Klinik Araştırma
BibTex RIS Kaynak Göster

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

Yıl 2021, Cilt: 18 Sayı: 3, 927 - 932, 25.09.2021
https://doi.org/10.38136/jgon.762977

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.

Kaynakça

  • 1. Younge N, Goldstein RF, Bann CM, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Survival and neurodevelopmental outcomes among periviable infants, N Engl J Med. 2017;376(7):617–628.
  • 2. Horbar JD, Edwards EM, Greenberg LT, et al. Variation in performance of neonatal intensive care units in the United States. JAMA Pediatr. 2017;171(3):e164396.
  • 3. Patel RM, Kandefer S, Walsh MC,et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med. 2015;372(4):331–340.
  • 4. Stoll BJ, Hansen NI, Bell EF, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA 2015;314(10):1039–1051.
  • 5. Naeye RL, Burt LS, Wright DL, Blanc WA, Tatter D. Neonatal mortality, the male dis- advantage. Pediatrics 1971;48(6):902–906.
  • 6. Itabashi K, Horiuchi T, Kusuda S, et al. Mortality rates for extremely low birth weight infants born in Japan in 2005. Pediatrics 2009;123(2):445–450.
  • 7. Ingemarsson I. Gender aspects of preterm birth. BJOG 2003;110(suppl 20):34–38.
  • 8. Ray B, Platt MP. Mortality of twin and singleton live births under 30 weeks’ gestation: a population-based study. Arch Dis Child Fetal Neonatal Ed. 2009;94(2): 140–143.
  • 9. Rankin J, Pearce MS, Bell R, Glinianaia SV, Parker L. Perinatal mortality rates: adjusting for risk factor profile is essential. Paediatr Perinat Epidemiol. 2005;19(1): 56–58.
  • 10. Oygür N, Önal EE, Zenciroğlu A. Turkish Neonatal Society national guideline for the delivery room management. Turk Pediatri Ars. 2018;53(Suppl 1): S3-S17.
  • 11. Köksal N, Aygün C, Uras N. Turkish Neonatal Society guideline on the management of patent ductus arteriosus in preterm infants. Turk Pediatri Ars. 2018;53(Suppl 1):S76-S87.
  • 12. Özkan H, Erdeve Ö, Kanmaz Kutman HG. Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment. Turk Pediatri Ars. 2018;53(Suppl 1):S45- S54.
  • 13. Satar M, Engin Arısoy A, Çelik İH. Turkish Neonatal Society guideline on neonatal infections - diagnosis and treatment. Turk Pediatri Ars. 2018;53(Suppl 1): S88-S100.
  • 14. Kültürsay N, Bilgen H, Türkyılmaz C. Turkish Neonatal Society guideline on enteral feeding of the preterm infant. Turk Pediatri Ars. 2018;53(Suppl 1): S109-S118.
  • 15. Arsan S, Korkmaz A, Oğuz S. Turkish Neonatal Society guideline on prevention and management of bronchopulmonary dysplasia. Turk Pediatri Ars. 2018;53(Suppl 1): S138-S150.
  • 16. Koç E, Yağmur Baş A, Özdek Ş, Ovalı F, Başmak H. Turkish Neonatal and Turkish Ophthalmology Societies consensus guideline on the retinopathy of prematurity. Turk Pediatri Ars. 2018;53(Suppl 1): S151-S160.
  • 17. Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann. Surg. 1978; 187:1–7.
  • 18. Papile LA, Munsick-Bruno G, Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J. Pediatr. 1983; 103:273–7.
  • 19. Gujral IB, Stallones L, Gabella BA, Keefe TJ, Chen P. Sex differences in mortality after traumatic brain injury, Colorado 1994-1998. Brain Inj. 2006; 20:283–91.
  • 20. Johnston MV, Hagberg H. Sex and the pathogenesis of cerebral palsy. Dev Med Child Neurol. 2007; 49:74–8.
  • 21. Baenziger O, Jaggi JL, Mueller AC, Morales CG, Lipp HP, Lipp AE, et al. Cerebral blood flow in preterm infants affected by sex, mechanical ventilation, and intrauterine growth. Pediatr Neurol. 1994; 11:319– 24.
  • 22. Gur RC, Gur RE, Obrist WD, Hungerbuhler JP, Younkin D, Rosen AD, et al. Sex and handedness differences in cerebral blood flow during rest and cognitive activity. Science 1982; 217:659–61.
  • 23. Whitehouse, A. J. et al. Sex-specific associations between umbilical cord blood testosterone levels and language delay in early childhood. J Child Psychol Psychiatry 2012; 53:726–734.
  • 24. Cho, J. & Holditch-Davis, D. Effects of perinatal testosterone on infant health, mother-infant interactions, and infant development. Biol Res Nurs. 2014; 16:228–236.
  • 25. Vu HD, Dickinson C, Kandasamy Y. Sex difference in mortality for premature and low birth weight neonates: a systematic review. Am J Perinatol. 2018;35(8):707–715.
  • 26. Stark MJ, Clifton VL, Wright IM. Sex-specific differences in peripheral microvascular blood flow in preterm infants. Pediatr Res 2008; 63(04):415–419.
  • 27. Ishak, N. et al. Sex differences in cardiorespiratory transition and surfactant composition following preterm birth in sheep. Am J Physiol Regul Integr Comp Physiol. 2012; 303: R778–789.
  • 28. Di Renzo, G. C., Rosati, A., Sarti, R. D., Cruciani, L. & Cutuli, A. M. Does fetal sex affect pregnancy outcome? Gend Med. 2007; 4:19–30.
  • 29. Pongou, R. Why is infant mortality higher in boys than in girls? A new hypothesis based on preconception environment and evidence from a large sample of twins. Demography 2013; 50:421–444.
  • 30. Bhaumik U, et al. Narrowing of sex differences in infant mortality in Massachusetts. J Perinatol. 2004; 24:94 –99.

