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Infant sex, obstetric risk factors, and 2‐year neurodevelopmental outcome among preterm infants
Author(s) -
SPINILLO ARSENIO,
MONTANARI LAURA,
GARDELLA BARBARA,
ROCCIO MARIANNA,
STRONATI MAURO,
FAZZI ELISA
Publication year - 2009
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2009.03273.x
Subject(s) - medicine , odds ratio , gestational age , pediatrics , bayley scales of infant development , obstetrics , pregnancy , premature rupture of membranes , confidence interval , motor impairment , psychomotor learning , cognition , genetics , psychiatry , biology , physical medicine and rehabilitation
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.