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Boys and girls differ in symptoms and neurodevelopmental outcome after perinatal metabolic acidosis, a

Maria Hafström1,2,3, Øyvind Salvesen4, Ingemar Kjellmer1

  • 1Department of Paediatrics, Institute of Clinical Science, University of Gothenburg, Gothenburg, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|December 20, 2018
PubMed

Insights

Sex differences impact infant health and development. Boys with birth metabolic acidosis, even if seemingly healthy, show worse outcomes than girls, suggesting sex is a key factor in assessing these infants.

Area of Science:

  • Neonatal Medicine
  • Developmental Pediatrics
  • Perinatal Health

Background:

  • Metabolic acidosis in term infants can affect perinatal health and long-term development.
  • Existing research may not fully account for sex-based variations in outcomes.

Purpose of the Study:

  • To investigate sex differences in term infants with metabolic acidosis.
  • To evaluate the impact of sex on perinatal health, symptomatology, and neurodevelopmental outcomes at 6.5 years.

Main Methods:

  • Population-based cohort study of 14,687 term infants.
  • Prospective identification of 78 infants with metabolic acidosis, with two matched controls per case.
  • Analysis of sex differences in perinatal characteristics and neurodevelopmental outcomes at 6.5 years, with subgroup analysis based on neonatal care needs.

Main Results:

  • Acidotic boys without need for specialized neonatal care exhibited poorer perinatal symptoms and less favorable neurodevelopmental outcomes compared to girls.
  • A male disadvantage in neurodevelopmental outcomes was also observed in infants without acidosis.
  • Neurodevelopmental outcome at 6.5 years was significantly associated with Apgar score at 10 minutes, need for neonatal care, and sex, but not with acidosis itself.

Conclusions:

  • Sex significantly influences immediate symptomatology and neurodevelopmental outcomes in term infants with metabolic acidosis.
  • These sex-based differences are evident even in infants who appear healthy neonatally.
  • The findings underscore the importance of considering sex as a factor in the clinical assessment of infants with metabolic acidosis.
Abstract

Keywords:
Infants and childrenMetabolic acidosisNeurodevelopmental outcomePerinatal vitalitySex differences

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