Abstract Objective To study the effect of sex on the clinical outcome of extremely preterm infants (EPIs)/extremely low birth weight infants (ELBWIs) by propensity score matching. Methods A retrospective analysis was performed for the medical data of 731 EPIs or ELBWIs who were admitted from January 1, 2011 to December 31, 2020. These infants were divided into two groups: male and female. A propensity score matching analysis was performed at a ratio of 1:1. The matching variables included gestational age, birth weight, percentage of withdrawal from active treatment, percentage of small-for-gestational-age infant, percentage of use of pulmonary surfactant, percentage of 1-minute Apgar score ≤3, percentage of mechanical ventilation, duration of mechanical ventilation, percentage of antenatal use of inadequate glucocorticoids, and percentage of hypertensive disorders in pregnancy. The two groups were compared in the incidence rate of main complications during hospitalization and the rate of survival at discharge. Results Before matching, compared with the female group, the male group had significantly higher incidence rates of neonatal respiratory distress syndrome, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, and patent ductus arteriosus (P<0.05), while after matching, the male group only had a significantly higher incidence rate of BPD than the female group (P<0.05). There was no significant difference in the rate of survival at discharge between the two groups before and after matching (P>0.05). Conclusions Male EPIs/ELBWIs have a higher risk of BPD than female EPIs/ELBWIs, but male and female EPIs/ELBWIs tend to have similar outcomes. Citation:Chinese Journal of Contemporary Pediatrics, 2022, 24(5): 514-520
SU Zhi-Wen,LIN Li-Li,SHI Bi-Jun et al. Sex differences in clinical outcomes of extremely preterm infants/extremely low birth weight infants: a propensity score matching study[J]. CJCP, 2022, 24(5): 514-520.
SU Zhi-Wen,LIN Li-Li,SHI Bi-Jun et al. Sex differences in clinical outcomes of extremely preterm infants/extremely low birth weight infants: a propensity score matching study[J]. CJCP, 2022, 24(5): 514-520.
Fr?hlich M, Tissen-Diabaté T, Bührer C, et al. Sex-specific long-term trends in length of hospital stay, postmenstrual age at discharge, and survival in very low birth weight infants[J]. Neonatology, 2021, 118(4): 416-424. PMID: 34091458. PMCID: PMC8491473. DOI: 10.1159/000515899.
Vu HD, Dickinson C, Kandasamy Y. Sex difference in mortality for premature and low birth weight neonates: a systematic review[J]. Am J Perinatol, 2018, 35(8): 707-715. PMID: 29241280. DOI: 10.1055/s-0037-1608876.
Ito M, Tamura M, Namba F, et al. Role of sex in morbidity and mortality of very premature neonates[J]. Pediatr Int, 2017, 59(8): 898-905. PMID: 28477387. DOI: 10.1111/ped.13320.
Boghossian NS, Geraci M, Edwards EM, et al. Sex differences in mortality and morbidity of infants born at less than 30 weeks' gestation[J]. Pediatrics, 2018, 142(6): e20182352. PMID: 30429272. DOI: 10.1542/peds.2018-2352.
Garfinkle J, Yoon EW, Alvaro R, et al. Trends in sex-specific differences in outcomes in extreme preterms: progress or natural barriers?[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(2): 158-163. PMID: 31186268. DOI: 10.1136/archdischild-2018-316399.
Binet ME, Bujold E, Lefebvre F, et al. Role of gender in morbidity and mortality of extremely premature neonates[J]. Am J Perinatol, 2012, 29(3): 159-166. PMID: 21818733. DOI: 10.1055/s-0031-1284225.
Papile LA, Burstein J, Burstein R, et al. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm[J]. J Pediatr, 1978, 92(4): 529-534. PMID: 305471. DOI: 10.1016/s0022-3476(78)80282-0.
Huang J, Zhang L, Kang B, et al. Association between perinatal hypoxic-ischemia and periventricular leukomalacia in preterm infants: a systematic review and meta-analysis[J]. PLoS One, 2017, 12(9): e0184993. PMID: 28931047. PMCID: PMC5607162. DOI: 10.1371/journal.pone.0184993.
Boghossian NS, Geraci M, Edwards EM, et al. Morbidity and mortality in small for gestational age infants at 22 to 29 weeks' gestation[J]. Pediatrics, 2018, 141(2): e20172533. PMID: 29348195. DOI: 10.1542/peds.2017-2533.
Nakamura N, Ushida T, Nakatochi M, et al. Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy[J]. Sci Rep, 2021, 11(1): 1729. PMID: 33462302. PMCID: PMC7814115. DOI: 10.1038/s41598-021-81292-7.
Gemmell L, Martin L, Murphy KE, et al. Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28 weeks' gestation[J]. J Perinatol, 2016, 36(12): 1067-1072. PMID: 27583388. DOI: 10.1038/jp.2016.133.
Charles E, Hunt KA, Harris C, et al. Small for gestational age and extremely low birth weight infant outcomes[J]. J Perinat Med, 2019, 47(2): 247-251. PMID: 30335614. DOI: 10.1515/jpm-2018-0295.
Seaborn T, Simard M, Provost PR, et al. Sex hormone metabolism in lung development and maturation[J]. Trends Endocrinol Metab, 2010, 21(12): 729-738. PMID: 20971653. DOI: 10.1016/j.tem.2010.09.001.
Dammann CE, Ramadurai SM, McCants DD, et al. Androgen regulation of signaling pathways in late fetal mouse lung development[J]. Endocrinology, 2000, 141(8): 2923-2929. PMID: 10919280. DOI: 10.1210/endo.141.8.7615.
Avorgbedor F, Gondwe KW, Zou B, et al. A systematic review on outcomes of preterm small for gestational infants born to women with hypertensive disorders in pregnancy[J]. J Perinat Neonatal Nurs, 2021, 35(4): E58-E68. PMID: 34726657. DOI: 10.1097/JPN.0000000000000603.
WANG Ming-Jie, YUE Shao-Jie, LIN Jin, GAO Xi-Rong, PENG Xiao-Ming, CHEN Meng-Yu, PENG Hua-Bao, CAO Bei, ZENG Yun-Qing, WANG Shu-Lian, WEN Bo, HUANG Xi-Lin, LI Xiao-Ping, ZHANG Ai-Zhen, CAO Ting, CHEN Yi-Hua, CHEN Tie-Qiang, YE Chun-Hua, BO Tao, JIANG De-Lin, HUANG Xiu-Qun, REN Na-Fang, TAO Long-Zhang, YAO Fang, TIAN Chang-Jun, LI Hong-Ming, ZHANG Ai-Min, HUANG Fu-Rong, ZHANG Wei-Guo, CHEN Xiang-Hong, LIU Yu-Chan, LIU Zheng-Lin, XU Yan-Shan, MING Jing-Song, CHEN Li, ZHU Ning-Yi, HE Jun-Min, YI Sai-Jun, WANG Tuan-Mei, LI Zhao-Hui, WANG Gui-Tian. A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province[J]. CJCP, 2020, 22(6): 561-566.