Influence of Sex on Gestational Complications, Fetal-to-Neonatal Transition, and Postnatal Adaptation

Lorente-Pozo, Sheila; Parra-Llorca, Anna; Torres, Begoña; Torres-Cuevas, Isabel; Núñez-Ramiro, Antonio; Cernada, María; García-Robles, Ana; Vento, Máximo

doi:10.3389/fped.2018.00063

Cited by 38 publications

(41 citation statements)

References 55 publications

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“…In males, lung maturation is delayed compared to females, and male newborn infants have higher incidences of birth asphyxia as well as common neonatal disorders linked to oxidative stress. It has been suggested that the lower antioxidant capacity in males results in increased risk of pulmonary vasoconstriction, vascular instability, and hypoxia [ 25 ]. These constitutional differences between boys and girls might explain some of the preponderance of SDH in boys.…”

Section: Discussion Principal Findingsmentioning

confidence: 99%

Epidemiology of subdural haemorrhage during infancy: A population-based register study

et al. 2018

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ObjectivesTo analyse subdural haemorrhage (SDH) during infancy in Sweden by incidence, SDH category, diagnostic distribution, age, co-morbidity, mortality, and maternal and perinatal risk factors; and its association with accidents and diagnosis of abuse.MethodsA Swedish population-based register study comprising infants born between 1997 and 2014, 0–1 years of age, diagnosed with SDH-diagnoses according to the (International Classification of Diseases, 10th version (ICD10), retrieved from the National Patient Register and linked to the Medical Birth Register and the Death Cause Register. Outcome measures were: 1) Incidence and distribution, 2) co-morbidity, 3) fall accidents by SDH category, 4) risk factors for all SDHs in the two age groups, 0–6 and 7–365 days, and for ICD10 SDH subgroups: S06.5 (traumatic SDH), I62.0 (acute nontraumatic), SDH and abuse diagnosis.ResultsIncidence of SDH was 16·5 per 100 000 infants (n = 306). Median age was 2·5 months. For infants older than one week, the median age was 3·5 months. Case fatality was 6·5%. Male sex was overrepresented for all SDH subgroups. Accidental falls were reported in 1/3 of the cases. One-fourth occurred within 0–6 days, having a perinatal risk profile. For infants aged 7–365 days, acute nontraumatic SDH was associated with multiple birth, preterm birth, and small-for-gestational age. Fourteen percent also had an abuse diagnosis, having increased odds of being born preterm, and being small-for-gestational age.ConclusionsThe incidence was in the range previously reported. SDH among newborns was associated with difficult birth and neonatal morbidity. Acute nontraumatic SDH and SDH with abuse diagnosis had similar perinatal risk profiles. The increased odds for acute nontraumatic SDH in twins, preterm births, neonatal convulsions or small-for-gestational age indicate a perinatal vulnerability for SDH beyond 1st week of life. The association between prematurity/small-for-gestational age and abuse diagnosis is intriguing and not easily understood.

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Section: Discussion Principal Findingsmentioning

confidence: 99%

Epidemiology of subdural haemorrhage during infancy: A population-based register study

et al. 2018

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“…Boys are at greater risk than girls for perinatal adversities. Male infants undergo Caesarean section (OR 1.2) have low Apgar scores (OR 1.5) and experience severe hypoxic ischaemic encephalopathy (OR 1.2) more often than female babies . Reviews of the literature have also found that male infants react more frequently than females to a variety of adversities and hardships including infections, preterm birth, respiratory problems and toxic exposures during perinatal life .…”

Section: Introductionmentioning

confidence: 99%

Boys and girls differ in symptoms and neurodevelopmental outcome after perinatal metabolic acidosis, a population‐based study

2019

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Aim: To evaluate sex differences in infants born at term with metabolic acidosis with regard to perinatal health and symptomatology, and developmental outcome.Methods: From a population-based cohort of infants born at term (n = 14 687), 78 were prospectively identified as having metabolic acidosis at birth. Two matched controls per case were selected. Sex differences in perinatal characteristics and in neurodevelopmental outcome at 6.5 years of age were analysed. Subgroup analysis was made based on need of neonatal care and planned follow-up.Results: Acidotic boys who appeared healthy, that is with no need of specialised neonatal care respectively only followed at ordinary health care service, have worse perinatal symptoms and less favourable neurodevelopmental outcome compared to girls. The male disadvantage concerning neurodevelopmental outcome was also indicated in children without acidosis. Outcome at 6.5 years was associated with Apgar at 10 minutes (p = 0.03), need of neonatal care (p = 0.04) and sex (p = 0.02) but not acidosis per se (p = 0.54).Conclusion: Sex affected immediate symptomatology in term acidotic infants and neurodevelopmental outcome at the age of 6.5 years. The findings were seen in those who appeared healthy in the neonatal period. The results suggest that sex should be considered in assessment of acidotic children.

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“…In contrast, male feto-placental units adopt a more "minimalist approach" where they undergo very few placental changes and continue to grow normally under adverse in utero environment. However, this adaptation places male fetuses at higher risk to exposures that may contribute to deleterious health impacts on later development due to environmental toxins and/or sub-optimal maternal nutrition [9][10][11] .…”

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confidence: 99%

Placental Metabolomics for Assessment of Sex-specific Differences in Fetal Development During Normal Gestation

Saoi

Kennedy

Gohir

et al. 2020

Sci Rep

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The placenta is a metabolically active interfacial organ that plays crucial roles in fetal nutrient delivery, gas exchange and waste removal reflecting dynamic maternal and fetal interactions during gestation. There is growing evidence that the sex of the placenta influences fetal responses to external stimuli in utero, such as changes in maternal nutrition and exposure to environmental stressors. However, the exact biochemical mechanisms associated with sex-specific metabolic adaptations during pregnancy and its link to placental function and fetal development remain poorly understood. Herein, multisegment injection-capillary electrophoresis-mass spectrometry is used as a high throughput metabolomics platform to characterize lyophilized placental tissue (~2 mg dried weight) from C57BL/6J mice fed a standardized diet. Over 130 authentic metabolites were consistently measured from placental extracts when using a nontargeted metabolomics workflow with stringent quality control and robust batch correction. Our work revealed distinct metabolic phenotype differences that exist between male (n = 14) and female (n = 14) placentae collected at embryonic day E18.5. Intracellular metabolites associated with fatty acid oxidation and purine degradation were found to be elevated in females as compared to male placentae (p < 0.05, effect size >0.40), including uric acid, valerylcarnitine, hexanoylcarnitine, and 3-hydroxyhexanolycarnitine. This murine model sheds new insights into sexspecific differences in placental mitochondrial function and protective mechanisms against deleterious oxidative stress that may impact fetal growth and birth outcomes later in life.

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Influence of Sex on Gestational Complications, Fetal-to-Neonatal Transition, and Postnatal Adaptation

Cited by 38 publications

References 55 publications

Epidemiology of subdural haemorrhage during infancy: A population-based register study

Epidemiology of subdural haemorrhage during infancy: A population-based register study

Boys and girls differ in symptoms and neurodevelopmental outcome after perinatal metabolic acidosis, a population‐based study

Placental Metabolomics for Assessment of Sex-specific Differences in Fetal Development During Normal Gestation

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