Månsson Johanna, Fellman Vineta, Stjernqvist Karin
Department of Psychology, Lund University, Lund, Sweden.
Acta Paediatr. 2015 May;104(5):514-21. doi: 10.1111/apa.12937. Epub 2015 Mar 23.
The early identification of at-risk extremely preterm (EPT) children could improve long-term outcomes. This study sought to investigate sex differences in developmental outcomes and to identify sex-specific predictors at two and a half years of age.
We assessed 217 boys and 181 girls born before 27-week gestation using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), as a part of the Extremely Preterm Infants in Sweden Study. Sex-specific differences were calculated. Socio-economic, birth and neonatal factors were calculated separately for boys and girls using regression models.
Girls scored significantly higher than boys on all Bayley-III indices. In both sexes, brain injury, long-term ventilator treatment and foreign-born mothers predicted lower scores. Receiving breast milk by hospital discharge predicted higher scores. Severe retinopathy of prematurity was the strongest predictor of cognitive and language deficits in boys. High parental education predicted higher cognitive and language scores in girls, whereas severe bronchopulmonary dysplasia was the strongest predictor of motor deficits.
Extreme prematurity seems to affect boys more than girls. Socio-economic and neonatal factors confer similar risks or protections on both sexes, but some variables pose sex-specific risks. An awareness of risk factors may provide the basis for treatment and follow-up guidelines.
早期识别高危极早产儿（EPT）可改善其长期预后。本研究旨在调查发育结局中的性别差异，并确定两岁半时的性别特异性预测因素。
作为瑞典极早产儿研究的一部分，我们使用贝利婴幼儿发展量表第三版（Bayley-III）对217名孕周小于27周出生的男婴和181名女婴进行了评估。计算了性别特异性差异。使用回归模型分别计算了男孩和女孩的社会经济、出生和新生儿因素。
在所有Bayley-III指标上，女孩的得分显著高于男孩。在两性中，脑损伤、长期呼吸机治疗和母亲出生在国外均预示着得分较低。出院时接受母乳喂养预示着得分较高。重度早产儿视网膜病变是男孩认知和语言缺陷的最强预测因素。父母受教育程度高预示着女孩的认知和语言得分较高，而重度支气管肺发育不良是运动缺陷的最强预测因素。
极早产对男孩的影响似乎大于女孩。社会经济和新生儿因素对两性具有相似的风险或保护作用，但一些变量存在性别特异性风险。了解危险因素可为治疗和随访指南提供依据。
