Extremely preterm birth affects boys more and socio‐economic and neonatal variables pose sex‐specific risks

Månsson, Johanna; Fellman, Vineta; Stjernqvist, Karin

doi:10.1111/apa.12937

Cited by 55 publications

(47 citation statements)

References 27 publications

(55 reference statements)

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“…PE was generally positively associated with weight and BMI in boys and girls, while in boys only, severe PE was generally negatively associated with weight and BMI. Although there are inconsistencies in the literature regarding sex differences in growth after exposure to PE [10, 12, 22], boys are generally more prone to neonatal complications [44]; whether born to term and of adequate birthweight, small for gestational age [45] and extreme prematurity affects boys more severely than it does to girls [46]. …”

Section: Discussionmentioning

confidence: 99%

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

et al. 2017

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Background and objectiveAn adverse intrauterine environment may affect offspring growth and development. Our aim was to explore whether preeclampsia (PE) exposure in utero influences growth from birth to 13 years.MethodsIn a nested case-control study, 229 children were exposed to PE (mild/moderate: n = 164, severe: n = 54) and 385 were unexposed. Length/height and weight were abstracted from records at birth, 3 and 6 months, 1 and 4 years, and measured along with waist circumference and skinfolds at follow-up at 11/12 (girls/boys) and 13 years (both sexes). Associations between PE and z-scores for growth were analyzed by multiple linear and fractional polynomial regression with adjustment for potential confounders.ResultsIn boys, exposure to mild/moderate PE was positively associated with linear growth after 0.5 years, but severe PE was negatively associated with linear growth in all ages. In girls, both exposure to mild/moderate and severe PE were negatively associated with linear growth. Exposure to PE was negatively associated with weight and body mass index (BMI) during infancy, but positively associated with weight and BMI thereafter, except that boys exposed to severe PE consistently had a lower weight and BMI compared to the unexposed. Exposure to severe PE only was positively associated with waist-to-height ratio at 11/12 (girls/boys) and 13 years (both sexes).ConclusionsFrom birth to adolescence, linear growth, weight and BMI trajectories differed between the sexes by severity of exposure to PE. In general, PE exposure was negatively associated with linear growth, while in girls; positive associations with weight and BMI were observed. This underlines fetal life as a particularly sensitive period affecting subsequent growth and this may have implications for targeted approaches for healthy growth and development.

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Section: Discussionmentioning

confidence: 99%

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

et al. 2017

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“…Preterm birth (≤37 weeks gestation) is the greatest cause of neonatal mortality and morbidity and, in case of survival, leads to long‐term negative health consequences (Lawn et al, ; Moster, Lie, & Markestad, ). Mounting evidence suggests strong male disadvantage in the preterm population including increased preterm birth incidence, lower survival rates and worse long‐term outcomes (Hindmarsh, O'Callaghan, Mohay, & Rogers, ; Hintz et al, ; Ingemarsson, ; Månsson et al, ; Peacock, Marston, Marlow, Calvert, & Greenough, ; Rose et al, ; Schindler et al, ; Whitfield, Grunau, & Holsti, ). Even in the absence of major pathologies and developmental impairments, preterm boys tend to experience more behavioral and cognitive difficulties, in particular: executive control (Urben et al, ); language and speech problems (Wolke, Samara, Bracewell, & Marlow, ); language and cognitive ability (Skiöld et al, ; Wood et al, ; Young et al, ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in brain connectivity and male vulnerability in very preterm children

