The Effect of Sex Differences on Premature Morbidities and Mortality in Very Low Birth Weight Infants

Öz

Objective: The aim of this study is to evaluate the effect of gender on premature morbidity and mortality in very low birth weight (VLBW) infants. Material and Methods: In this retrospective study, infants gestational age of less than 30 weeks admitted to the neonatal intensive care unit of Zekai Tahir Burak Maternity and Teaching Hospital between January 2013 and December 2017 were evaluated. Infants of both sexes; demographic characteristics, neonatal morbidities and mortality were compared. The infants were then divided into subgroups according to their gestational weeks (<28 weeks, >28 weeks) and neonatal outcomes were reevaluated. Results: Data of 757 infants were analyzed. In the study group, mean gestational age was 27.7 ± 1.4 weeks, mean birth weight was 1023 ± 241 gr and 53% of the babies were male and 47% were female. Comparing the genders, the frequency of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, moderate-severe bronchopulmonary dysplasia and premature retinopathy requiring laser treatment were similar in all patients included in the study. However, severe intraventricular hemorrhage (IVC), mortality and severe IVC or mortality were higher in males than females. The study group was stratified as <28 weeks and >28 weeks. It was observed that mortality and severe IVC or mortality were higher in males at <28 weeks and serious IVC was higher in males at >28 weeks. There was no difference in terms of other premature morbidities in females and males in both gestational week groups. Conclusion: Gender is one of the important factors to be considered in the clinical follow-up of preterm infants, and studies are needed to develop additional sex-specific strategies to reduce the physiopathological process and neonatal adverse outcomes.

Anahtar Kelimeler

• preterm
• gender
• morbidity
• mortality

Çok Düşük Doğum Ağırlıklı Bebeklerde Cinsiyetin Prematüre Morbiditeleri ve Mortalite Üzerine Etkisi

Öz

Amaç: Bu çalışmanın amacı çok düşük doğum ağırlıklı (ÇDDA) bebeklerde cinsiyetin prematüre morbiditeleri ve mortalite üzerine etkisini değerlendirmektir. Yöntem: Bu retrospektif çalışmaya, 2013-2017 yılları arasında Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi’nde doğarak yenidoğan yoğun bakım ünitesinde izleme alınan, gebelik haftası 30 haftadan küçük tüm prematüre bebekler alındı. Her iki cinsiyetteki bebekler; demografik özellikler, neonatal morbiditeler ve mortalite açısından karşılaştırıldı. Ardından bebekler gebelik haftalarına göre (<28 hafta, 28 hafta) alt gruplara ayrılarak neonatal sonuçlar tekrar değerlendirildi. Bulgular: Toplam 757 bebeğin verileri analiz edildi. Çalışma grubunda ortalama gebelik yaşı 27.7±1.4 hafta, ortalma doğum ağırlığı 1023±241 gr ve bebeklerin %53’ü erkek, %47’si kız idi. Çalışmaya alınan tüm hastalarda kız ve erkek cinsiyet karşılaştırıldığında respiratuvar distres sendromu, patent duktus arteriozus, nekrotizan enterokolit, orta-ağır bronkopulmoner displazi ve laser tedavisi gerektiren prematüre retinopati sıklığı benzer bulundu. Ancak erkek bebeklerde kızlara göre ciddi intraventriküler kanama (İVK), mortalite ve ciddi İVK veya mortalite daha yüksek oranda saptandı. Çalışma grubu <28 hafta ve 28 hafta olarak tabakalandırıldı. Erkeklerde 28 hafta altında mortalite ile ciddi İVK veya mortalite oranı daha fazla iken; 28 haftada erkelerde sadece ciddi İVK oranının daha fazla olduğu görüldü. Sonuç: Preterm bebeklerin klinik izleminde göz önünde bulundurulması gereken önemli faktörlerden biri de cinsiyet olup, fizyopatolojik süreç ve neonatal olumsuz sonuçların azaltılmasına yönelik cinsiyete özgü ek stratejiler geliştirilmesi ile ilgili çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Prematüre
• cinsiyet
• morbidite
• mortalite

Kaynakça

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