Arch Dis Child Fetal Neonatal Ed 2000;83:F182-F185 ( November )

Sex differences in outcomes of very low birthweight infants: the newborn male disadvantage

D K Stevenson^a, J Verter^b, A A Fanaroff^c, W Oh^d, R A Ehrenkranz^e, S Shankaran^f, E F Donovan^g, L L Wright^h, J A Lemonsⁱ, J E Tyson^j, S B Korones^k, C R Bauer^l, B J Stoll^m, L-A Papileⁿ, for the National Institute of Child Health and Human Development Neonatal Research Network

^a Stanford University, Palo Alto, CA, USA, ^b The Biostatistics Center, George Washington University, Washington, DC, USA, ^c Case Western Reserve University, Cleveland, OH, USA, ^d Women and Infants Hospital, Providence, RI, USA, ^e Yale University, New Haven, CT, USA, ^f Wayne State University, Detroit, MI, USA, ^g University of Cincinnati, Cincinnati, OH, USA, ^h National Institute of Child Health and Human Development, Bethesda, MD, USA, ⁱ Indiana University, Indianapolis, IN, USA, ^j University of Texas Southwestern Medical Center, Dallas, TX, USA, ^k University of Tennessee at Memphis, Memphis, TN, USA, ^l University of Miami, Miami, FL, USA, ^m Emory University, Atlanta, GA, USA, ⁿ University of New Mexico, Albuquerque, NM, USA

Correspondence to: Dr Stevenson, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305-5119, USA dstevenson{at}stanford.edu

Accepted 16 June 2000

OBJECTIVETo determine the differences in short term outcome of very low birthweight infants attributable to sex.
METHODSBoys and girls weighing 501-1500 g admitted to the 12 centres of the National Institute of Child Health and Human Development Neonatal Research Network were compared. Maternal information and perinatal data were collected from hospital records. Infant outcome was recorded at discharge, at 120 days of age if the infant was still in hospital, or at death. Best obstetric estimate based on the last menstrual period, standard obstetric factors, and ultrasound were used to assign gestational age in completed weeks. Data were collected on a cohort that included 3356 boys and 3382 girls, representing all inborn births from 1 May 1991 to 31 December 1993.
RESULTSMortality for boys was 22% and that for girls 15%. The prenatal and perinatal data indicate few differences between the sex groups, except that boys were less likely to have been exposed to antenatal steroids (odds ratio (OR) = 0.80) and were less stable after birth, as reflected in a higher percentage with lower Apgar scores at one and five minutes and the need for physical and pharmacological assistance. In particular, boys were more likely to have been intubated (OR = 1.16) and to have received resuscitation medication (OR = 1.40). Boys had a higher risk (OR > 1.00) for most adverse neonatal outcomes. Although pulmonary morbidity predominated, intracranial haemorrhage and urinary tract infection were also more common.
CONCLUSIONSRelative differences in short term morbidity and mortality persist between the sexes.


Keywords: very low birthweight infants; neonatal outcome; sex; mortality

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© 2000 by Archives of Disease in Childhood
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