Tioseco Jennifer A, Aly Hany, Milner Josh, Patel Kantilal, El-Mohandes Ayman A E
Department of Neonatology, The Children's National Medical Center, Washington, DC, USA.
Pediatr Crit Care Med. 2005 Mar;6(2):171-4. doi: 10.1097/01.PCC.0000154961.37833.79.
Neonatal mortality and morbidity are gender-biased in low-birth-weight (LBW) infants. The male disadvantage theory has been suggested to be responsible for these maturational differences.
To examine the impact of gender on neonatal hyperbilirubinemia.
DESIGN/METHODS: A retrospective observational study. Data on all LBW infants admitted to George Washington University neonatal intensive care unit and surviving for >48 hrs from January 1992 to March 2003 were analyzed. Males and females were compared for gestational age, birth weight, race, Apgar scores at 1 and 5 mins, peak bilirubin levels, sepsis, and intraventricular hemorrhage (IVH). Significant differences were entered in a regression model to detect the influence of gender on bilirubin (Bili). Analysis was repeated after stratification of infants into: group A, <1000 g; group B, 1000-1499 g; and group C, 1500-2499 g.
A total of 840 infants were included in this study. When comparing males (n = 407) with females (n = 433), significant differences were detected in birth weight (1,539 +/- 541 vs. 1,428 +/- 549 g; p = .003), IVH (14.2% vs. 9%; p = .025), and Bili (10.1 +/- 3.0 vs. 9.2 +/- 2.8 mg%; p < .001). No differences were detected in gestational age, sepsis, or Apgar 1 and 5. Difference in Bili for the entire group remained significant in the regression model (regression coefficient [RC] = 0.79 +/- 0.22; p < .001). In subgroup analyses: group A Bili (8.4 +/- 2.3 vs. 8.0 +/- 2.0; p = .14) and group B Bili (9.0 +/- 2.1 vs. 9.2 +/- 2.2; p = .51) did not differ in bivariate or multivariate analyses. In group C, Bili was (11.3 +/- 3.1 vs. 10.1 +/- 3.3; p < .001) and remained the only significant difference in the regression model (RC = 1.19 +/- 0.37; p = .001).
Bili in LBW infants is significantly higher in males when compared with females. After stratification to birth weight subgroups, significance is retained in the 1500- to 2499-g group after logistic regression analysis. Bili levels in infants <1500 g are influenced more significantly by factors other than gender, such as sepsis and IVH.
低出生体重（LBW）婴儿的新生儿死亡率和发病率存在性别差异。男性劣势理论被认为是造成这些成熟差异的原因。
研究性别对新生儿高胆红素血症的影响。
设计/方法：一项回顾性观察研究。分析了1992年1月至2003年3月入住乔治华盛顿大学新生儿重症监护病房且存活超过48小时的所有低出生体重婴儿的数据。比较了男性和女性在胎龄、出生体重、种族、1分钟和5分钟时的阿氏评分、胆红素峰值水平、败血症和脑室内出血（IVH）情况。将显著差异纳入回归模型以检测性别对胆红素（Bili）的影响。在将婴儿分层为：A组，<1000克；B组，1000 - 1499克；C组，1500 - 2499克后重复分析。
本研究共纳入840名婴儿。比较男性（n = 407）和女性（n = 433）时，在出生体重（1539±541 vs. 1428±549克；p = 0.003）、脑室内出血（14.2% vs. 9%；p = 0.025）和胆红素（10.1±3.0 vs. 9.2±2.8毫克%；p < 0.001）方面检测到显著差异。在胎龄、败血症或1分钟和5分钟时的阿氏评分方面未检测到差异。回归模型中整个组的胆红素差异仍然显著（回归系数[RC] = 0.79±0.22；p < 0.001）。在亚组分析中：A组胆红素（8.4±2.3 vs. 8.0±2.0；p = 0.14）和B组胆红素（9.0±2.1 vs. 9.2±2.2；p = 该文档没有给出具体结果，请补充完整）在双变量或多变量分析中无差异。在C组中，胆红素为（11.3±3.1 vs. 10.1±3.3；p < 0.001），并且在回归模型中仍然是唯一的显著差异（RC = 1.19±0.37；p = 0.001）。
与女性相比，低出生体重婴儿中的男性胆红素水平显著更高。在按出生体重亚组分层后，逻辑回归分析显示在1500至2499克组中差异仍然显著。体重<1500克的婴儿的胆红素水平受性别以外的因素如败血症和脑室内出血的影响更显著。