Kozhemiako

Nunes

Vakorin

et al. 2019

Human Brain Mapping

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Evidence indicates better cognitive and behavioral outcomes for females born very preterm (≤32 weeks gestation) compared to males, but the neurophysiology underlying this apparent resiliency of the female brain remains poorly understood. Here we test the hypothesis that very preterm males express more pronounced connectivity alterations as a reflection of higher male vulnerability. Resting state MEG recordings, neonatal and psychometric data were collected from 100 children at age 8 years:very preterm boys (n = 27), very preterm girls (n = 34), full-term boys (n = 15) and full-term girls (n = 24). Neuromagnetic source dynamics were reconstructed from 76 cortical brain regions. Functional connectivity was estimated using inter-regional phase-synchronization. We performed a series of multivariate analyses to test for differences across groups as well as to explore relationships between deviations in functional connectivity and psychometric scores and neonatal factors for very preterm children. Very preterm boys displayed significantly higher (p < .001) absolute deviation from average connectivity of same-sex full-term group, compared to very preterm girls versus full-term girls. In the connectivity comparison between very preterm and full-term groups separately for boys and girls, significant group differences (p < .05) were observed for boys, but not girls. Sex differences in connectivity (p < .01) were observed in very preterm children but not in full-term groups. Our findings indicate that very preterm boys have greater alterations in resting neurophysiological network communication than girls. Such uneven brain communication disruption in very preterm boys and girls suggests that stronger connectivity alterations might contribute to male vulnerability in long-term behavioral and cognitive outcome.K E Y W O R D S neuromagnetic brain connectivity, sex differences, very preterm children Ruth E. Grunau and Sam M. Doesburg are co-senior authors.

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“…Another variable that seems to influence language is gender, since premature girls have scored higher in cognitive, language and fine motor skills tests than boys (38) , although both genders have presented similar performance when submitted to environmental, socio-economic and multilingualism assessments (17) . Only infants having Spanish as mother tongue presented lower scores when assessed by the Bayley in English, in cases where the latter was their second language (17) .…”

Section: Resultsmentioning

confidence: 99%

“…In these, assessments of language and hearing were part of the procedures to carry out such studies in a complementary basis (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) . On the other hand, other studies found focused mainly on language and/or hearing impairments in premature infants (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) .…”

Section: Procedures and Instruments Used In The Studymentioning

confidence: 99%

Efeitos da prematuridade na aquisição da linguagem e na maturação auditiva: revisão sistemática

Rechia

Oliveira

Crestani

et al. 2016

CoDAS

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RESUMO Objetivo Verificar quais os prejuízos a prematuridade causa à linguagem e à audição. Estratégia de pesquisa Utilizou-se os descritores language/linguagem, hearing/audição, prematurity/prematuridade nas bases de dados LILACS, MEDLINE, Biblioteca Cochrane e Scielo. Critérios de seleção Ensaios randomizados controlados, estudos de intervenção não randomizados e estudos descritivos (transversais, de coorte, projetos de caso-controle). Análise dos dados Os artigos foram avaliados independentemente por dois autores, conforme os critérios de seleção. Foram selecionados 26 estudos, sete publicados no Brasil e 19 na literatura internacional. Resultados Dezenove estudos fizeram comparação entre nascidos a termo e prematuros. Dois dos estudos fizeram comparações entre prematuros pequenos para idade gestacional e adequados para idade gestacional. Em quatro estudos a amostra era composta de crianças com prematuridade extrema, os demais trabalhos foram realizados em crianças com prematuridade acentuada e moderada. Nestes estudos, foram utilizados, para análise da audição, as Emissões Otoacústicas, o Potencial Evocado de Tronco Encefálico, a timpanometria, o Potencial Evocado Auditivo de Estado Estável e audiometria de reforço visual. Para avaliação de linguagem, a maioria dos artigos utilizou a Escala Bayley de Desenvolvimento Infantil. Observou-se na maioria dos estudos revisados a prematuridade relacionando-se direta ou indiretamente à aquisição de habilidades auditivas e de linguagem nos primeiros anos de vida. Conclusão Dessa forma, pôde-se constatar que a prematuridade bem como os aspectos relacionados a ela (idade gestacional, baixo peso e intercorrências ao nascer) influenciam a maturação da via auditiva central podendo causar efeitos negativos na aquisição da linguagem.

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Extremely preterm birth affects boys more and socio‐economic and neonatal variables pose sex‐specific risks

Abstract: Extreme prematurity seems to affect boys more than girls. Socio-economic and neonatal factors confer similar risks or protections on both sexes, but some variables pose sex-specific risks. An awareness of risk factors may provide the basis for treatment and follow-up guidelines.

Cited by 55 publications

References 27 publications

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

Sex differences in brain connectivity and male vulnerability in very preterm children

Efeitos da prematuridade na aquisição da linguagem e na maturação auditiva: revisão sistemática

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