Fetal sex-specific differences in gestational age at delivery in pre-eclampsia: a meta-analysis

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Abstract

Background: : Pre-eclampsia (PE) is a major pregnancy disorder complicating up to 8% of pregnancies. Increasing evidence indicates a sex-specific interplay between the mother, placenta and fetus. This may lead to different adaptive mechanisms during pregnancy.

Methods: We performed an individual participant data meta-analysis to determine associations of fetal sex and PE, with specific focus on gestational age at delivery in PE. This was done on 219 575 independent live-born singleton pregnancies, with a gestational age at birth between 22.0 and 43.0 weeks of gestation, from 11 studies participating in a worldwide consortium of international research groups focusing on pregnancy.

Results: Of the women, 9033 (4.1%) experienced PE in their pregnancy and 48.8% of the fetuses were female versus 51.2% male. No differences in the female/male distribution were observed with respect to term PE (delivered ≥ 37 weeks). Preterm PE (delivered < 37 weeks) was slightly more prevalent among pregnancies with a female fetus than in pregnancies with a male fetus [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.02-1.21]. Very preterm PE (delivered < 34 weeks) was even more prevalent among pregnancies with a female fetus as compared with pregnancies with a male fetus (OR 1.36, 95% CI 1.17-1.59).

Conclusions: Sexual dimorphic differences in the occurrence of PE exist, with preterm PE being more prevalent among pregnancies with a female fetus as compared with pregnancies with a male fetus and with no differences with respect to term PE.

Original languageEnglish
Pages (from-to)632-642
Number of pages11
JournalInternational Journal of Epidemiology
Volume46
Issue number2
DOIs
Publication statusPublished - 1 Apr 2017
Externally publishedYes
Publication typeA1 Journal article-refereed

Keywords

  • Adult
  • Delivery, Obstetric/statistics & numerical data
  • Female
  • Fetal Development
  • Fetal Growth Retardation/epidemiology
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Male
  • Pre-Eclampsia/epidemiology
  • Pregnancy
  • Pregnancy Complications/epidemiology
  • Sex Factors
  • Young Adult

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