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Updated: Jul 9, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Response to Therapeutic Interventions in the NICU: Role of Sex as a Biological Variable

Rose Albert1, Albertina Lee1, Krithika Lingappan1

  • 1Division of Neonatology and Department of Pediatrics; Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA.

Neoreviews
|November 30, 2023
PubMed

Insights

Biological sex significantly impacts preterm infant health and treatment responses. Analyzing outcomes by sex is crucial for personalized neonatal medicine and improving therapeutic strategies.

Area of Science:

  • Neonatal Medicine
  • Pediatric Research
  • Biological Sex Differences

Background:

  • Biological sex is a critical factor in disease pathophysiology and treatment response.
  • Sex-specific differences are observed in prematurity-related outcomes and neonatal therapies.
  • Limited reporting of neonatal study outcomes stratified by sex hinders understanding.

Purpose of the Study:

  • To highlight the importance of sex as a biological variable in neonatal research.
  • To emphasize the need for sex-disaggregated data in clinical and translational studies.
  • To advocate for reporting outcomes by biological sex in neonates.

Main Methods:

  • Review of existing literature on sex differences in neonatal outcomes.
  • Analysis of the impact of biological sex on prematurity-related conditions.
  • Assessment of therapeutic responses stratified by biological sex.

Main Results:

  • Preterm infants show sex-specific differences in disease predisposition and resilience.
  • Neonatal therapies (e.g., steroids, indomethacin) elicit different responses based on sex.
  • Most neonatal studies collect sex data but do not report outcomes by sex.

Conclusions:

  • Sex-specific differences in neonates necessitate tailored medical approaches.
  • Disaggregating neonatal study data by sex is essential for precision medicine.
  • Future research and meta-analyses should prioritize sex-stratified outcome reporting.

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