Su Zhi-Wen, Lin Li-Li, Shi Bi-Jun, Huang Xiao-Xia, Wei Jian-Wei, Jia Chun-Hong, Wu Fan, Cui Qi-Liang
Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 May 15;24(5):514-520. doi: 10.7499/j.issn.1008-8830.2201049.
To study the effect of sex on the clinical outcome of extremely preterm infants (EPIs)/extremely low birth weight infants (ELBWIs) by propensity score matching.
A retrospective analysis was performed for the medical data of 731 EPIs or ELBWIs who were admitted from January 1, 2011 to December 31, 2020. These infants were divided into two groups: male and female. A propensity score matching analysis was performed at a ratio of 1:1. The matching variables included gestational age, birth weight, percentage of withdrawal from active treatment, percentage of small-for-gestational-age infant, percentage of use of pulmonary surfactant, percentage of 1-minute Apgar score ≤3, percentage of mechanical ventilation, duration of mechanical ventilation, percentage of antenatal use of inadequate glucocorticoids, and percentage of hypertensive disorders in pregnancy. The two groups were compared in the incidence rate of main complications during hospitalization and the rate of survival at discharge.
Before matching, compared with the female group, the male group had significantly higher incidence rates of neonatal respiratory distress syndrome, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, and patent ductus arteriosus (<0.05), while after matching, the male group only had a significantly higher incidence rate of BPD than the female group (<0.05). There was no significant difference in the rate of survival at discharge between the two groups before and after matching (>0.05).
Male EPIs/ELBWIs have a higher risk of BPD than female EPIs/ELBWIs, but male and female EPIs/ELBWIs tend to have similar outcomes.
通过倾向评分匹配研究性别对极早产儿(EPIs)/极低出生体重儿(ELBWIs)临床结局的影响。
对2011年1月1日至2020年12月31日收治的731例EPIs或ELBWIs的医疗数据进行回顾性分析。这些婴儿分为两组:男性和女性。以1:1的比例进行倾向评分匹配分析。匹配变量包括胎龄、出生体重、主动治疗撤机百分比、小于胎龄儿百分比、肺表面活性物质使用百分比、1分钟阿氏评分≤3的百分比、机械通气百分比、机械通气持续时间、产前糖皮质激素使用不足百分比以及妊娠期高血压疾病百分比。比较两组住院期间主要并发症的发生率和出院存活率。
匹配前,与女性组相比,男性组新生儿呼吸窘迫综合征、支气管肺发育不良(BPD)、重度脑室内出血、脑室周围白质软化、坏死性小肠结肠炎和动脉导管未闭的发生率显著更高(<0.05),而匹配后,男性组仅BPD的发生率显著高于女性组(<0.05)。匹配前后两组出院存活率差异无统计学意义(>0.05)。
男性EPIs/ELBWIs患BPD的风险高于女性EPIs/ELBWIs,但男性和女性EPIs/ELBWIs的结局往往相似。