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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
OBJECTIVE
To 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.
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