Borges-Lujan Moreyba, Gonzalez-Luis Gema E, Roosen Tom, Huizing Maurice J, Villamor Eduardo
Department of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil (CHUIMI) de Canarias, 35016 Las Palmas de Gran Canaria, Spain.
Department of Pediatrics, Maastricht University Medical Centre (MUMC+), School for Oncology Reproduction (GROW), 6202 Maastricht, The Netherlands.
J Pers Med. 2022 Jul 14;12(7):1143. doi: 10.3390/jpm12071143.
A widely accepted concept in perinatal medicine is that boys are more susceptible than girls to complications of prematurity. However, whether this 'male disadvantage of prematurity' also involves persistent patent ductus arteriosus (PDA) has been scarcely investigated. Our aim was to conduct a systematic review and meta-analysis on studies addressing sex differences in the risk of developing PDA among preterm infants. We also investigated whether the response to pharmacological treatment of PDA differs between boys and girls. PubMed/Medline and Embase databases were searched. The random-effects male/female risk ratio (RR) and 95% confidence interval (CI) were calculated. We included 146 studies (357,781 infants). Meta-analysis could not demonstrate sex differences in risk of developing any PDA (37 studies, RR 1.03, 95% CI 0.97 to 1.08), hemodynamically significant PDA (81 studies, RR 1.00, 95% CI 0.97 to 1.02), or in the rate of response to pharmacological treatment (45 studies, RR 1.01, 95% CI 0.98 to 1.04). Subgroup analysis and meta-regression showed that the absence of sex differences was maintained over the years and in different geographic settings. In conclusion, both the incidence of PDA in preterm infants and the response rate to pharmacological treatment of PDA are not different between preterm boys and girls.
围产期医学中一个被广泛接受的概念是，男孩比女孩更容易受到早产并发症的影响。然而，这种“早产的男性劣势”是否也涉及动脉导管未闭（PDA）一直鲜有研究。我们的目的是对有关早产儿发生PDA风险的性别差异的研究进行系统评价和荟萃分析。我们还研究了男孩和女孩对PDA药物治疗的反应是否存在差异。检索了PubMed/Medline和Embase数据库。计算随机效应的男性/女性风险比（RR）和95%置信区间（CI）。我们纳入了146项研究（357,781名婴儿）。荟萃分析未能证明在发生任何PDA的风险（37项研究，RR 1.03，95%CI 0.97至1.08）、血流动力学显著的PDA（81项研究，RR 1.00，95%CI 0.97至1.02）或药物治疗反应率（45项研究，RR 1.01，95%CI 0.98至1.04）方面存在性别差异。亚组分析和荟萃回归表明，多年来以及在不同地理环境中，性别差异均不存在。总之，早产儿中PDA的发生率以及PDA药物治疗的反应率在早产男孩和女孩之间并无差异。
