Brief Introduction: Several publications suggest a male preponderance in a variety of pregnancy complications. The objective of this analysis was to investigate the influence of infant sex on perinatal outcome in the setting of fetal growth restriction (FGR). This is a secondary analysis of the Prospective Observational Trial to Optimise Paediatric Health in FGR (PORTO) Study.
Materials & Methods: The cohort consisted of 1,200 prospectively recruited fetuses with EFW <10th centile between 24 + 0 and 36 + 6 weeks’ gestation. Details on sonographic parameters including multi-vessel Doppler assessment were recorded together with information on pregnancy details and perinatal outcome. Adverse perinatal outcome was defined as composite outcome of intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL), hypoxic ischaemic encephalopathy (HIE), necrotising enterocolitis (NEC), bronchopulmonary dysplasia (BPD), sepsis or death. Statistical comparisons between male and female infants were made using Fisher’s exact test and logistic regression. A p-value < 0.05 was considered statistically significant.
Clinical Cases or Summary Results: Of the 1,116 fetuses completing the study protocol, 684 (61%) were female and 432 (39%) were male. Male infants were more commonly affected by adverse perinatal outcome (8% vs 3%; p < 0.001). Both, male and female fetuses, showed similar longitudinal growth and Doppler patterns in utero (figure 1), therefore the increase in composite morbidity in boys could not be explained by decelerative growth or abnormal Doppler parameters. Interestingly, boys were delivered earlier than girls (37.2 vs 38.6 weeks; p < 0.001). This was due to the fact that gestational hypertension (16% vs 11%; 0.039) and pre-eclampsia (12% vs 7%; p = 0.014) was more frequently observed in mothers carrying male fetuses. While adverse perinatal outcomes were more common for males than females, the numbers of outcomes were no longer statistically significant after adjusting for gestational age at delivery (table 1).
Conclusions: Data from this large prospective cohort of fetuses with EFW <10th centile could not contribute evidence to support the concept of male sex bias in adverse pregnancy outcome.
Read More: http://informahealthcare.com/doi/full/10.3109/14767058.2014.924236