Infant sex, obstetric risk factors, and 2-year neurodevelopmental outcome among preterm infants

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Abstract

Aim: To evaluate the effect of the interaction between fetal sex and obstetric variables on the risk of neurodevelopmental impairment among preterm infants. Method: A cohort study of 394 male and 360 female surviving infants born at 24 to 33 completed weeks of gestational age. Neurological examination and cognitive assessment of the infants (Bayley Scales of Infant Development) were performed at 2 years corrected age. Results: Mean gestational age was 30.4 weeks (SD 2.4). Rates of mild and moderate-to-severe neurodevelopmental impairment were 14.6% (110/754) and 7% (53/754) respectively. In logistic analysis, male sex was associated with an increased risk of neurodevelopmental impairment (odds ratio 1.8, 95% confidence interval 1.21-2.68) compared with females. The excess risk of neurodevelopmental impairment associated with male sex was higher among preeclamptic than normotensive pregnancies (p for interaction=0.004), among infants who were either small for gestational age or delivered to a mother with preeclampsia (p for interaction=0.001) and in iatrogenic as opposed to spontaneous preterm birth or preterm premature rupture of membranes (p for interaction=0.035). Interpretation: The excess risk of neurodevelopmental impairment associated with male sex among preterm infants is modulated by obstetric risk factors.

Original languageEnglish
Pages (from-to)518-525
Number of pages8
JournalDevelopmental Medicine and Child Neurology
Volume51
Issue number7
DOIs
Publication statusPublished - 2009

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Premature Infants
Obstetrics
Gestational Age
Premature Birth
Neurologic Examination
Child Development
Pre-Eclampsia
Cohort Studies
Odds Ratio
Mothers
Confidence Intervals
Pregnancy

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience

Cite this

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title = "Infant sex, obstetric risk factors, and 2-year neurodevelopmental outcome among preterm infants",
abstract = "Aim: To evaluate the effect of the interaction between fetal sex and obstetric variables on the risk of neurodevelopmental impairment among preterm infants. Method: A cohort study of 394 male and 360 female surviving infants born at 24 to 33 completed weeks of gestational age. Neurological examination and cognitive assessment of the infants (Bayley Scales of Infant Development) were performed at 2 years corrected age. Results: Mean gestational age was 30.4 weeks (SD 2.4). Rates of mild and moderate-to-severe neurodevelopmental impairment were 14.6{\%} (110/754) and 7{\%} (53/754) respectively. In logistic analysis, male sex was associated with an increased risk of neurodevelopmental impairment (odds ratio 1.8, 95{\%} confidence interval 1.21-2.68) compared with females. The excess risk of neurodevelopmental impairment associated with male sex was higher among preeclamptic than normotensive pregnancies (p for interaction=0.004), among infants who were either small for gestational age or delivered to a mother with preeclampsia (p for interaction=0.001) and in iatrogenic as opposed to spontaneous preterm birth or preterm premature rupture of membranes (p for interaction=0.035). Interpretation: The excess risk of neurodevelopmental impairment associated with male sex among preterm infants is modulated by obstetric risk factors.",
author = "Arsenio Spinillo and Laura Montanari and Barbara Gardella and Marianna Roccio and Mauro Stronati and Elisa Fazzi",
year = "2009",
doi = "10.1111/j.1469-8749.2009.03273.x",
language = "English",
volume = "51",
pages = "518--525",
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T1 - Infant sex, obstetric risk factors, and 2-year neurodevelopmental outcome among preterm infants

AU - Spinillo, Arsenio

AU - Montanari, Laura

AU - Gardella, Barbara

AU - Roccio, Marianna

AU - Stronati, Mauro

AU - Fazzi, Elisa

PY - 2009

Y1 - 2009

N2 - Aim: To evaluate the effect of the interaction between fetal sex and obstetric variables on the risk of neurodevelopmental impairment among preterm infants. Method: A cohort study of 394 male and 360 female surviving infants born at 24 to 33 completed weeks of gestational age. Neurological examination and cognitive assessment of the infants (Bayley Scales of Infant Development) were performed at 2 years corrected age. Results: Mean gestational age was 30.4 weeks (SD 2.4). Rates of mild and moderate-to-severe neurodevelopmental impairment were 14.6% (110/754) and 7% (53/754) respectively. In logistic analysis, male sex was associated with an increased risk of neurodevelopmental impairment (odds ratio 1.8, 95% confidence interval 1.21-2.68) compared with females. The excess risk of neurodevelopmental impairment associated with male sex was higher among preeclamptic than normotensive pregnancies (p for interaction=0.004), among infants who were either small for gestational age or delivered to a mother with preeclampsia (p for interaction=0.001) and in iatrogenic as opposed to spontaneous preterm birth or preterm premature rupture of membranes (p for interaction=0.035). Interpretation: The excess risk of neurodevelopmental impairment associated with male sex among preterm infants is modulated by obstetric risk factors.

AB - Aim: To evaluate the effect of the interaction between fetal sex and obstetric variables on the risk of neurodevelopmental impairment among preterm infants. Method: A cohort study of 394 male and 360 female surviving infants born at 24 to 33 completed weeks of gestational age. Neurological examination and cognitive assessment of the infants (Bayley Scales of Infant Development) were performed at 2 years corrected age. Results: Mean gestational age was 30.4 weeks (SD 2.4). Rates of mild and moderate-to-severe neurodevelopmental impairment were 14.6% (110/754) and 7% (53/754) respectively. In logistic analysis, male sex was associated with an increased risk of neurodevelopmental impairment (odds ratio 1.8, 95% confidence interval 1.21-2.68) compared with females. The excess risk of neurodevelopmental impairment associated with male sex was higher among preeclamptic than normotensive pregnancies (p for interaction=0.004), among infants who were either small for gestational age or delivered to a mother with preeclampsia (p for interaction=0.001) and in iatrogenic as opposed to spontaneous preterm birth or preterm premature rupture of membranes (p for interaction=0.035). Interpretation: The excess risk of neurodevelopmental impairment associated with male sex among preterm infants is modulated by obstetric risk factors.

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