obstetric Outcome

Contact Info

Product

Resources

About