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Int J Epidemiol. 2017 Apr 1;46(2):632-642. doi: 10.1093/ije/dyw178.

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

Author information

1
Erasmus Medical Centre, Department of Obstetrics and Gynecology, Rotterdam, The Netherlands.
2
Institute of Psychology, and Department of Pedagogical Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands, and Erasmus Medical Centre, Department of Biostatistics, Rotterdam, The Netherlands.
3
Norwegian Institute of Public Health, Oslo, Norway.
4
Women's Health Academic Centre, King's College London and King's Health Partners, London, UK.
5
Lund University, Department of Clinical Sciences, Obstetrics and Gynecology, Lund, Sweden, and Skåne University Hospital, Perinatal Unit, Malmo, Sweden.
6
Oslo University Hospital, Department of Obstetrics, Oslo, Norway.
7
Lund University, Department of Clinical Sciences, Obstetrics and Gynecology, Lund, Sweden, and Skåne University Hospital, Department of Obstetrics and Gynecology, Malmo, Sweden.
8
University of Pittsburgh School of Medicine, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, PA, USA.
9
Medical and Clinical Genetics and Obstetrics and Gynecology, and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.
10
MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, Bristol, UK.
11
Maternal & Fetal Health Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
12
Aarhus University, Institute of Clinical Epidemiology, Aarhus, Denmark, and UCLA Los Angeles, Los Angeles, CA, USA.
13
Nuffield Department of Obstetrics and Gynecology, John Radcliffe Hospital, Oxford, UK.
14
Oslo University Hospital, Department of Obstetrics and Department of Gynecology, University of Oslo, Oslo, Norway.
15
Obstetrics and Gynecology, and Clinical Graduate School in Pediatrics and Obstetrics/Gynecology, University of Helsinki, Helsinki, Finland.
16
Department of Obstetrics, Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research University of Pittsburgh, Pittsburgh, PA, USA.

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.

KEYWORDS:

ALSPAC; Sexual dimorphism; placenta; pre-eclampsia; sex ratio

PMID:
27605586
PMCID:
PMC5837300
DOI:
10.1093/ije/dyw178
[Indexed for MEDLINE]
Free PMC Article

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