Impact of sex on perinatal mortality and morbidity in twins

Abstract

Objective: Twin studies offer opportunities to investigate mechanisms underlying sex-associated differences in perinatal outcomes. The objective of the study was to investigate sex-related differences in perinatal complications. Study design: A cohort of 16,045 twin pregnancies -32,090 twins -was explored for obstetric complications, perinatal and infant mortality, and neonatal morbidities. Results: Twin pregnancies with a female fetus had an increased risk for preeclampsia, but otherwise there were no pregnancy complications associated with fetal sex. After birth, female-female twins had lower early neonatal and infant mortality, and lower risk for respiratory morbidities than male-male twins at all gestational ages. In unlike-sexed twin pairs, very preterm males had higher respiratory morbidity than females and, females were at higher risk for being growth restricted. Conclusion: Male-male twins have higher respiratory morbidity and neonatal mortality than female-female twins. In unliked-sexed twin pairs, the males seem to be protected by having a female co-twin.

Early-life mortality risks in opposite-sex and same-sex twins: a Danish cohort study of the twin testosterone transfer hypothesis

“…The present study agreed with previous twin studies reporting higher mortality for male-male than for female-female twins [15–17]. However, we found that within OS twin pairs, sex-related differences in mortality were much less pronounced with no significant mortality differences between girls and boys, also consistent with earlier reports [17,32].…”

“…However, we found that within OS twin pairs, sex-related differences in mortality were much less pronounced with no significant mortality differences between girls and boys, also consistent with earlier reports [17,32]. …”

“…The literature comparing OS and SS twins with regard to early-life mortality risks is limited and inconsistent, but higher infant mortality for SS boys than for OS boys [15–17] and adverse outcomes including increased respiratory morbidity and higher mortality for OS twin girls in agreement with the TTT hypothesis have been reported [18–20]. Our study using data on a sample of 68,629 Danish twins aims to compare mortality in twin boys and girls and in OS and SS twins by age and over time within the first 15 years of life.…”

Maternal hypoglycemia on 50 g glucose challenge test: outcomes are influenced by fetal gender

“…Various studies have focused on gender-specific outcomes in different conditions, and it has been found that spontaneous abortions and preterm deliveries [17][18][19], as well as respiratory morbidity and neonatal mortality in twin pregnancies, are more common in male infants [20]. Carlsen et al analyzed fetal and neonatal morbidity rates in a 38-year period, and the overall mortality rates were always higher in male infants [21].…”

Management of Pregnancy and Delivery in Multiple Pregnancy

“…Различия в биологической эффективности прогестерона при многоплодной и одноплод-ной беременности могут быть связаны с преоб-ладанием в патогенезе преждевременных родов при двойне чрезмерного растяжения мышечных волокон, в то время как при одноплодной бере-менности основная роль отводится инфекцион-но-воспалительным процессам [55].…”