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

Yıl 2021, Cilt: 18 Sayı: 3, 927 - 932, 25.09.2021
https://doi.org/10.38136/jgon.762977

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.

Kaynakça

  • 1. Younge N, Goldstein RF, Bann CM, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Survival and neurodevelopmental outcomes among periviable infants, N Engl J Med. 2017;376(7):617–628.
  • 2. Horbar JD, Edwards EM, Greenberg LT, et al. Variation in performance of neonatal intensive care units in the United States. JAMA Pediatr. 2017;171(3):e164396.
  • 3. Patel RM, Kandefer S, Walsh MC,et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med. 2015;372(4):331–340.
  • 4. Stoll BJ, Hansen NI, Bell EF, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA 2015;314(10):1039–1051.
  • 5. Naeye RL, Burt LS, Wright DL, Blanc WA, Tatter D. Neonatal mortality, the male dis- advantage. Pediatrics 1971;48(6):902–906.
  • 6. Itabashi K, Horiuchi T, Kusuda S, et al. Mortality rates for extremely low birth weight infants born in Japan in 2005. Pediatrics 2009;123(2):445–450.
  • 7. Ingemarsson I. Gender aspects of preterm birth. BJOG 2003;110(suppl 20):34–38.
  • 8. Ray B, Platt MP. Mortality of twin and singleton live births under 30 weeks’ gestation: a population-based study. Arch Dis Child Fetal Neonatal Ed. 2009;94(2): 140–143.
  • 9. Rankin J, Pearce MS, Bell R, Glinianaia SV, Parker L. Perinatal mortality rates: adjusting for risk factor profile is essential. Paediatr Perinat Epidemiol. 2005;19(1): 56–58.
  • 10. Oygür N, Önal EE, Zenciroğlu A. Turkish Neonatal Society national guideline for the delivery room management. Turk Pediatri Ars. 2018;53(Suppl 1): S3-S17.
  • 11. Köksal N, Aygün C, Uras N. Turkish Neonatal Society guideline on the management of patent ductus arteriosus in preterm infants. Turk Pediatri Ars. 2018;53(Suppl 1):S76-S87.
  • 12. Özkan H, Erdeve Ö, Kanmaz Kutman HG. Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment. Turk Pediatri Ars. 2018;53(Suppl 1):S45- S54.
  • 13. Satar M, Engin Arısoy A, Çelik İH. Turkish Neonatal Society guideline on neonatal infections - diagnosis and treatment. Turk Pediatri Ars. 2018;53(Suppl 1): S88-S100.
  • 14. Kültürsay N, Bilgen H, Türkyılmaz C. Turkish Neonatal Society guideline on enteral feeding of the preterm infant. Turk Pediatri Ars. 2018;53(Suppl 1): S109-S118.
  • 15. Arsan S, Korkmaz A, Oğuz S. Turkish Neonatal Society guideline on prevention and management of bronchopulmonary dysplasia. Turk Pediatri Ars. 2018;53(Suppl 1): S138-S150.
  • 16. Koç E, Yağmur Baş A, Özdek Ş, Ovalı F, Başmak H. Turkish Neonatal and Turkish Ophthalmology Societies consensus guideline on the retinopathy of prematurity. Turk Pediatri Ars. 2018;53(Suppl 1): S151-S160.
  • 17. Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann. Surg. 1978; 187:1–7.
