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Sex differences in intraventricular hemorrhage rates among very low birth weight newborns
Eduardo Cuestas1, Jose Bas, Josefina Pautasso
1Department of Pediatrics and Neonatology, Hospital Privado, School of Medicine, Catholic University of Córdoba, Córdoba, Argentina. ecuestas@hospitalprivadosa.com.ar
Insights
Male newborns have a significantly higher risk of intraventricular hemorrhage (IVH) compared to females. This study found male sex to be a key factor in IVH development in very low birth weight infants.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Perinatal Medicine
Background:
- Sex-based differences in neonatal outcomes, including mortality and morbidity, are well-documented.
- The specific impact of sex on postnatal complications like intraventricular hemorrhage (IVH) in very low birth weight (VLBW) neonates remains unclear.
Purpose of the Study:
- To investigate potential sex-related disparities in the incidence of IVH among VLBW neonates.
- To determine if male sex is an independent risk factor for IVH in this vulnerable population.
Main Methods:
- Retrospective observational study of 322 VLBW newborns over 12 years.
- Comparison of maternal, labor, delivery, and neonatal parameters between males and females.
- Cranial ultrasound used for IVH detection; bivariate and multivariate logistic regression analyses performed.
Main Results:
- Male neonates exhibited a higher risk of overall IVH (26.8% vs. 9.7%) and severe IVH (grades III-IV: 16.1% vs. 1.9%) compared to females.
- Multivariate analysis confirmed male sex as a significant independent risk factor for IVH (OR = 6.8).
Conclusions:
- Male sex is significantly associated with an increased risk of IVH in VLBW newborns.
- Further research is needed to elucidate the underlying mechanisms and other contributing factors to this sex-based difference.
Background:
The influence of male or female sex on newborn outcomes has been recognized for >30 years. Several studies have observed higher mortality and morbidity in males than in females. It is not clear how this sex difference is sustained in postnatal complications such as intraventricular hemorrhage (IVH), especially in very low birth weight (VLBW) newborns.
Objective:
This study examined possible sex-related differences in IVH rates among VLBW neonates.
Methods:
In a retrospective observational study conducted in Hospital Privado, Córdoba, Argentina, data from 332 consecutive VLBW newborns in a 12-year period were reviewed. Maternal factors, labor and delivery characteristics, and neonatal parameters, including the results of cranial ultrasound examination to detect IVH, were compared for males and females. Bivariate and multivariate logistic regression analyses were performed.
Results:
A total of 322 VLBW newborns were included, 168 males and 154 females. Compared with female neonates, male neonates had a higher risk of overall IVH (26.8% vs 9.7%; odds ratio [OR] = 3.4 [95% CI, 1.8-6.4]; P < 0.001) and for grades III or IV on the Papile scale (16.1% vs 1.9%; OR = 9.6 [95% CI, 2.9-32.5]; P < 0.001). In the multivariate logistic regression model, male sex sustained the association with a greater risk of IVH (OR = 6.8 [95% CI, 3.8-12.0]).
Conclusions:
IVH was significantly associated with male sex in these VLBW newborns. Because other factors affect these differences, further research is required.
