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Male infants face higher risks of severe neonatal morbidity in late preterm births. Betamethasone treatment intensifies this risk for males, highlighting sex-specific outcomes in preterm infants.

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Area of Science:

  • Neonatalogy
  • Obstetrics
  • Pharmacology

Background:

  • Late preterm birth (34-37 weeks) is associated with significant neonatal morbidity.
  • Sex-specific differences in neonatal outcomes are increasingly recognized.
  • Betamethasone is used to mature fetal lungs but its effect on sex-specific outcomes is unclear.

Purpose of the Study:

  • To investigate sex-specific differences in severe neonatal morbidity among late preterm infants.
  • To determine if betamethasone modifies the association between infant sex and adverse outcomes.

Main Methods:

  • Secondary analysis of a multicenter trial involving 2,331 infants born between 34-37 weeks gestation.
  • Infants were randomized to receive betamethasone or placebo.
  • Severe neonatal morbidity was the primary outcome; logistic regression and likelihood ratio testing were used to assess sex differences and betamethasone's effect modification.

Main Results:

  • Male infants delivered between 34-37 weeks had a higher risk of severe neonatal morbidity compared to females when treated with betamethasone (aOR 1.95, 95% CI 1.25-3.05).
  • No significant sex-based difference in morbidity was observed in the placebo group.
  • Betamethasone significantly modified the association between infant sex and severe neonatal morbidity (p=0.047).

Conclusions:

  • Male sex is a significant risk factor for severe neonatal morbidity in late preterm infants.
  • Betamethasone administration increases the risk of adverse outcomes for males born late preterm.
  • These findings underscore the need for sex-specific considerations in managing late preterm births and antenatal steroid therapy.