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

TitleFetal sex-specific differences in gestational age at delivery in pre-eclampsia: a meta-analysis.
Publication TypeJournal Article
Year of Publication2017
AuthorsSchalekamp-Timmermans, S, Arends, L, Alsaker, E, Chappell, L, Hansson, S, Harsem, N, Jälmby, M, Jeyabalan, A, Laivuori, H, Lawlor, DA, Macdonald-Wallis, C, Makanga, P, Myers, J, Olsen, J, Poston, L, Redman, C, Staff, A, Villa, P, Roberts, J, Steegers, E
Corporate AuthorsGlobal Pregnancy Collaboration:
JournalInt J Epidemiol
Volume46
Issue2
Pagination632-642
Date Published2017 04 01
ISSN1464-3685
KeywordsAdult, COLAB, Delivery, Obstetric, Female, Fetal Development, Fetal Growth Retardation, Gestational Age, Global Pregnancy Collaboration (CoLab), Humans, Infant, Newborn, Male, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Sex Factors, Young Adult
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.

DOI10.1093/ije/dyw178
Alternate JournalInt J Epidemiol
Citation Key570
PubMed ID27605586
PubMed Central IDPMC5837300
Grant ListP01 HD030367 / HD / NICHD NIH HHS / United States
UL1 RR024153 / RR / NCRR NIH HHS / United States
RP-2014-05-019 / / Department of Health / United Kingdom
U01 NS047537 / NS / NINDS NIH HHS / United States
102215 / / Wellcome Trust / United Kingdom
N01ES75558 / ES / NIEHS NIH HHS / United States
MC_PC_15018 / / Medical Research Council / United Kingdom
MR/J011932/1 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom
MC_UU_12013/5 / / Medical Research Council / United Kingdom