Foetal Gender and Obstetric Outcome

Abstract

Introduction: Data on specific characteristics based on the gender of the unborn baby and their significance for obstetrics are limited. The aim of this study is to analyse selected parameters of obstetric relevance in the phases pregnancy, birth and postpartum period in dependence on the gender of the foetus. Materials and Methods: The selected study method comprised a retrospective data acquisition and evaluation from the Austrian birth register of the Department of Clinical Epidemiology of Tyrolean State Hospitals. For the analysis all inpatient singleton deliveries in Austria during the period from 2008 to 2013 were taken into account (live and stillbirths n?=?444?685). The gender of the baby was correlated with previously defined, obstetrically relevant parameters. Results: In proportions, significantly more premature births and sub partu medical interventions (vaginal and abdominal surgical deliveries. episiotomies) were observed for male foetuses (p?<?0.001). The neonatal outcome (5-min Apgar score, umbilical pH value less than 7.1, transfer to a neonatal special unit) is significantly poorer for boys (p?<?0.001). Discussion: In view of the vulnerability of male foetuses and infants, further research is needed in order to be able to react appropriately to the differing gender-specific requirements in obstetrics.

Sex‐dependent consequences of neonatal brain hypoxia‐ischemia in the rat

“…It is known that male infants are more prone to preterm birth and frequently exhibit morbidities such as respiratory distress syndrome and intraventricular hemorrhage (Tioseco et al, ; Schildberger and Leitner, ) with poorer long‐term neurologic outcome (Kent et al, ). The same is also noted for birth asphyxia, because male infants have increased prevalence of hypoxia and worse outcomes compared with females with similar brain injury (Costeloe et al, ; Lauterbach et al, ; Kesler et al, ; Marlow et al, ; Raz et al, ); however, the exact molecular mechanism involved in such differences are not known.…”

Iron Status of Newborns and Umbilical Cord Blood Hepcidin Levels in Gender Differences

“…Several studies have recognized the male gender as a risk factor during pregnancy and childbirth. However, the biological mechanism of this gender-specific difference is still unknown, even though various theories discuss the influence of hormonal, physiological, or genetic factors (13)(14)(15).…”

“…Gender considerations in patient management that have been carried out since the perinatal phase help to optimize the process of general care and health since early life "as an important step in bridging individualized treatment" (15). An understanding of the mechanisms associated with gender-related differences in iron metabolism is vital for overcoming the iron deficiency in infants.…”

“…From this point of view, logically thinking normally, the fetuses/infant male will need more macronutrients and micronutrients, including Fe, to be able to grow normally. Several studies have recognized male gender as a risk factor both during pregnancy and birth, and various theories discuss the influence of hormonal, physiological, or genetic factors, but the biological mechanism of this gender-specific difference is still unclear (13)(14)(15). A better understanding of the mechanisms associated with gender-related differences in iron metabolism during pregnancy can contribute ideas or concepts in preventing and treating infant iron deficiency.…”

Ovine prenatal growth-restriction and sex influence fetal adipose tissue phenotype and impact postnatal lipid metabolism and adiposity in vivo from birth until adulthood

“…Indeed, the greater PAT expression of IGF1 in males, a gene we have shown to be most highly expressed at an earlier stage of adipocyte proliferation and differentiation in mid-gestation [22], further aligns with a relative delay in adipose tissue development in this gender. These sex differences in fetal fat status may play a role in the lower Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores and poorer neonatal outcomes observed in male babies across settings [70][71][72][73]. The origin of the dimorphism in prenatal adipose tissue development in both sheep and humans is likely to be differences in circulating sex steroid concentrations as the gonads of both species are steroidogenically-active from the point of sexual differentiation in early pregnancy [74,75].…”