  • 18. Papile LA, Munsick-Bruno G, Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J. Pediatr. 1983; 103:273–7.
  • 19. Gujral IB, Stallones L, Gabella BA, Keefe TJ, Chen P. Sex differences in mortality after traumatic brain injury, Colorado 1994-1998. Brain Inj. 2006; 20:283–91.
  • 20. Johnston MV, Hagberg H. Sex and the pathogenesis of cerebral palsy. Dev Med Child Neurol. 2007; 49:74–8.
  • 21. Baenziger O, Jaggi JL, Mueller AC, Morales CG, Lipp HP, Lipp AE, et al. Cerebral blood flow in preterm infants affected by sex, mechanical ventilation, and intrauterine growth. Pediatr Neurol. 1994; 11:319– 24.
  • 22. Gur RC, Gur RE, Obrist WD, Hungerbuhler JP, Younkin D, Rosen AD, et al. Sex and handedness differences in cerebral blood flow during rest and cognitive activity. Science 1982; 217:659–61.
  • 23. Whitehouse, A. J. et al. Sex-specific associations between umbilical cord blood testosterone levels and language delay in early childhood. J Child Psychol Psychiatry 2012; 53:726–734.
  • 24. Cho, J. & Holditch-Davis, D. Effects of perinatal testosterone on infant health, mother-infant interactions, and infant development. Biol Res Nurs. 2014; 16:228–236.
  • 25. Vu HD, Dickinson C, Kandasamy Y. Sex difference in mortality for premature and low birth weight neonates: a systematic review. Am J Perinatol. 2018;35(8):707–715.
  • 26. Stark MJ, Clifton VL, Wright IM. Sex-specific differences in peripheral microvascular blood flow in preterm infants. Pediatr Res 2008; 63(04):415–419.
  • 27. Ishak, N. et al. Sex differences in cardiorespiratory transition and surfactant composition following preterm birth in sheep. Am J Physiol Regul Integr Comp Physiol. 2012; 303: R778–789.
  • 28. Di Renzo, G. C., Rosati, A., Sarti, R. D., Cruciani, L. & Cutuli, A. M. Does fetal sex affect pregnancy outcome? Gend Med. 2007; 4:19–30.
  • 29. Pongou, R. Why is infant mortality higher in boys than in girls? A new hypothesis based on preconception environment and evidence from a large sample of twins. Demography 2013; 50:421–444.
  • 30. Bhaumik U, et al. Narrowing of sex differences in infant mortality in Massachusetts. J Perinatol. 2004; 24:94 –99.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk Sağlığı ve Hastalıkları
Bölüm Araştırma Makaleleri
Yazarlar

Şehribanu IŞIK 0000-0003-2999-059X

Fatma Nur SARI 0000-0003-4643-7622

Mehmet BÜYÜKTİRYAKİ 0000-0001-8937-4671

Ömer ERTEKİN 0000-0002-7846-7634

Evrim ALYAMAC DİZDAR 0000-0001-8956-0917

Cüneyt TAYMAN 0000-0002-9970-0714

Yayımlanma Tarihi 25 Eylül 2021
Gönderilme Tarihi 2 Temmuz 2020
Kabul Tarihi 17 Haziran 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 18 Sayı: 3

Kaynak Göster

Vancouver IŞIK Ş, SARI FN, BÜYÜKTİRYAKİ M, ERTEKİN Ö, ALYAMAC DİZDAR E, TAYMAN C. Çok Düşük Doğum Ağırlıklı Bebeklerde Cinsiyetin Prematüre Morbiditeleri ve Mortalite Üzerine Etkisi. JGON. 2021;18(3):927-32.