The effect of sex on outcome of preterm infants – a population‐based survey

Neubauer, Vera; Griesmaier, Elke; Ralser, Elisabeth; Kiechl‐Kohlendorfer, Ursula

doi:10.1111/j.1651-2227.2012.02709.x

Cited by 33 publications

(30 citation statements)

References 27 publications

(74 reference statements)

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“…Male infants are more likely to experience complications because of respiratory disorders, have poorer psychomotor development when born preterm, and have higher mortality rates than female infants. 34–38 Thus, this observation is consistent with our hypothesis that DNAm age is reflective of neonatal morbidity. Our previous study 16 did not show a significant sex difference in accuracy based on the median error, but did not examine the association between sex and gestational age acceleration.…”

Section: Discussionsupporting

confidence: 91%

Relationship between Epigenetic Maturity and Respiratory Morbidity in Preterm Infants

Knight

Smith

Conneely

et al. 2018

The Journal of Pediatrics

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Objective To assess associations between epigenetic maturity of extremely preterm babies (born at less than 28 weeks of gestation), neonatal interventions, and respiratory outcomes, including the administration of surfactant and postnatal corticosteroids, duration of assisted ventilation, and development of bronchopulmonary dysplasia (BPD). Study design DNA was extracted from neonatal blood spots collected after birth from 143 extremely preterm infants born 1991–1992 in Victoria, Australia and used to determined DNA methylation (DNAm). A DNAm based gestational age was determined using our previously published method. The residual of DNAm gestational age and clinically estimated gestational age (referred to as “gestational age acceleration”) was used as a measure to assess developmental maturity. Associations between gestational age acceleration and respiratory interventions and morbidities were determined. Results Infants with higher gestational age acceleration were less likely to receive surfactant (P =.009) or postnatal corticosteroids (P = .008), had fewer days of assisted ventilation (P = .01), and had less BPD (P = .02). Respiratory measures are known to correlate with gestational age; however, models comparing each with clinically estimated gestational age were improved by the addition of the gestational age acceleration measure in the model. Conclusions Gestational age acceleration correlates with respiratory interventions and outcomes of extremely preterm babies. Surfactant and postnatal corticosteroid use, assisted ventilation days, and BPD rates were all lower in babies who were epigenetically more mature than their obstetrically estimated gestational age. This suggests that gestational age acceleration is a clinically relevant metric of developmental maturity.

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Section: Discussionsupporting

confidence: 91%

Relationship between Epigenetic Maturity and Respiratory Morbidity in Preterm Infants

Knight

Smith

Conneely

et al. 2018

The Journal of Pediatrics

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“…On the other hand, the sex differential in CP rates was lowest at 28 to 31 weeks and highest at <28 weeks and 37+ weeks. Sex‐specific differences in longer‐term outcomes, including CP, are not completely understood . At least two explanations for sex‐dependent differences in neurological outcomes after both term and preterm birth have emerged from the literature.…”

Section: Discussionmentioning

confidence: 99%

Biological sex and the risk of cerebral palsy in Victoria, Australia

Reid

Meehan

Gibson

et al. 2016

Develop Med Child Neuro

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AIM Males typically outnumber females in cerebral palsy (CP) cohorts. To better understand this 'male disadvantage' and provide insight into causal pathways to CP, this study used 1983 to 2009 Australian CP and population birth cohorts to identify associations and trends with respect to biological sex and CP.METHOD Within birth gestation groups, sex ratios were calculated to evaluate any male excess in the CP cohort compared with livebirths, neonatal deaths, neonatal mortality and survival rates, neonatal survivors, and CP rates in survivors. Sex-and gestation-specific trends in neonatal mortality, CP rates, and CP sex ratios were assessed by plotting their annual frequencies and fitting quadratic curves.RESULTS Over-representation of males in preterm live births partly explained the male excess in the CP cohort after preterm birth, especially at 28 to 31 weeks. Higher CP rates in male neonatal survivors also contributed to the male excess in CP, particularly at <28 and 37+ weeks. Higher neonatal mortality rates in males at all gestations had little impact on the CP sex ratio. There was no clearly discernible change over time in the CP sex ratio.

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“…This means that our cohort consisted of 273 infants with a mean gestational age of 29.6 ± 1.9 (median 30.1, range 24.0–31.9) weeks and a mean birthweight of 1300 ± 370 (median 1250, range 420–2125) grams. The clinical characteristics of the study participants were defined as described in detail in our previous papers , and a summary of all the patient characteristics is shown in Table .…”

Section: Methodsmentioning

confidence: 99%