Gender Differences in Outcomes of Low Birth Weight and Preterm Neonates: the Male Disadvantage

Roy, Priyamvada; Kumar, Ashwani; Faridi, M. M. A.

doi:10.1093/tropej/fmu042

Cited by 35 publications

(31 citation statements)

References 2 publications

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“…Similar findings on sex-difference in low birth weight prevalence was also observed in studies from other low and middle-income countries [11]. Moreover, current literature suggests that the likelihood of mortality during infancy is higher among male babies with low birth weight than female babies with low birth weight [12,13]. Little is known about which factors contributes to the sex-difference in low birth weight.…”

Section: Discussionsupporting

confidence: 67%

Low birth weight in Bangladesh and associated maternal and socioeconomic factors: results from a recent nationally-representative survey

Hossain

Adhikary

Arafat³

et al. 2019

Preprint

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ObjectivesLittle is known about the relative contributions of maternal and socioeconomic factors on low birth weight in Bangladesh and whether they differ by sex. We examined the prevalence and associated maternal and socioeconomic factors of low birth weight separately among boys and girls.Design and settingsThis is a cross-sectional study based on the Bangladesh Demographic and Health Survey 2014.ParticipantsA total of 4728 children with information on birth size were included in this study.Outcome measureLow birth weight was defined according to mother’s perception of birth size of their children. Logistic regression analysis was used to estimate the association between maternal and socioeconomic factors with low birth weight.ResultsThe overall prevalence of low birth weight was 17.8% among boys and 22.4% among girls. Low birth weight was associated with maternal factors like maternal age of <20 years at birth (adjusted OR vs. 20-29 years: 1.40, 95% CI 1.09-1.78), and maternal undernutrition (adjusted OR 1.33, 95% CI 1.05-1.69) among boys while only the association with maternal undernutrition was significant among girls. The association for no antenatal care visit was explained by socioeconomic factors. Lower level of mother’s education and poorest wealth index were found to be associated with low birth weight in both sexes.ConclusionOur study identifies that maternal factors are associated with increased risk of having low birth weight babies, which cannot be explained by socioeconomic factors, and vice versa. Community-based interventions to reduce low birth weight in Bangladesh should focus on these factors.Strengths and limitations of this studyTo the best of our knowledge our study is the first study in Bangladesh that has looked at the factors for low birth weight separately among boys and girls.We used multiple logistic regression to examine the associations of maternal and socioeconomic factors with low birth weight in a large and nationally-representative sample.This study is limited because we used mother’s perception of child’s size at birth to define low birth weight.We did not have information about gestational age and thereby could not take prematurity into account in our study.

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Section: Discussionsupporting

confidence: 67%

Low birth weight in Bangladesh and associated maternal and socioeconomic factors: results from a recent nationally-representative survey

Hossain

Adhikary

Arafat³

et al. 2019

Preprint

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“…Male gender is a well-established risk factor for adverse outcome in preterm neonates[15, 16] as are bad starting conditions like emergency cesarean section[17, 18] and transport to another center in the immediate postnatal period[19–21]. Here the mortality risk in emergency section and postnatal transport may not only come from those unplanned actions themselves but also from the severe patient conditions leading to the respective actions.…”

Section: Discussionmentioning

confidence: 99%

Pathogen-specific mortality in very low birth weight infants with primary bloodstream infection

