Baik-Schneditz Nariae, Schwaberger Bernhard, Mileder Lukas, Höller Nina, Avian Alexander, Koestenberger Martin, Urlesberger Berndt, Martensen Johann, Pichler Gerhard
Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Research Unit for Neonatal Micro- and Macrocirculation, Division of Neonatology, Medical University of Graz, Graz, Austria.
Cardiovasc Diagn Ther. 2021 Apr;11(2):342-347. doi: 10.21037/cdt-20-844.
The immediate transition from foetus to neonate includes substantial changes especially concerning the cardiovascular system. As sex related differences have been shown in cardiovascular medicine, this topic warrants further investigation in neonatology. Aim: The aim of this present study was to measure cardiac output (CO) and cerebral oxygenation (cTOI) non-invasively in term neonates and to investigate potential sex related differences between female and male neonates after birth.
This is a mono-centric prospective observational study. For CO-measurements, the electrical velocimetry method was used. The pulse oximetry for arterial oxygen saturation and heart-rate measurements was placed on the right hand or wrist. cTOI was measured using a NIRO 200NX monitor. The near-infrared spectroscopy probe was positioned on the right side of forehead in each infant. Monitoring started at minute 1 and was continued until minute 15 after birth. At minutes 5, 10, and 15 after birth, CO was calculated as an average out of six 10-second periods.
99 term neonates were enrolled. In our study population, we could identify 54 female and 45 male neonates. Males had higher cardiac output compared to females throughout the observational period, with a significant difference in minute 15 after birth (217, 95% CI: 203-231 mL/kg/min versus 178, 95% CI: 163-192 mL/kg/min; P<0.001). cTOI, SpO, and HR did not differ between male and female neonates.
The present work is the first to investigate sex related differences concerning cardiac output in term neonates during postnatal transition, showing a significantly higher cardiac output in male neonates 15 minutes after birth.
从胎儿到新生儿的即刻转变包括诸多显著变化，尤其是心血管系统方面。由于心血管医学中已显示出性别相关差异，该主题在新生儿学中值得进一步研究。目的：本研究的目的是对足月儿进行心输出量（CO）和脑氧合（cTOI）的无创测量，并调查出生后男女新生儿之间潜在的性别相关差异。
这是一项单中心前瞻性观察性研究。对于CO测量，使用了电测速法。用于测量动脉血氧饱和度和心率的脉搏血氧饱和度仪放置在右手或手腕上。使用NIRO 200NX监测仪测量cTOI。每个婴儿的近红外光谱探头放置在前额右侧。监测从出生后第1分钟开始，持续到出生后第15分钟。在出生后第5、10和15分钟，将CO计算为六个10秒时间段的平均值。
纳入了99名足月儿。在我们的研究人群中，可识别出54名女新生儿和45名男新生儿。在整个观察期内，男性的心输出量高于女性，在出生后第15分钟有显著差异（217，95%可信区间：203 - 231 mL/kg/min 对比 178，95%可信区间：163 - 192 mL/kg/min；P<0.001）。男女新生儿之间的cTOI、SpO和HR没有差异。
本研究首次调查了足月儿出生后过渡期间心输出量的性别相关差异，显示出生后15分钟男新生儿的心输出量显著更高。
