Division of Neonatology, Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA.
Division of Health Services and Outcomes Research, Children's Mercy-Kansas City, Kansas City, MO, USA.
J Perinatol. 2021 Aug;41(8):1835-1844. doi: 10.1038/s41372-021-01099-2. Epub 2021 May 25.
Both postnatal growth and sex play a crucial role in long-term outcomes of extremely preterm newborns (EPNs), but the relationship between sex and postnatal growth is not clear. This study aims to assess sex differences in weight trajectories.
Weight data in the first 200 days of life from 4327 EPNs were used for generalized additive mixed modeling. We considered gestational age and sex as fixed-effects, and included random intercepts and random slopes for postnatal age. We assessed interactions between fixed-effects and postnatal age.
Male EPNs had higher predicted weight trajectories than females. Weight z-score trajectories decreased in both sexes before term-equivalent age comparably, but females showed faster increases afterward. Although weight gain velocity was comparable between both sexes, weight gain velocity in male EPNs was lower compared to the corresponding reference values from the 2013 Fenton growth charts, which explained slower z-score rises.
Sex disparity exists in postnatal weight gain trajectories of EPNs after reaching the term-equivalent age.
出生后生长和性别对极早产儿(EPN)的长期结局起着至关重要的作用,但性别与出生后生长之间的关系尚不清楚。本研究旨在评估体重轨迹的性别差异。
使用 4327 例 EPN 出生后 200 天内的体重数据进行广义加性混合建模。我们将胎龄和性别视为固定效应,并为出生后年龄纳入随机截距和随机斜率。我们评估了固定效应和出生后年龄之间的相互作用。
男性 EPN 的预测体重轨迹高于女性。在达到胎龄相等年龄之前,两性的体重 Z 评分轨迹都相应地下降,但之后女性的增长速度更快。尽管两性的体重增长速度相当,但男性 EPN 的体重增长速度低于 2013 年 Fenton 生长图表的相应参考值,这解释了 Z 评分上升较慢的原因。
达到胎龄相等年龄后,EPN 的出生后体重增长轨迹存在性别差异。