et al. 2017

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ObjectiveMortality in very low birth weight infants following microbiology confirmed primary bloodstream infections varies with the type of causative pathogen. Given evidence from other studies that infections with gram negative bacteria and fungi cause a higher case fatality risk. We tried to confirm this in a nation-wide multi-center trial.MethodsA cohort of 55,465 very low birth weight infants from 242 neonatal departments participating in the German national neonatal infection surveillance system NEO-KISS was used to investigate differences in the case fatality risk of microbiology confirmed primary bloodstream infections according to individual pathogens. Cox proportional hazard regression analyses were performed with the outcomes death and time from microbiology confirmed primary bloodstream infections. The results were adjusted to the recorded risk factors and hospital and department characteristics.ResultsA total of 4 094 very low birth weight infants with microbiology confirmed primary bloodstream infections were included in the analysis. The crude case fatality risk was 5.7%. The Cox proportional hazard regression analysis with adjustment for available risk factors revealed that microbiology confirmed primary bloodstream infections caused by Klebsiella spp. (HR 3.17 CI95 1.69–5.95), Enterobacter spp. (HR 3.42 CI95 1.86–6.27), Escherichia coli (HR 3.32 CI95 1.84–6.00) and Serratia spp. (HR 3.30 CI95 1.44–7.57) were associated with significantly higher case fatality risk compared to Staphylococcus aureus. After adjusting, case fatality risk of Candida albicans causing microbiology confirmed primary bloodstream infections was not higher than that of S. aureus.ConclusionIn very low birth weight infants, bloodstream infections caused by gram negative pathogens have an increased case fatality risk compared to bloodstream infections caused by gram positive pathogens. This should be considered for prevention and therapy. Further research should address the specific risk factors for case fatality of C. albicans bloodstream infections.

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“…In order to decrease variability, only pregnancies carrying male caucasian fetuses were selected as an inclusion criteria, since ethnicity [25-28] and gender [29-33] can directly affect inflammatory responses and birth outcome. Exclusion criteria included samples from pregnant women experiencing PTD associated with asthma, cardiovascular diseases, cervical incompetence, diabetes, fetal growth restriction, fetal malformation, hypertension, multiple gestation, preeclampsia, sexually transmitted diseases, thyroid disease and uterine malformations [34].…”

Section: Methodsmentioning

confidence: 99%

Chorioamnionitis Induces a Specific Signature of Placental ABC Transporters Associated with an Increase of miR-331-5p in the Human Preterm Placenta

Império

Bloise

Javam³

et al. 2018

Cell Physiol Biochem

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Background/Aims: The ATP-binding cassette (ABC) transporters mediate drug biodisposition and immunological responses in the placental barrier. In vitro infective challenges alter expression of specific placental ABC transporters. We hypothesized that chorioamnionitis induces a distinct pattern of ABC transporter expression. Methods: Gene expression of 50 ABC transporters was assessed using TaqMan® Human ABC Transporter Array, in preterm human placentas without (PTD; n=6) or with histological chorioamnionitis (PTDC; n=6). Validation was performed using qPCR, immunohistochemistry and Western blot. MicroRNAs known to regulate P-glycoprotein (P-gp) were examined by qPCR. Results: Up-regulation of ABCB9, ABCC2 and ABCF2 mRNA was detected in chorioamnionitis (p<0.05), whereas placental ABCB1 (P-gp; p=0.051) and ABCG2 (breast cancer resistance protein-BCRP) mRNA levels (p=0.055) approached near significant up-regulation. In most cases, the magnitude of the effect significantly correlated to the severity of inflammation. Upon validation, increased placental ABCB1 and ABCG2 mRNA levels (p<0.05) were observed. At the level of immunohistochemistry, while BCRP was increased (p<0.05), P-gp staining intensity was significantly decreased (p<0.05) in PTDC. miR-331-5p, involved in P-gp suppression, was upregulated in PTDC (p<0.01) and correlated to the grade of chorioamnionitis (p<0.01). Conclusions: Alterations in the expression of ABC transporters will likely lead to modified transport of clinically relevant compounds at the inflamed placenta. A better understanding of the potential role of these transporters in the events surrounding PTD may also enable new strategies to be developed for prevention and treatment of PTD.

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Gender Differences in Outcomes of Low Birth Weight and Preterm Neonates: the Male Disadvantage

Cited by 35 publications

References 2 publications

Low birth weight in Bangladesh and associated maternal and socioeconomic factors: results from a recent nationally-representative survey

Low birth weight in Bangladesh and associated maternal and socioeconomic factors: results from a recent nationally-representative survey

Pathogen-specific mortality in very low birth weight infants with primary bloodstream infection

Chorioamnionitis Induces a Specific Signature of Placental ABC Transporters Associated with an Increase of miR-331-5p in the Human Preterm Placenta

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